Stage 4 guidelines ask businesses to voluntarily operate at 25%-50% capacity. Additionally, higher-risk residents, including those who are over age 65 or have underlying health conditions, should avoid gatherings with more than two people from outside the household. Previously, the recommendation was for those individuals to avoid gatherings of more than 10 people from outside the household. For those who are not at a higher risk to contract the virus, the recommendation remains to avoid gatherings of more than 10 people.
"If we do not take the steps to change now to mitigate the risk, to flatten the curve, we could be in Stage 5 territory in just a few weeks. We must do all we can to prevent that from happening so that we can keep our businesses healthy, keep our schools healthy and keep our community healthy," said Dr. Mark Escott, Austin-Travis County interim Health Authority.
Escott had warned that restrictions could heighten for several weeks prior to the shift to Stage 4. With new cases surpassing 300 on Nov. 18; the seven-day moving average of coronavirus hospital admissions at 32; and a testing positivity rate close to 7%, he said, it was time to make the shift.
The daily average of hospital admissions is the key indicator APH uses to determine the community's risk. Until now, a seven-day moving average of 40 hospital admissions had been the trigger for Stage 4. According to Escott, a deeper understanding of the limits of local hospital staffing caused APH to reassess and make 30 admissions the threshold. With Travis County hospitals and ICUs accepting some patients from virus-burdened cities in Texas, such as El Paso, where active cases have surged well past 4,000, hospital capacity becomes an even more critical factor.
"We can see that a surge is happening across Texas," Escott said. "The challenge is that a surge like [El Paso's] in Austin would require us to have more than 600 ICU beds and more than 2400 hospital beds just to care for the people in our jurisdiction. We don't have that many beds."
Also present at the news conference with Austin Mayor Steve Adler and Travis County Judge Andy Brown, who said they support APH's move to Stage 4. They encouraged residents to practice caution with Thanksgiving gatherings, which Escott called a "significant risk."
"Our actions are going to tell us how serious we are about whether we want to top the increase in hospitalizations. The bottom line here is we have control over our future," Adler said. "Don't jeopardize years of future holidays for you or for other Austin families by taking unnecessary risks this Thanksgiving."
On Thanksgiving, Escott said people should celebrate only with their own households and should celebrate outside with masks on if they do not heed the household-only advice.
Editor's note: This story was updated to include additional details about Stage 4 recommended guidelines.