Travis County’s coronavirus testing positivity rate and hospital admission rate have ramped up in the past week after briefly showing some improvement ahead of Halloween, and Austin-Travis County Health Authority Dr. Mark Escott said at a Nov. 9 press briefing that the county could be looking at tightened restrictions for restaurants and businesses if case trends continue on their current upward trajectory.

“We're not at the stage of recommending a lockdown, but, certainly, we need people to take [fewer risks] in the coming weeks,” Escott said.

After a surge in COVID-19 cases over the summer months, Travis County’s transmission improved until Oct. 4, when the area had a seven-day moving average of 64 cases. Currently, the county’s moving average is 135 cases, having more than doubled since the early October lull. The county’s seven-day moving average for coronavirus hospital admissions is now 129, up 67% from Oct. 4, according to Escott, who said he suspected Halloween gatherings were responsible for some of this increase.

More encouraging numbers reported Nov. 2 previously prompted Escott to express cautious optimism about the possibility of Travis County’s bars reopening—with the blessing of outgoing Travis County Judge Sam Biscoe—but he took a much different view at Austin Public Health’s Nov. 9 briefing.

“With increasing cases of hospitalizations and ICU admissions, now's not a good time to take on more risk,” Escott said. “In fact, the discussion that we should be anticipating in the coming weeks is, 'Do we need to scale back on risk? Do we need to ask restaurants to move back to 50% from 75%?’”

With other cities in Texas, such as El Paso, experiencing severe surges in COVID-19 hospitalizations, Escott said Austin is “in a precarious spot.” El Paso’s hospital capacity has been exhausted, and other cities, including Austin, have begun accepting coronavirus patients from El Paso to help meet the need. If Travis County too experiences a severe surge in cases, however, its hospitals’ ability to aid other struggling jurisdictions will be diminished, Escott said.

“Luckily, because of the work of this community, we have the ability to provide [hospital beds] to other jurisdictions who are in need, but we have to protect that capacity. I would much rather us be in the circumstance where our cases and our hospitalizations are low, and then, we can offer availability to other jurisdictions who are facing a surge, rather than us being in surge ourselves,” he said.

Escott’s message about how to ward off the surge that is currently growing in Travis County was consistent with all his previous messaging: Avoid unnecessary gatherings, especially those without social distancing and masking protocols in place. He applied this advice especially to younger adults ages 20-39, who comprise the age group with the highest positivity rates. Over the last week, he said that group has seen more than 50% of the positive tests in the county.

“It's important for people in those age groups, as well as other age groups, to decrease that person-to-person interaction. I think we've all gotten a little too relaxed over the past month or two, and we need to start acting in a more productive way to decrease that transmission,” he said.

Austin Public Health’s briefing came the same day as did news of a promising vaccine developed jointly by companies Pfizer and BioNTech, which the companies said has been more than 90% effective against COVID-19 in clinical trials. Escott cautioned against being overly optimistic about this vaccine’s effectiveness and its trajectory for reaching the public. More peer-reviewed testing will be required, he said; the best-case scenario is that the vaccine be released by late December. More likely, he said, a vaccine will not be available until 2021, and will first be administered to first responders and health care providers.

“We have to be very careful about determining efficacy while the studies are still underway,” he said.

County health officials, including APH Chief Epidemiologist Janet Pichette, are preparing to distribute a vaccine whenever it does become available. At the Nov. 9 briefing, Pichette said APH representatives have worked with the Texas State Health Department weekly to get ready. For instance, on Nov. 7, APH used a drive-thru influenza vaccine event to gauge a drive-thru model’s viability for the distribution of a COVID-19 vaccine.

“The purpose of that drive-thru point of dispensing was to see if it would be a suitable model to use during COVID vaccines, and we felt like it was very effective. There were definitely lessons learned from that drive-thru exercise, but we continue to practice and refine so that when we do have the opportunity to deliver that vaccine to the community, we can do this as timely and as efficiently as possible,” Pichette said.