Watch the AMA's daily COVID-19 update, with insights from AMA leaders and experts about the pandemic.

COVID-19 Update for July 16

In part one of a two-part series, AMA Chief Experience Officer Todd Unger speaks with physicians about the impact of COVID-19 in Texas, which has become one of the nation's hot spots.

Learn more at the AMA COVID-19 resource center.

Speakers

  • Susan R. Bailey, MD, president, AMA
  • Diana L. Fite, MD, president, Texas Medical Association
  • Hilary Fairbrother, MD, MPH, emergency medicine physician

Unger: Hello, this is the American Medical Association's COVID-19 update. We're here today with part one of a two part series looking at the impact of COVID-19 in Texas, which has quickly become one of the nation's hotspots. I'm joined today by Dr. Susan R. Bailey, president of the AMA and an allergist and immunologist in Fort worth, Texas. Dr. Diana L. Fite, president of the Texas Medical Association and an emergency medicine physician in Houston, and Dr. Hilary Fairbrother, chair of the AMA Young Physician Section and an emergency medicine physician in Houston. I'm Todd Unger, AMA's chief experience officer in Chicago. Over the last few weeks. We've seen hotspots moved from the East coast to states in the South and the West. Dr. Bailey, tell us about the current situation in Texas.

Dr. Bailey: Texas is definitely in crisis mode right now when it comes to the coronavirus pandemic. Cases have been skyrocketing since the Memorial Day weekend. We are now seeing areas, Houston, and we'll hear more about that in a little bit, the Dallas Fort Worth area, and especially in South Texas, where hospitals are full and are having a difficult time keeping up with all the patients that they're seeing. As of last week, Texas was reporting one out of every seven new coronavirus cases in the country, and that that's something that we don't want to be first in. At that point in time, last week, Texas basically made up about 14% of all the coronavirus cases in the country. And in early May our share was less than 4%. So we are definitely in the exponential growth phase of the infection and all need to work together to stop the spread.

Unger: Dr. Fite, anything to add?

Dr. Fite: Well, we're certainly hearing from all over the state of Texas on physicians who are needing PPE, personal protective equipment. They're running short in many areas. The hospitals are also having a lot of trouble with keeping up plenty of PPE and making rooms for all the patients that are coming in that need hospitalization. Many of the COVID patients are younger and are not as seriously ill overall, but our volume has increased so much that their floor is–there aren't enough rooms, not enough ICU rooms and all. They're all going to further phases of the surge making regular hospital rooms into ICU rooms or intermediate care rooms using facilities that hadn't been used for a while. Although we did practice in March and April and got a lot of that up and going.

Unger: Dr. Fairbrother.

Dr. Fairbrother: I am lucky enough to practice in Houston, Texas at the Texas Medical Center and the number of cases is pretty profound. We are in phase two of our ICU surge and we did fill all of our ICU beds earlier in June, and we have moved into what we call phase two. There's also a phase three, but like Dr. Fite said, we are changing beds and increasing beds, pulling in staff. We're really lucky on the PPE front. The Texas Medical Center and the hospitals in Houston have really done a lot with verifying that the staff has PPE and we've been very lucky with that so far, but we are full. Our emergency departments are busy and Houston is just full of patients with coronavirus and many, many cases. It's a busy time for us.

Unger: What is the difference between phase two and phase three for you?

Dr. Fairbrother: It's really just which rooms are getting transferred into ICU rooms and then where staffing has to change. So do we have more people that we can move that already exist within our Texas Medical Center? Or do we have to now start pulling in additional staff from outside our institutions?

Unger: All right. Dr. Fite, Dr. Bailey, can you talk a little bit about the joint statement that the TMA and the AMA made to Texans at the end of June?

Dr. Fite: Well, certainly Dr. Bailey, representing the entire American Medical Association, that was very forceful coming from her, that this is not a time to think the pandemic's over. Just because some of the states were opening things up doesn't mean we stop our protective measures, and this is clearly a result of people letting down their guard. We've got to socially distance, have to wear a mask, have to wash hands frequently. All those things are more important than ever right now, as we're suddenly getting this extreme increase in cases.

Dr. Bailey: We felt that it was very important that we have an AMA president from Texas, the presidents of TMA and AMA are both women. We've worked together for many, many years. And we felt that it was important to show that physicians have a united opinion on this. Everybody across the country agrees that the one tool that we have to help mitigate the spread of the virus are our common sense public health measures. Mask wearing, hand-washing, and physical distancing. People have been trying to accuse various states of, "opening up too quickly," and I think we can open up safely if everybody adheres to wearing masks, physical distancing, and hand washing. That's really the key.

Unger: So let's talk a little bit more about the reopening. That's a question across many, many states. Texas did begin a phased reopening of businesses on May first, and was one of the earliest states to do that. How much of this spike Texas is experiencing do you attribute to the way the state opened and what can other states learn from the situation in Texas?

Dr. Fite: I think we had a lot of people that just let their guard down. They thought that reopening meant that things were well under control and it didn't apply to everybody, and it does. We would see pictures of people just standing shoulder to shoulder without masks on, whether it was with protests or in various areas of inside parties, all sorts of things. A lot of people just didn't believe that we needed to be cautious anymore.

Dr. Fairbrother: You know, Todd, we were in a different place in Texas when the decisions were made to reopen. Texas in the early months of this pandemic never got the number of cases that we were expected to get, and our rate of transmission was obviously quite low for this virus. So without ever getting the expected spike, I like to call it a plateau. We had a small increase that was slow and gradual, and then we just kind of flattened out. So I don't think that it was unexpected or honestly even irrational for us to decide that at this point we could end the lockdown, we could start a phased reopening, a responsible reopening of our communities and our state.

At that point in time, we still had many counties and towns that had not had a single case, but unfortunately that is no longer the case. Almost every county in Texas has seen a coronavirus case and our cities and the South of Texas are particularly hard hit. And I do think that we missed the boat. We knew that the virus was still out there. Patients still had this virus. So when we reopened our community, there really wasn't anything wrong with that. The problem was, like Dr. Fite and Dr. Bailey said, people let their guard down. People stopped wearing masks. They stopped social distancing. They stopped washing their hands. And those things, together with a more open community, gave the virus all that it needed to spread like wildfire, and now we're at where we're at.

Unger: Well, thank you very much, Dr. Bailey, Dr. Fight, Dr. Fairbrother for being here and sharing your perspectives. That concludes part one of our series on COVID-19 in Texas. We'll hope you join us tomorrow for part two. In the meantime, for updated resources on COVID-19 visit ama-ssn.org/covid-19. Thanks for joining us and please take care.


Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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