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Texas hospitals are on the brink, againA surge of Covid-19 cases driven by the Delta variant is hobbling the health care system in Texas, where health officials are warning of overloaded hospitals, a dangerous crisis which the state also experienced in early February. In Houston, at least two hospitals have erected overflow tents outside. In Austin, hospitals are nearly out of beds in their intensive care units. And in San Antonio, children as young as 2 months old are tethered to supplemental oxygen. My colleague Edgar Sandoval, who covers South Texas for The Times, recently reported from inside a San Antonio hospital. He told us that the strength of the surge left many in the state flat-footed. “They were kind of caught off guard this time around,” Edgar said. “People in South Texas, like the rest of the country, thought that the virus was behind them. And even the experts believed that, even if they were going to have surges from the Delta variant, they were going to be able to manage it. But in the last couple of weeks we’ve seen an explosion of cases. Medical officials in Texas are — as we speak — still trying to figure out how to handle this coming surge.” More than 10,000 Texans have been hospitalized this week and at least 53 hospitals were at maximum capacity in their intensive care units. Hospitals are being taxed across the South in places like Huntsville, Ala., Jackson, Miss., New Orleans and Miami. As with previous waves this summer in Florida, Louisiana and Arkansas, the vast majority of patients who are hospitalized in Texas are not vaccinated. The surge also comes as the state’s governor, Greg Abbott, refuses to enact any statewide mandates requiring masks while prohibiting local officials from doing so. To help manage the surge, Abbott has instead asked health care workers outside the state to travel to Texas and help the overloaded hospitals. Some health officials have blamed the state for not putting enough government effort toward increasing vaccination rates, which Abbott has framed as an issue of individual rights. Still, local officials in some of Texas’ largest cities, including San Antonio, Houston, Dallas and Austin, have defied Abbott’s orders and issued new mask requirements in city buildings and schools, citing community spread and low vaccination rates. The worst is also far from over for Texas. According to the University of Texas at Austin Covid-19 Modeling Consortium, the number of coronavirus-related hospitalizations across the state is projected to climb to well over 15,000 by the end of this month. “Hospitals are trying to figure out day by day how to manage the flow of people,” Edgar said, such as treating patients in waiting rooms because of a shortage of beds. “I’m surprised there was no plan implemented after the last surge,” Edgar said. “But here we are.” Who should be wearing masks?Last month, as the contagious Delta variant spread, the C.D.C. workshopped its advice. One internal presentation obtained by The Times had a clear recommendation: “Given higher transmissibility and current vaccine coverage, universal masking is essential.” But the agency’s ultimate guidance was more nuanced. The C.D.C. advised masking in indoor public settings in communities with “substantial” or “high” transmission, regardless of a person’s vaccination status. Looking back, some experts think the agency should have just gone with a nationwide call to wear masks indoors. “The messaging from the C.D.C. was less than optimal,” said Dr. Ezekiel Emanuel, vice president for global initiatives at the University of Pennsylvania. “We need to be clear and relatively simple about it.” The C.D.C. maintains a map of where people should wear masks indoors, and numbers of transmission levels are only climbing. When the agency issued its revised recommendations, at least 80 percent of Americans should have started wearing masks. As of Tuesday, the virus was spreading rapidly in 90 percent of the country. So, then, what should you do? “If you’re indoors,” Dr. Carlos del Rio, an infectious disease specialist at the Emory University School of Medicine in Atlanta, told The Times, “you should wear a mask.” Vaccine rollout
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What you’re doingMy boys are systematically tearing my house up as I am cleaning it. I’m doing my best to not scream at people for not wearing masks. We are all on each other’s last nerves, and the light at the end of the tunnel (back to school) has been all but extinguished by the willful ignorance and complacency of maskhole covidiots. — Mona Merical, West Des Moines, Iowa Let us know how you’re dealing with the pandemic. Send us a response here, and we may feature it in an upcoming newsletter. Email your thoughts to briefing@nytimes.com. Did a friend forward you the briefing? Sign up here.
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