Rising coronavirus cases and hospitalizations in Texas are underscoring fears about the danger of reopening.

The state has been relatively aggressive about reopening, lifting its stay-at-home order on May 1 and gradually increasing capacity at shops, bars and restaurants since then. 

Now, though, the state is seeing a surge of cases of the coronavirus. The state reached a new high of coronavirus hospitalizations on Monday, with 1,935 people hospitalized with the illness, according to state data. 

Texas is not alone. Arizona and North Carolina have also reached new highs of coronavirus hospitalizations in recent days. South Carolina, Arkansas and Florida are seeing spikes in cases as well. 

The data illustrates how the virus is still gathering steam in some areas, even as the situation improves dramatically in old hot spots like New York and New Jersey. 

There has also been an element of unpredictability, though, given that some states, like Georgia, which drew national scrutiny after moving quickly to reopen, have not yet seen spikes in cases. 

In Texas, Gov. Greg Abbott (R) is forging ahead with reopening and expressing confidence. Last week, he announced the state was moving into phase three of the reopening plan, allowing almost all businesses to move up to operating at 50 percent capacity. Restaurants will be able to move up to 75 percent capacity. 

Abbott said the increased cases are “largely the result of isolated hot spots in nursing homes, jails and meatpacking plants.”

However, Lina Hidalgo (D), the executive of Harris County, home to Houston, raised alarms. 

“Over the past 7 days we’ve seen a statistically significant (95% confidence level) increase in COVID-19 hospital admissions,” she tweeted last week. “I remain very concerned about the impact of reopening too quickly.”

Marcia Ory, a professor at the Texas A&M School of Public Health, said “it is not surprising that the numbers of cases are going up as social distancing reduces.”

Hospitals are expressing concern. Texas Medical Center in Houston warned last week that the “upswing in the current COVID-19 caseload growth trajectory suggests base ICU [intensive care unit] capacity could be exceeded in 2 weeks.”

Carrie Williams, a spokeswoman for the Texas Hospital Association, said there “has been a concerning increase in the number of hospitalizations in Texas.”

“We’re incredibly focused on this number and can’t get to a spot where we have a sustained wave that taxes hospitals and our ability to take care of people,” she added. “We’re pushing for more widespread testing, stricter use of face masks in public and limits on large-scale gatherings.”

John Wittman, a spokesman for the governor, pointed to increased testing as part of the reason for rising cases, saying it has increased 210 percent since reopening on May 1.  

“Every Texan who needs access to a hospital bed will have access to a hospital bed,” he said. “Current hospital capacity includes 15,402 available beds, 1,723 ICU beds and 5,911 ventilators, with the ability to surge capacity in regions across the state if necessary.”

To the west, Arizona has seen concerning increases in hospitalizations as well, setting off its own warnings from hospitals. Coronavirus hospitalizations in the state have risen over 1,200 for the first time in recent days, state data shows. 

Banner Health, the state’s largest hospital system, warned last week that “if these trends continue, Banner will soon need to exercise its surge plan to increase ICU capacity.”

The hospital system released slides showing that the increase in cases in the state began about one incubation period after the stay-at-home order ended on May 15. 

“It’s a concerning trend because it’s going in the wrong direction,” said Ann-Marie Alameddin, CEO of the Arizona Hospital and Healthcare Association, noting that a lack of testing supplies is still a persistent problem hindering the response. 

“We need people to stay safe so the hospital capacity can be preserved,” she said. “There is capacity currently in the system, but yeah I think I would like to see the trend stop in terms of increasing and start to go down.”

Patrick Ptak, a spokesman for Arizona Gov. Doug Ducey (R) said the rise in cases is in part due to increased testing, and noted that the state is working to increase hospital capacity and has the option of putting patients at previously-closed St. Luke’s Medical Center, which has been prepared to serve as overflow space. 

“We have anticipated increased cases in June based on various modeling, including the projections in the model provided by FEMA, and we’ve spent the last few months working to increase capacity to ensure every Arizonan has access to care, should they need it,” he said. “St. Luke’s is ready for activation if and when we need additional capacity, something that is not necessary at this time.” 

Luis Ostrosky, a professor of infectious diseases at McGovern Medical School at UTHealth in Houston, said Texas’s reopening plan would have worked better if people had actually followed the limits on crowding and been diligent about wearing masks, but that people in the state have been too lax. 

He said wearing masks and keeping 6 feet apart from others are two of the most important things to do, and could allow businesses to reopen safely if people followed them. 

“I’m just baffled as to how masking became such a political and ideological issue,” he said.

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