A baffling COVID claim by Austin’s top doc

Yesterday multiple media outlets reported on a claim made by Dr. Mark Escott, the interim director of Austin Public Health, in a presentation to the Travis County Commissioners Court. Escott, discussing the risk of re-opening schools, said that we should assume that 70% of the students would become infected and that that could lead to between 40 and 1,300 student deaths. 

Time out. Let’s consider some statistics. Here is the age distribution of COVID-19 deaths from the CDC about a month ago, when the U.S. had already hit over 100,000 deaths. 
That shows 24 deaths for those under age 15 nationwide. And yet we’re supposed to believe that just in the Austin school district we could have scores or hundreds or thousands of youth deaths? 

You know all of those idiots who say that the coronavirus is no worse than the flu? Well, if we were just talking about kids, they’d be right. In fact, the flu appears to present a much greater risk to minors than COVID-19. 

Check out this chart from the CDC. I’m sorry if the numbers are blurry. Notice how many more deaths there are in the two columns on the far right for the youngest age groups. 
Today, in a press conference involving a number of public health officials, Dr. Jason Pickett, who was filling in for Escott, defended the projection, saying that the sheer number of AISD students made the high death toll plausible. 

Both Escott and Pickett said that the case fatality rate for minors could range from 0.03 to over 1%. That is a range so wide as to be useless, but I cannot believe they are really suggesting the rate could be over 1%. The case fatality rate for COVID-19 is not even 1% for the general population. 

What makes this extra frustrating is that there are actually very serious concerns about re-opening schools. There could be a big risk to staff and to the families of students. I think they’re right to hold off on re-opening at this time. But raising the prospect of mass death among students is irresponsible and will make it much harder for the community to make a rational decision about when schools can be re-opened. 

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Is the Tesla deal worth it for Austin?

Tomorrow the Travis County Commissioners Court may vote to grant Tesla major tax breaks to set up a massive manufacturing facility in eastern Travis County. Tesla already secured a much bigger tax break from the Del Valle School District, but it is also seeking breaks from its county taxes. 

This is a big deal. This could be an opportunity for thousands of good-paying jobs that don’t require college degrees — something that will be particularly welcome as we try to claw our way back from a recession that has disproportionately impacted low and middle-wage service workers.

Like many (perhaps most) other corporations, Tesla is run by an entitled narcissist who gets what he wants by bullying and lying. That’s certainly a relevant factor when assessing Tesla’s stated commitment to being a good community partner, but it shouldn’t be a deal-breaker. I’ll take good jobs from a bad person. 

Tesla’s mega-douche CEO Elon Musk. Credit: Wikicommons

What we’re offering Tesla 
The original proposal was that Tesla would get an 80% property tax rebate for the first ten years and a 65% rebate for the next ten. That has since been restructured to now say: 

70% rebate for the first $1.1 billion invested
75% rebate for investment between $1.1 billion & $2 billion
80% rebate for investment beyond $2 billion

I assume Tesla plans on investing more than $2 billion and this is therefore a vastly improved deal since it will guarantee the company an 80% tax break in perpetuity. In a memo, county staff defends the new proposal: 

If Tesla invests the original amount ($1.1 billion) the restructured deal is essentially a wash with the original proposal; above that amount is a net gain for the community, both in terms of jobs and economic activity, and fiscal gains for the County.

What we get in return
County staff has estimated that the Tesla property will generate $8.8 million in tax revenue for the county over the first ten years of the deal assuming a $1.1 billion investment. However, the total could be much higher if the investment and the corresponding land value is higher.

Whatever happens is certainly a marked improvement from the $6,400 a year that the county is currently getting from the unused property. However, we shouldn’t be comparing what Tesla offers compared to what the vacant land offers. We should be comparing Tesla’s offer to what that land could offer. In other words, what is the chance that, if not for Tesla, one or more other employers would occupy the land in the near future?

It’s unlikely that another use would rival Tesla in size and jobs, but it might still be something that generates more tax revenue than the vacant land. What’s the opportunity cost to the county of putting a 70-80% property tax break on that land forever? 

Tesla has agreed to “build a road that serves as a flood evacuation route for the residents of Austin’s Colony,” the residential area to the east.

But I don’t see any discussion of what the likely impact of the factory will be on the surrounding infrastructure. In addition to the thousands of car trips that the employees will add to nearby roads, notably FM 969 and FM 973, the constant arrival and departure of trucks transporting parts and vehicles will no doubt be a burden on the roads, which are not cheap to repair. 

Workers rights
Tesla has committed to paying all workers $15/hr. But I don’t see any language that would prevent them from getting around this requirement via contract workers. Although there is language about construction worker pay, there should also be provisions to ensure that other workers who are likely to be contracted (food service, maintenance, custodial) are paid a living wage. 

Finally, you know that if it were City Council Tesla were dealing with, Greg Casar and others would be putting pressure on the company to take a “neutral” stance in response to union organizing and not try to discourage workers from unionizing. Even better, the company could agree to voluntarily recognize the union once more than half of the workers sign a union card, as opposed to forcing a secret ballot election. The concessions contractors at the airport, for instance, agreed to such a deal. 

So far there has not been a similar push from the sleepy commissioners court. Tesla’s representatives have skated around the question of labor relations by stating that it’s up to workers whether they want to unionize. No shit. That’s the law, which Tesla has a history of disregarding

The near total absence of unions in Texas is not a good thing. It’s a very bad thing that contributes to our high poverty rates and nation leading rate of worker deaths. “Progressive” local governments should do what they can to help workers get a seat at the table. 

City Council needs to get serious about Project Connect

Transitways – Envisioning Possible Center Lanes
A light rail rendering, courtesy of Cap Metro.

Even when it looked like Trump had a good shot at reelection, there was little doubt that turnout in Travis County would be through the roof. If there was ever a year to put a progressive wishlist on the ballot, it was 2020. 

Which is why leaders at both City Hall and Cap Metro were confident that Project Connect, the proposed generational investment in public transit, would easily win voters’ approval in November. Even if it meant voters had to approve a significant 11¢ property tax increase (about $360/yr for median homeowner). After all, most young people don’t (directly) pay property taxes. 

I still think voters will approve Project Connect. But it’s not clear whether City Council members believe so. In fact, it’s not clear what City Council members think. There’s no evidence that the most consequential transportation policy in a generation has crossed any of their minds in recent weeks. 

In their defense, they are distracted by the greatest public health crisis in a century and the largest protest movement in American history. But Austin’s desperate need for mass transit also needs immediate attention. This is not a niche issue; it is one that strikes at the heart of all of our most pressing issues: affordability, mobility, climate change and economic/racial segregation. 

Why this can’t wait until 2022
Some political and business leaders who were initially supportive of Project Connect will be tempted to say that, due to the extraordinary circumstances of the moment, we should postpone action until a future election. Maybe 2022. After all, the centerpieces of Project Connect — the 2-3 light rail lines — likely won’t be built and ready to go until 2027 if the funding is approved this November. So what if they aren’t built until 2029? 

The problem is, there is unlikely to be another election as favorable to mass transit and tax increases as 2020. In a hyperpolarized political environment, the key to success is picking an election where there are as many Democratic voters — particularly young and low-income Democrats — at the polls.

The party that holds the White House, which in 2022 will likely be the Dems, typically performs poorly in midterm elections. That is particularly true for Democrats because youth and minority turnout is VERY low in midterms. Indeed, this dynamic helps explain the GOP wave elections in 2010 and 2014, which have erroneously been interpreted by pundits as a rejection by “swing voters” of Obama but were in reality simply a result of low turnout among young and minority voters. Yes, the 2014 rail bond suffered due to sincere opposition from some transit activists, but it likely would have passed in 2016 or 2018 simply due to increased Dem turnout. 

In other words, the only way the 2022 will be a good year for a major transit bond is if Trump happens to pull off another victory this year, setting us up for another blue wave midterm. 

Don’t wait for polling. Shape the polling
It’s 36 days until City Council will decide exactly what, if anything, to put on the ballot in November. Do we go for the whole thing? Do we cut the project down a little to bring the cost down? Do we propose a less scary financing mechanism? 

Unfortunately, the powers-that-be are waiting for polling to tell them what to do. This is a recurring theme since Reagan: Democrats follow public opinion, while Republicans shape it. 

While City Council and Transit for Austin, the business-backed group founded to support Project Connect, are sitting on their hands, transit opponents are kicking into gear to shape opinion on the issue (see below in News Around Town). 

As is the case for housing, the surge in progressive activism over the last few weeks offers an amazing opportunity for public transit advocacy. Sure, there are plenty of people who turned out for Black Lives Matter protests who won’t see the connection between public transit and racial injustice, but many others will if they’re presented with the evidence. Car-based transportation systems were built with racial and economic segregation in mind. Nowhere should that be better-understood than in Austin, where only a few weeks ago protesters were tear-gassed on the same highway that has historically separated white Austin from black and brown Austin. 

Many of the powers-that-be backing Transit for Austin likely are much more comfortable making arguments and congestion and economic development than economic and racial equality, but they shouldn’t be the ones speaking anyway. The leaders on City Council and activists in the community are much better messengers. 

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Can Austin’s exclusionary zoning survive Black Lives Matter?

Over the past month, every local elected official has fallen over themselves to stress their commitment to fighting systemic racism.

So why aren’t we talking about abolishing single-family zoning? 

By many accounts, Austin is one of the most racially and economically segregated metro areas in the U.S. The most popular explanation focuses on the legacy of Austin’s very first comprehensive plan, in 1928, which created the infamous “Negro District” in East Austin.

Passage from 1928 plan. H/T David Whitworth.

Many other neighborhoods, both before and after the 1928 plan, were built with “deed restrictions” that stated that the properties could only be sold to whites. The most famous example is Hyde Park.

An advertisement for Austin’s first suburb, Hyde Park.

As court rulings and civil rights legislation gradually chipped away at explicitly racial housing restrictions, cities across the country, including Austin, found other ways to keep white neighborhoods white. 

It was made all the easier by the fact that African Americans, very few of whom had any generational wealth and most of whom continued to be denied opportunity for good jobs, tended to be much poorer than whites. Therefore, they were far less likely to be able to own or rent a large piece of property. 

Hence single-family zoning, which essentially creates an income floor for a neighborhood. If you can’t afford a 3-bedroom house, you’re not welcome. 

A large swath of West Austin shows the great majority (yellow) is currently zoned single-family.

In case single-family zoning alone wouldn’t keep the poors out, the city also put in place other rules that created de facto wealth restrictions for neighborhoods. The most glaring example are minimum lot sizes. The 1928 plan recommended 5,000 square foot minimum lot sizes, although the city appeared to ignore that, instead implementing a 3,000 sq ft minimum a few years later, in 1931. Ten years later it was raised again to 3,500 sq ft and finally, in 1946, it was raised to its present level: 5,750 sq ft.

Plenty of families would be willing to accept a smaller piece of property in order to be near good schools, parks and all the other things that characterize Austin’s most expensive neighborhoods. But if you can’t afford 5,750 sq ft, you’re out of luck. The code says you belong elsewhere. Historically, “elsewhere” was the east side. Now it’s Pflugerville, Manor, Elgin and Bastrop. 

Granted, supporters of the status quo will say that they are not opposed to different forms of housing, including small and large multifamily developments. They just need to be on corridors. The loud, dangerous streets where most people with money don’t want to live anyway.

Exclusionary zoning is racist. But not all of its defenders are
Many of today’s proponents of exclusionary zoning are not motivated by racism or class snobbery. Many of them are simply attached to the current aesthetic of the neighborhood and worry that allowing more or different types of housing in their neighborhood will bring more traffic, noise etc. Many of them do not appreciate how their position leads to economic and racial segregation. Some of them are people or color or facing serious affordability pressures themselves. 

There’s also a tremendous amount of confusion about zoning because the people most often requesting changes to the zoning code are profit-motivated developers. The housing that developers are building is always more expensive than whatever already exists in the area, so many people seem to think that if we just don’t give developers what they want, the affordability problem will go away. 

In fact, most of the expensive housing that is being built is at least partially explained by our segregationist zoning code. When you’re only allowed to build one house on 5,750 sq ft, you’re going to build the biggest, most expensive house possible. If you were allowed to build four units on that lot, the resulting product would probably not be cheap, but it would be cheaper and accessible to a greater percentage of residents than the McMansion. 

We’re seeing that dynamic at play at the Grove at Shoal Creek, the massive development at 45th St and Bull Creek Rd. The neighbors who bitterly opposed the development four years ago probably feel vindicated when they look at the prices on the gigantic homes being built there. But those gigantic homes are the logical outcome of the unit cap that the neighbors demanded. If we had allowed the developer to build twice as many homes, we would have seen them drop in size and price. 

Looking at you, City Council
If we are to take the statements City Council members have made over the past month seriously, there’s no way they can defend maintaining segregationist zoning. If they all acknowledge that the zip code you’re born in hugely impacts where you go in life, how can they justify policies that keep the best zip codes out of reach for so many Austin children? 

At this point many of you are rolling your eyes and telling me that of course we shouldn’t take their statements seriously. “Equity” to them is about uncontroversial and largely toothless actions: change some street names, hire a diversity consultant etc. 

Perhaps, but then again, just a few weeks ago it would have been unfathomable to imagine every City Council member committing to cutting funding from the police department. It’s far from clear that that will amount to much either, but it at least signals a profound shift in the policy conversation. 

The momentum created by what is potentially the largest protest movement in U.S. history offers a unique opportunity for housing supporters on Council to make big strides on behalf of housing justice. Natasha Harper-Madison, Council’s only black member, also happens to the most adamant supporter of land use reform. The three other minority members of Council, all of whom represent majority-minority districts with large low-income populations, are allies. The four CMs who have blocked reform also happen to be white people from West Austin. As I stated before, opinion on this issue is hardly dictated entirely by race and class but in this instance the optics are deeply unfortunate for supporters of the status quo. 

Earlier this year Council voted 7-4 in favor of a new code that didn’t go nearly far enough but at least made some progress on new housing. The code is now tied up in court after a judge ruled that, essentially, Council needs nine votes to approve it. 

If they’re seriously committed to building a more equitable city, Ann Kitchen, Leslie Pool, Kathie Tovo and Alison Alter need to rethink their position on land use. More importantly, the other seven need to put pressure on them to do so. 

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What did Austin City Council do to the police dept?

After hours of public testimony Thursday night, City Council took a series of unanimous votes on resolutions calling for a reimagining of public safety in Austin. Among other things, they called for the elimination of certain police tactics and weapons, the shifting of funds from APD to other public safety strategies and changes to police training. 

But as Delia Garza said towards the end of the meeting, “These are easy votes compared to the ones coming.”

It’s far from clear what the outcome of these resolutions will be. Don’t be distracted by the headlines around town claiming that Council voted to “divest” from the police. In terms of funding, the only rock-solid direction to the city manager is that he should not prepare a 2020-21 budget that adds police positions. But considering how awful the fiscal situation is due to COVID, he probably wasn’t going to do this anyway. 

There is another line telling the city not to fill any vacant police positions that can’t be “reasonably” filled in the next year. The department reports it currently has 142 vacancies just in sworn positions (people with badges and guns) but there are also vacancies in civilian roles. If all of those positions are actually taken away from APD, and it’s not clear that they will be, that would be a nice chunk of money. I’d guess the average per-year cost of a cop position (salary + benefits) is near $100,000, so maybe $12-16 million. 

Otherwise, the language leaves a lot of wiggle-room for city staff and Council to leave things largely the way that they are. It tells the city manager to “explore options” for reallocating APD roles to other departments. It’s not hard to imagine this direction being ignored entirely by staff, especially if Council doesn’t continue to apply pressure in the coming weeks as staff begins to craft the budget. 

The problem is, despite the unanimous votes, the message from Council actually isn’t that clear. There is a wide range of appetites of reform on the dais. Casar, Garza, Harper-Madison and Flannigan appear willing to support a dramatic reallocation of funding to other programs. Alison Alter, who has been a critic of APD spending long before this, may even be up for more radical change than one might guess. But for the other Council members, it’s hardly clear what kind of change they’re willing to support. 

What is Cronk thinking?
Last night both Alter and Garza expressed disappointment in City Manager Spencer Cronk for his aloofness over the past two weeks. 

“Your silence has been deafening to me,” said Alter. “You are the leader of 13,000 employees and we do expect you to take initiative for critical issues, especially when the lives of citizens are in jeopardy. We provide you direction but nothing precludes you from taking action.” 

True to form, when pressed by Alter about what changes he has discussed with the chief or what changes will be made, Cronk responded in substance-free bureaucratese.

I also have been frustrated by Cronk’s principled refusal to never answer a question, but some City Hall insiders suggest that the fault for his indecision lies with Council. While a number of CMs have called for Manley to go, a majority have not made a clear statement. The mayor, for instance, has not spoken to the issue. So what is Cronk supposed to do with that? 

Moreover, Cronk’s job is harder than Council’s. If he fires the chief, he needs to find a new one. In the midst of a pandemic that will likely make it much harder to do the typical national search that typically precedes these high-level appointments.

Sure, he could appoint an interim chief, but is that person will likely be another APD veteran cut from the same cloth as Manley. A loyal soldier who will not be an agent of change. This is a problem.

For what it’s worth, I still think that Manley’s position is untenable. It’s simply not respectable to the community to let the repeated errors go unpunished. That’s a terrible message to send. 

Remember who put Manley in the position? 
After Chief Art Acevedo left at the end of 2016, Manley took over as interim chief. He was in the interim position all throughout 2017 and the first months of 2018.

I can’t remember exactly what was taking the city so long to search for a new chief, but I do recall the Public Safety Commission instructing City Council to do a full national search and not to simply elevate Manley to the position. I remember one member of the commission, Preston Tyree, suggesting that that might be a waste of time and money and to just stick with Manley. “If it ain’t broke, don’t fix it,” he said. 

Chris Harris, the criminal justice reform advocate who was not a member of the commission at that point, replied that there were many in the community, particularly black and brown people, who didn’t agree that the status quo wasn’t broken. 

City Council, however, showed very little patience in doing a national search. At least two CMs — Delia Garza and Leslie Pool — called on the city manager to forgo the process, citing his conduct during the Austin bombings. That demand got no pushback from anyone else on the dais. Cronk obliged and Council unanimously approved him as chief. 

Garza, to her credit, acknowledged last night that she was a big supporter of Manley’s at the beginning. She also conceded that her views on public safety policy have evolved over the years. 

Indeed, the fact that Council’s posture on public safety has changed so radically in the last couple weeks is another reason why staff may still feel reluctant to implement dramatic change. It’s hard to know how sincerely committed Council members are to change considering that few of them pushed back on increase to the police budget in recent years. Some of them may have had a genuine change of heart as a result of the protests, but some may just be posturing in the short-term. Time will tell which one it is. 

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What good are Street Impact Fees?



A lot more people are out and about than a few weeks ago, but this was Congress Ave just north of Ben White at 8:30 a.m. That certainly doesn’t look like pre-COVID rush hour. 

COVID cases surge in Austin
Travis County experienced its two highest one-day totals for new COVID cases on Monday and Tuesday, with 118 and 164 new cases, respectively. The previous one-day high was 88 on June 1. 

The good news is that this has not been accompanied by a surge in hospitalizations so far. There are currently 91 hospitalized, 36 of whom are in the ICU and 26 are on ventilators in the five-county metro area. 

Could this be due to a surge in people getting tested after attending protests? Austin Public Health director Mark Escott says that’s probably not the big reason because it often takes a week for people to get test results. 

Unanimous support on Council for police reform resolutions
City Council’s discussion yesterday on police reform showed no signs of disagreements between Council members. At the very least, it appears that the resolutions scheduled for Thursday that call for reforms to use-of-force policies and shifting funds from APD to other public safety strategies will encounter no resistance. 

Alter says APD needs new leadership
Council members have used different words to make the point, but by my count Alison Alter became the fifth Council member to call for APD Chief Brian Manley’s resignation or demotion. She came to the conclusion, she said, after re-watching the chief’s responses to questions from last week’s meeting over the weekend. 

“We need to breathe new air into a department that time and time again has come short,” she said, highlighting the mishandling of sexual assault cases, APD’s response to the protests, use-of-force incidents, and the Tatum Report, which alleged that officers were afraid to report misconduct within the department. 

She added: “This is really difficult for me to say, but I feel that at this point in time, we need different leadership of our public safety department.”

She suggested that a resistance to “cultural change” at the department was an issue not just for Manley, but for Rey Arrellano, the assistant city manager who oversees APD, and for Troy Gay, the #2 at the department. 

Nobody on Council responded to Alter’s comments, which came at the end of the meeting. The mayor’s office declined to comment when asked whether he believed Manley should resign. 

What good are Street Impact Fees? 
Over the last four years City Council has been exploring the idea of implementing Street Impact Fees. SIFs are a fee that is levied on new development to pay for the road improvements made necessary by the project. Specifically, they are calculated based on the number of car trips that the project is anticipated to add to the existing infrastructure. 

The city already forces developers to pay for the impact their projects have on infrastructure through a convoluted “pro rata” system. However, the money the city collects from those payments can only be used for streets that are directly impacted by the project. 

A universal SIF would be different. The city could use the fee revenue on any projects that boost vehicle capacity within a six mile radius. Thus, the idea is that the city would be split into 17 districts, and the fees levied on a project could be used for a project in its district. 

The problem is, state law requires that SIFs only be used to expand car-carrying capacity by building new roads, expanding existing roads, improving access management or improving intersections. 

You can’t use a SIF to build an urban trail, a bus stop or a standalone bike lane. You can, however, use SIFs to build new sidewalks and bike lanes that are part of a project to boost roadway capacity. And at least according to an ATD spokesperson, that could include upgrading an existing bike lane from unprotected to protected. 

Could they incentivize good things? 
Driving up the cost of housing to build more car lanes is definitely not my idea of good policy for Austin. So my inclination is to view this potential change as worse than the status quo. 

There are some ways the outcomes could be less bad than expected, though. The SIF policy proposed by a task force envisions a number of ways that developers could cut their fees, including by offering some affordable housing or things that discourage car use, such as bike racks, bike lanes, on-site showers (for employers). Mixed-use developments could also be eligible for a discount.

Fees could vary dramatically by area
The fees would differ between the 17 districts based on the roadway capacity needs. Below is the anticipated median fee that would be levied for a single-family home by district. You can see it would be nearly 7x higher in Southwest District K than in Central District I. 
The good thing is that the fees go down as the units go up. Below, for instance, are the estimated median fees that would be levied per unit for duplexes and other “missing middle” multifamily. 
For larger multifamily projects, the per-unit fee would be even lower. See below. 
What’s important to remember is that the fee is only supposed to be levied based on the cost of the demand that will be generated in the next 10 years. The fee is not supposed to account for the current unmet demand or demand that is generated more than 10 years from now. 

If the city really wanted to, it could levy fees that would generate up to $1.8 billion over the next decade, staff estimates. However, the proposal that is being floated does not imagine charging the maximum allowed by state law, but about 35% of the max for residential projects and 50% of the max for commercial projects. And then there are the discounts that developers can qualify for. Taking all of that into account, staff estimates the fees will generate $285 million over a decade, only a sliver of the estimated $1.2 billion of current demand for new road capacity. 

It doesn’t seem like this is getting any pushback on Council but a lot of developers, particularly infill builders, are worried about the costs and say this will drive up the cost of housing. 

Below is another set of hypothetical projects and how they would be impacted by the new fees compared to the status quo. The IFAC Recommendation is what Council will likely be considering. 
NEWS AROUND TOWN

Lax behavior, lack of masks tied to surge in COVID cases say officials: Escott said the reopening of businesses alone is not the reason for the increase in positive tests. Also, because of it can take a week or more to receive results after getting tested, Escott said the recent spike in new cases can’t be tied to the social justice protests that began in the final days of May. Any infections that arose from the protests would be reported later this week and into next week, Escott said.“Quite frankly we also have an increase in risk-taking behavior,” he said. “People are less cautious, they’re not wearing masks as much, they’e not social distancing as much, and there not paying as close attention to personal hygiene messages like washing your hands frequently and not touching your face.”

We’ll see what things look like a week from now, after protesters start getting their results back. Q&A with Austin’s largest apartment builder: Journeyman Group President Sam Kumar said his company will probably build at least 600 fewer apartment units in Austin this year than it had initially planned.Despite that, the company is still projected to have 2,100 apartment units under construction this year, he said. That’s about the same or slightly more than Journeyman built last year.

Cool. 

Fires under I-35 left homeless with nothing. Volunteers stepped up: “During the riots, all my stuff got burnt up. My mattress, my tent – all that stuff got burnt up,” he said. “So, [I’m] starting all over – again.”Howard said he’s been living under I-35 for four months. When the protests outside APD headquarters got heated May 30, he decided to leave.

What’s interesting is that everybody seems to agree there is nothing lower than burning a homeless man’s mattress and yet many of us believe that person should be ticketed/arrested and have his belongings confiscate

Austin has flattened the curve. Now what?

Screen Shot 2020-05-05 at 1.31.43 PM
The green line represents the rate at which confirmed COVID cases have increased each day. The yellow lines are the new cases each day. The red lines are the cumulative total.

The rise in the number of positive COVID cases in Travis County has slowed as a result of a sharp reduction in person-to-person contact, Mark Escott, interim head of Austin Public Health, told City Council this morning.

The rate at which new confirmed cases are doubling is now at about 20 days, even though testing has ramped up significantly in the last couple weeks. In more encouraging news, of the first 735 people who signed up for tests through APH’s online portal, only 16 tested positive (2.18%). Remember, that’s only a fraction of the tests being conducted countywide (many through private providers), but it’s a big drop from the 10% positive rate among those who had been tested up until last week.

We still don’t have the capacity to do widespread testing of those without symptoms, which would be ideal because it would allow us to get a sense of how many asymptomatic cases are floating around. Right now we’re still only testing those who report symptoms or those who have been in close contact with somebody who was infected.

“This is really reflecting of this community’s efforts to flatten the curve,” said Escott. “We need these efforts to continue. It’s critical that we continue to remind folks that this is not the result of luck.”

Those experiencing severe symptoms are disproportionately black and Hispanic. Latinos account for about 35% of Travis County’s population but 51% of local COVID hospitalizations. African Americans are about 8% of the population but 12% of hospitalizations.

Lots of constructions workers getting sick
Although the city and county stay-at-home orders initially restricted construction to projects deemed “essential,” Gov. Greg Abbott’s deemed all residential and commercial construction essential. Like me, CM Kathie Tovo said today that she had seen job sites that were not complying with social distancing guidelines and had heard constituents voice the same concerns.

Escott said among the infected there have been “a significant number of construction workers as well as families of construction workers.” It is “one of the dominant industries” among those infected, along with the grocery and health care sectors.

In other words: “The people getting sick right now tend to be the people who are working right now.”

Should we be optimistic? Ehh…
Where we go from here depends on how behavior changes in the coming weeks. We certainly are nowhere near the testing and contact tracing capacity to practically stamp out the disease, ala South Korea. The absolute best case scenario will be a steady, slow burn of hospitalizations and death until a vaccine arrives.

The slow burn will be possible only if people continue to interact at a far lower rate than usual. And frankly, I think it’s a good bet that person-to-person contact will continue to be far under normal levels. A national poll released today by the Washington Post shows that 63% of Americans are at least “somewhat” worried about getting ill and only 22% say they’d feel comfortable going to a restaurant at this point. There are sharp partisan divides, but even a majority of Republicans say they’re ready to dine out yet.

But there’s definitely going to be increased interaction. That’s for sure. And that is going to lead to an increase in transmission.

What is unclear to me is what the governor will do if hospitals around the state become overwhelmed in June or July. Will he reimpose restrictions or is he going to let us ride this out? Both outcomes seem plausible to me. The United States has failed to contain the virus and is now in the process of giving up the fight in the hopes that we will eventually achieve herd immunity.

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Experts tell Council: Get ready for COVID chaos

481px-Greg_Abbott_2018
Credit: Wikicommons

Moves to “reopen” Texas could very likely prompt a surge in COVID infections that will overwhelm area hospitals and lead to thousands of deaths, two experts told City Council yesterday.

Lauren Ancel Meyers, a UT professor of biology and statistics who has been modeling the progress of the disease in the Austin area, attributed Austin’s relatively low body count to its success in reducing person-to-person interaction over the past five weeks. She estimates that interactions are down 95%.

If we drop back to a semi-normal situation, where interactions are only down 40% from their usual level, the model projects that area hospitals will exceed their surge capacity in early to mid-June. If no additional social distancing measures were ordered to reverse the trend, Austin will experience a “catastrophic” three months that would Meyers said would resemble the chaos that engulfed Italy and New York City in recent weeks.

However, the death toll in that scenario will vary widely depending on how effectively we “cocoon” high-risk populations: the elderly and those with certain health conditions. If overall interactions are reduced by 40% but the at-risk population is able to avoid 95% of interactions, her model projects 2,900 deaths in the metro area by September. If, however, the at-risk group’s interactions only stay 80% below normal, deaths would shoot up to 6,500.

For what it’s worth, it’s hard for me to imagine how a change in most of our behavior would not also impact the behavior of those in at-risk groups. It’s one thing to tell retired people to stay at home, but many people at-risk are younger people who are not able to get out of work, despite underlying health conditions. So far the governor has not suggested that those people will be eligible for unemployment or disability.

Assuming no measures were taken to counteract the catastrophic scenario Meyers described, the community would reach “herd immunity,” at some point in September, which would significantly reduce the spread of the disease.

The prospect of another lockdown
Meyers also offered another scenario, in which state government responds to a major surge in cases by putting in place another lockdown.

For instance, if the goal was to reduce overwhelming hospitals, a logical “trigger” for another lockdown would be 100 COVID hospitalizations per day. If we only reduce interactions by 40%, we’ll hit that point in mid-June and then lock down for another three months, likely forcing schools to delay opening until mid-September.

The good news, she says, is that the second lockdown would probably be the last. Drastic measures will not be necessary after that due to herd immunity.

The consequences of exceeding hospital capacity
Clay Johnston, dean of the Dell Medical School, said that Meyers’ model likely understated the limits on hospital capacity. There are only about 1,000 available hospital beds in the metro area right now, he said. The 3,200 beds in her model is the “surge capacity” that would involve doubling up of beds and putting people in hallways and the emergency room.

Johnston also noted that Meyers’ model does not assume that the death rate will increase as hospitals overcrowd. In fact, patients will be far more likely to die in that scenario because they won’t be getting adequate care, said Johnston.

So what do we do? 
If we don’t dramatically increase testing capacity and boost contact tracing, it won’t make much of a difference whether we reopen now or some time in the future, says Meyers. The benefit of continuing the lockdown for at least a couple more weeks is that it will “buy us valuable time” to ramp up testing, she said.

Travis County still has a far higher testing rate than the other major urban counties in Texas. At about 66 per 10,000, we’re way ahead of Harris, Dallas, Bexar, El Paso and Tarrant. It appears that most people who report symptoms of the virus can get scheduled for tests within 24 hours, but the testing capacity is still nowhere near what it would need to be at to effectively manage the spread of the disease through testing and contact tracing.

Until we have a vaccine, the most likely way to prevent a catastrophic spread is to conduct widespread testing, including of people who don’t have any symptoms, so that those who test positive can quarantine.

What will people do?
It will take a few weeks before we see whether the grim scenarios Meyers’ discussed come to pass. Her model cannot predict exactly how people will behave in the coming weeks. She had to make an educated guess about how people will act in a situation that we’ve never experienced before; therefore her model assumes that in the coming weeks the average Austinite will be engaging in 40% fewer interactions than they would be in the pre-COVID world.

It’s very possible, however, that interactions will not increase that much. Or that they’ll increase even more. Only time will tell.

This is just a small sample of what you get every weekday if you subscribe to the Austin Politics Newsletter