In your view, how well is Texas now handling COVID-19?
The picture is not clear, and the reason it’s not clear is because of that big ice storm. ... During that and after it, the [Texas Department of State Health Services] put out an announcement saying that case numbers would be artificially low because a lot of parts of Texas weren’t able to actually report the cases ... or they weren’t able to get there to receive them. And so when things like that have happened in the past, ... about once a month, there will be a correction. ... We have not yet seen that correction, and so we don’t really know how many cases are missing or how caught up we are, and I think that’s going to vary depending on where you’re talking about in the state. ... The idea that we would use low case numbers as the basis for a major change in policy that would potentially drive up case numbers when the case numbers may not actually be low—that’s the part that I have a hard time getting my head around.
What are your thoughts on Gov. Greg Abbott ending the mask mandate and lifting capacity limits?
I couldn’t believe it when I first heard it. ... I think the thing I was left with was frustration, for the most part. This is going to make it harder to stop COVID. So my worry was already that because of the high amount of antivaccine and/or antiscience sentiment in Texas—that we would run the risk of being one of the last places in the U.S. to still have the virus. When they get it under control everywhere else, my worry is that the Deep South is going to be the last bastion of COVID-19. And it doesn't have to be that way. That’s avoidable. I’m just not sure if we are on track to avoid it.
What have you thought of the state's vaccine rollout so far?
The way I was raised, you want to win the fight before you throw the parade. And that is not what we’re doing. We’ve got it the other way around here. Unfortunately, this makes everything much more difficult. The virus can only mutate when it is able to grow, and the virus can only survive if it is able to jump from one unmasked person to another unmasked person about every four or five days. If it stays any longer than that, it’s going to get cleaned up by the immune system, and it’s probably going to be gone. If you think about it, it actually takes a lot of work to keep a pandemic going, and fairly simple measures are very effective at stopping it. You can look at all the countries that have managed to get essentially virus-free without having a vaccine—like, before the vaccines were available—to see that. So the vaccine helps, but I think we are relying on it far too much, and not enough people have had a vaccine.
My other comment would be that the way we’ve rolled out the vaccine is a problem. We’ve taken a sort of ‘Honor your mother and father’ approach by going in and trying to protect the elderly and people with severe comorbidities first. The problem there is that a virus spreads through contact, and so the people who have the most contact with other people are going to be, for example, fast-food workers, elementary school teachers, bus drivers. ... We could've gotten the vaccine to more people and to people who are more connected with other people—basically, people who are positioned in a way that would make them potential hubs for virus transmission.
Do you have any additional comments on how the COVID-19 response in Texas might look over the year ahead?
This is likely to lead to more cases, this is likely to lead to greater spread, and this is likely to produce homegrown Texas variants. They’re going to be vaccine-resistant and antibody-resistant [and] treatment-resistant. The virus changes over time, and the more shots we give it at growing in a human, the better it’s going to get at the job. And in a place where you have a few people who are vaccinated and a vast number of people who are not vaccinated, the virus has plenty of places to go and plenty of room to evolve. Evolution is unpredictable, but evolution tends to do something that will evade whatever problems the virus is running into. And if that problem ends up being vaccine immunity because we’re kind of slowly dripping it out, then I could really see that.
[The governor’s] main justification is that this is an issue of personal responsibility and personal freedom, essentially. The problem there, and why that is not the case, is that you can't get the virus from yourself, and you can’t give it to yourself. The virus always comes from another person, which means this is a collective risk and is not something that one person can manage. ... I don’t know why we’re not treating this like secondhand smoke—why we’re not allowing smoking in buildings, but are fine with something that kills you much more rapidly and surely being in buildings.
The governor put in place a safeguard that I believe is designed never to be activated, and that is the county judges having the authority to put additional restrictions in place. Now, I don’t know how many county judges you know, but the ones I’ve met seem to be very busy people, and I don’t know how they would possibly find time to read up on the latest epidemiology and scientific papers about COVID-19. ... So you’ve got people in every community that has people who are trained to understand the virus, and those have been shut out of the decision-making process. We have left it, instead, to people who have expertise in jurisprudence, which, frankly, has nothing to do with COVID-19 one way or another.