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Friday, May 1, 2020

A Texas-Size Reopening Has Many Wondering: Too Much or Not Enough? - The New York Times

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HOUSTON — Texas pushed its way out of a statewide coronavirus lockdown on Friday, a wide-ranging reopening of restaurants, businesses and beaches in the midst of an ongoing outbreak that still left at least one local official hoping for even more.

“Who is the governor choosing as a winner or loser?” said Mark J. Keough, the chief executive in Montgomery County near Houston, who hinted this week that he was not going to accept the governor’s delay in opening businesses like bars, gyms, bowling alleys and salons. “I’m ready to start rolling here.”

Mr. Keough ultimately backed down, but the question of whether Texas is capable of doing anything halfway was much on the minds of mayors, residents and public health experts across the state as residents poured into malls and ordered pitchers of beer at Tex-Mex restaurants. How far would people who have been locked up for weeks push their newfound freedoms? How seriously would employers, workers and customers follow protocols about masks and distance?

Was it too soon?

Only a day earlier, the state reported its highest single-day death toll from the coronavirus, with 50 new fatalities. Dallas County reported 179 new cases, its highest so far, and for the first time exceeded 100 deaths. In Houston’s Harris County, the virus has spread in the sheriff’s office and at the county jail, infecting 238 sheriff’s employees and 411 inmates.

“What I say to my family members I’m saying to the people in this city: Be very, very cautious as you move forward,” Mayor Sylvester Turner of Houston told reporters this week. “Because as long as we’re reporting new cases, and as long as we’re reporting people who are dying, and as long as we can’t tell you that this virus is out of here, then you need to be very, very, very careful.”

The largest Republican-led state in the country is embarking down a politically charged path fraught with uncertainty and public health risks. The state ended its stay-at-home order weeks before some of the benchmark epidemiological models suggested doing so and shifted its focus to restoring a $1.8 trillion economy that has suffered from both the spread of the virus and plummeting oil prices.

The forecast for San Antonio is just one example of the risks ahead. If the state were to keep its stay-at-home orders in place, it would have about 1,800 coronavirus cases by Aug. 27, according to models by Juan B. Gutiérrez, a mathematical biologist at the University of Texas at San Antonio. If social distancing is reduced, the models suggest, the city could see 7,400 cases.

In San Antonio, waiters wearing face masks and gloves served plates of tacos to dine-in patrons seated at widely spaced tables. In Houston, the Galleria mall opened its doors from 11 a.m. to 7 p.m. but kept its playgrounds and water fountains shut. From border-city malls to small-town fast-food restaurants, from suburban barbecue joints to the Texas Chili Parlor in the shadow of the Capitol dome in Austin, people shopped, dined and mingled — all in the hope that they had already seen the worst of a pandemic that has infected 29,000 Texans and killed more than 800.

The rules require restaurants, movie theaters and retail shops to limit their capacity to 25 percent of their listed occupancy. In two weeks, if there has been no surge in coronavirus cases, capacity can expand to 50 percent and additional businesses, including those Mr. Keough in Montgomery County would like to see open, can resume operations.

The top infectious-disease experts in the state have been split on the partial reopening, with some saying that the scale of the state’s testing and contact-tracing system is still inadequate. They point to models developed by the Institute for Health Metrics and Evaluation, or I.H.M.E., which caution that the state should wait until mid-June to relax social distancing.

“It’s certainly too soon on the basis of what the I.H.M.E. models say,” said Dr. Peter Hotez, dean of the National School of Tropical Medicine at Baylor College of Medicine in Houston and a member of a state task force that advises the governor on infectious-disease preparedness. “There’s not a Covid-19 health system in place that’s commensurate with the economic recovery plans, and the risk is high that this virus will return later in the summer or fall.”

Dr. Hotez and other experts had a host of concerns as the state reopened. They said the two-week period for tracking any flare-ups after Friday’s initial reopening was not long enough, and needed to be up to four weeks. They particularly questioned allowing movie theaters to reopen, allowing people to sit for more than two hours in a closed space with air-conditioners recirculating air.

Other infectious-disease experts said Mr. Abbott’s reopening was an imperfect but prudent plan, and said the state could face equally dire social and public health impacts from an extended lockdown, including high rates of suicides, substance abuse and domestic violence.

“There isn’t a perfect game plan out there that’s evidence-based and proven for reopening a society in the midst of a pandemic,” said Dr. David L. Lakey, a former Texas health commissioner who helped oversee the Ebola crisis in Dallas in 2014 and now serves as the chief medical officer for the University of Texas System.

“This is on the more aggressive side of opening things up,” he said. “Is it wrong or not? I don’t know. It’s a judgment call. It’s going to need to be watched closely, with the ability to take a step backward if it looks like it’s moving faster than thought.”

Dr. Mark McClellan, a former commissioner of the U.S. Food and Drug Administration who is one of three chief medical advisers assisting the governor and state health officials, said Texas was ready to reopen in the measured way Mr. Abbott had laid out.

“We’re going to be living with this virus for quite awhile, so we need to figure out ways to get back out,” said Dr. McClellan, a physician and an economist at Duke University.

The reopening was a complex, muddled and scattershot endeavor in the second-largest state by both area and population. Mr. Abbott’s move superseded all local orders, angering many city and county leaders and adding to the confusion.

A Houston strip club planned to reopen as a restaurant with “featured entertainers.” Some restaurants required patrons to wear face masks, making eating and drinking a significant conundrum. James B. White, the owner of the Broken Spoke, a honky-tonk in Austin, was preparing to reopen on Friday — until the Alcoholic Beverage Commission reminded him that his establishment sells more alcohol than food and qualifies as a bar and not a restaurant. He called off the reopening.

In a state often defined by division — red versus blue, rural versus urban, black versus white, rich versus poor, immigrant versus native-born — the reopening gave Texans one more thing to be for or against. In Austin, critics of the reopening called for a boycott of reopened restaurants, while in the Houston suburb of Sugar Land, a Republican running for Congress, Kathaleen Wall, went on a celebratory four-stop “Back in Business” tour. The Texas Democratic Party dubbed it the “Back in Sickness” tour.

Many movie theaters, restaurants and other businesses kept their doors shut Friday, with some doing so because owners concluded that opening at a 25 percent limit did not make financial sense. Others said reopening so soon was too risky.

The celebrity chef Johnny Hernandez was reopening three of his seven restaurants in San Antonio and bringing back 40 furloughed employees, all of whom were being required to wear face masks and gloves. Patrons will be asked whether they have any symptoms, but Mr. Hernandez said he decided against checking diners for fevers as they enter.

At La Gloria Pearl, Mr. Hernandez’s flagship restaurant in the Pearl Brewery complex north of downtown, individual parties were limited to six, with a maximum of 28 indoor customers. He said he wanted the reopening of his restaurants to have an understated tone, in light of the pandemic.

“We want to be sensitive to what everyone’s going through,” Mr. Hernandez said.

The mayor of the border city of McAllen, Jim Darling, welcomed the reopening of the La Plaza Mall, which accounts for about 35 percent of the city’s sales tax revenue. The mall’s closure was one of the reasons the city had seen a $25 million virus-related loss in revenue.

Mr. Darling said the facility was going to operate “controlled entrances” and one-way foot traffic to prevent shoppers from congregating. Over all, he said, he thought malls could safely be part of Texas’ gradual re-emergence. “Considering everybody else that’s allowed to be open, I don’t have a problem with it,” he said.

Manny Fernandez reported from Houston and David Montgomery from Austin.

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A Texas-Size Reopening Has Many Wondering: Too Much or Not Enough? - The New York Times
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