The Dallas-Fort Worth Hospital Council approached the governor's office over the weekend with what the group's President and CEO Stephen Love described as an "urgent request." The group of 90 area hospitals asked Gov. Greg Abbott to enact a statewide "shelter in place" policy similar to one recently announced in Dallas County and another being considered in Collin County.
"[W]e are now 'raising our hand' to create awareness that if we have a significant surge, it could impact personal protective equipment, ... critical beds and other medical supplies," Love said in a statement to Community Impact Newspaper.
Abbott's office declined to adopt this stricter approach for now, arguing it is not yet appropriate for all Texas cities.
But Abbott said local governments could implement these policies themselves.
Dallas County's version orders residents to stay home unless they are running essential errands or are part of a select group of industries. The details of Collin County's shelter-in-place policy were expected to be unveiled in a press conference 10 a.m. March 24, County Judge Chris Hill said at a March 23 commissioners meeting.
Where adopted, the shelter-in-place policies would represent the most dramatic escalation by local officials yet in the effort to combat the spread of the coronavirus before its burdens are absorbed by the hospital system.
A strained system
The models informing Dallas County and the local hospital council painted a grim picture of Texas hospitals if the state's social distancing measures from last week were not accompanied by stricter action.
In one of the scenarios officials have reviewed, Texas hospitals could have to operate over-capacity for more than a month starting in late April. At the peak of the crisis, patients requiring hospital care could outnumber available beds by more than 4-to-1. In this scenario, hundreds of thousands of Texans could die from the disease.
But with more restrictive government measures, Texas cities may have a better chance of keeping the number of cases within the range of what hospitals can handle for the duration of the closures.
These estimates came from Covid Act Now, a group of data scientists, engineers and designers that is working with epidemiologists and public officials to visualize various coronavirus response scenarios.
The model is not meant to be a precise prediction, since there are a wide range of outcomes for how the coronavirus could spread and affect hospital systems, according to covidactnow.org.
But the model, its creators say, is intended to help government officials make decisions in real time that are "informed by best available data and modeling."
And some North Texas officials are watching it closely.
Dallas County Judge Clay Jenkins said the projections influenced the county's decision to order shelter-in-place restrictions this week.
And the Dallas-Fort Worth Hospital Council used the same projections in its correspondence with Abbott's office, Love said.
"The DFWHC, on behalf of regional hospitals, never said North Texas would run out of hospital beds," Love said, "but that the 'COVID Act Now' graph reflects a tremendous volume surge if no action is taken. According to this graph, Texas could exceed current bed capacity."
Other studies have given local hospitals cause for concern, Love said. These include numbers from the Centers for Disease Control and Prevention as well as an epidemiology paper on coronavirus mitigation from Imperial College in London that has been informing public response to the coronavirus.
"These models, if projected to Texas, reflect specific trends which all point to increased volume," Love said.
In Dallas County, officials ran their own, more conservative estimates. The Covid Act Now projection assumes more than 70% of the population would be on track to catch the virus over the course of the epidemic.
But even in one of Dallas County's estimates, which assumes a 40% infection rate, the local hospital system would not be able to contain the number of patients requiring hospitalization, said Dr. Philip Huang, director of Dallas County Health and Human Services.
With a rigorous shelter-in-place policy, Huang said, the number of hospitalizations would likely remain well within the range of what the system could support.