Houston's COVID-19 Czar, Harris County Public Health Director Discuss Protocols, Challenges for Reopening Economy
Asia Society at Home
HOUSTON, May 22, 2020 — In the eighth program of its weekly COVID-19 series, Asia Society Texas Center (ASTC) hosted a discussion on the reopening of Houston with the city’s COVID-19 Relief and Recovery Czar Marvin Odum and Harris County Public Health Executive Director Dr. Umair Shah. In conversation with Martyn Goossen, ASTC board member, the two speakers addressed the need to balance both health and economic concerns in combating the virus and its wider impact on Houston.
The present situation
Goossen opened the discussion by reporting that, as of May 21, the total global cases had exceeded 3 million with 330,000 deaths, with 1.5 million cases and nearly 94,000 deaths in the United States. He shared that the greater Houston area had 15,551 cases as well as 385 deaths, but also 6,100 recoveries — approximately one-third of those who had been infected.
Dr. Shah described the breadth of the impact of COVID-19 as “sobering,” as it has touched every country around the globe as well as every community in the U.S. He reminded the audience that each data point represents “a person with a life, an ecosystem around them, a family that loves them.” He also noted that the healthcare system’s focus on COVID-19 treatment has affected patients seeking outpatient or nonemergency procedures as well as providers, who have lost revenue.
Goossen indicated that the economic impact has also been significant, with 38 million people in U.S. — 2 million of whom are in Texas — filing for unemployment in the past two months. He noted that Houston’s energy industry had been impacted twice — by the coronavirus as well as an oil price war earlier in the year.
Odum elaborated on the effects on Houston’s economy with some staggering figures: The city typically sees an economy of $1.5 billion per day, with $500 million per day going into payroll. With the city reporting 10 percent unemployment, Odum said, $50 million per day is no longer going to people to participate in the economy.
Both Dr. Shah and Odum emphasized that reopening Houston is not a binary question of health versus the economy, but rather a matter of caring for and solving the disease in addition to the economy.
Strategic testing and monitoring in reopening Houston
Texas Governor Greg Abbott began opening Texas on May 1 with Phase 1, and Phase 2 began this week on May 18. Dr. Shah noted that local elected and public health officials in Houston have been working together to track five metrics: reduction in new cases, ability to treat patients in hospitals, capacity to test people with symptoms, having sufficient contact tracers, and mortality rate. He indicated that the rate of new cases appears to have plateaued and that testing capacity has increased, and emphasized the importance of PCR testing in helping officials understand transmission rates in the community. The ultimate goal, he said, is to prevent as many deaths as possible: “That’s my job as a doctor, as a public health official.”
Though testing has expanded, Odum highlighted the necessity of strategic monitoring and distribution of testing and resources. He explained that the process focuses on catching potential cases as early as possible by trying to understand where the most vulnerable across the population live and to direct monitoring to those areas. This includes areas with high risks of transmission and high risks of complications, such as nursing homes.
Odum added that smaller businesses, particularly in disadvantaged neighborhoods, are more vulnerable to disproportionate economic impact due to having less capacity to retain employees or providing adequate safety measures. The responsibility of the government, said Odum, is to look after the most vulnerable and to support people in the short and medium term so that the economy can resume growth to help people on a broader basis.
The roles of contact tracing and individual behavior
Odum said the toolkit for dealing with the virus until the creation of a vaccine is ultimately fairly straightforward, albeit limited: testing, contact tracing, and behavioral change. Dr. Shah noted that along with increased testing, Harris County Public Health is also in the process of bringing on 300 contact tracers. He explained the process: because an individual testing positive may have encountered a number of contacts, contact tracers will reach out to those people and try raise awareness and enact behavioral change. If that contact is symptomatic, Dr. Shah recommends staying home and isolating, as well as going to get tested. If the test is positive, it starts a new loop for contact tracing.
Both Odum and Dr. Shah emphasized the importance of individual behavior in combating the virus and helping reopen the economy. Odum said he supports the practice of wearing masks in public, suggesting that people perceive wearing a mask as “a sign of respect and a sign of supporting the economy.” He said while he does not believe it is government’s place to mandate masks, education is critical in helping people understand why it is important to change behavior to protect loved ones and the larger community.
Dr. Shah noted that when federal, state, and local systems are not aligned on protocols or responses, it often results in confusion and complacency in the public. He agreed on the importance of education, adding that health and the economy are not opposed, and that in fact people can make choices to support the economy based on health. For instance, he suggested opting to visit a restaurant that requires masks and enforces social distancing over a restaurant that does not.
Uncertainty and resilience in facing the future
Dr. Shah acknowledged that uncertainty remains about the future of the pandemic, including whether a second wave of cases will develop in the fall to coincide with the seasonal flu. Because COVID-19 stems from a novel coronavirus, he said, scientists are unsure whether transmission will reduce in the summer and resume in the fall, leaving unanswered questions for decision-makers about reopening businesses and schools and what the risks would be for pausing or reversing phased openings. Dr. Shah said he hoped that future decisions will be informed and driven by public health and the medical community, in collaboration with state and local leaders.
Odum said he envisions a transformed society, one that sees the development of a safety culture. He pointed out that individuals are often not skilled at assessing risks, and said he hoped that changing mindsets and behaviors to protect each other becomes the new normal. He added that we are building resilience in the community, using digital equity as an example. Taking the time to address those inequities now, he said, will help us be more prepared to shelter-in-place in the future.
Dr. Shah said COVID-19 did not cause the health disparities and inequalities in our communities, but has accentuated preexisting ones. “Resilience is really a commitment by all of us to do better and to do whatever we can to help our community get through this together,” he said.
Business and Policy programs are endowed by Huffington Foundation. We give special thanks to Bank of America, Muffet Blake, Anne and Albert Chao, ConocoPhillips, ExxonMobil, Nancy Pollok Guinee, United Airlines, and Wells Fargo, Presenting Sponsors of Business and Policy programs; Nancy C. Allen, Chinhui Juhn and Eddie Allen, and Leslie and Brad Bucher, Presenting Sponsors of Exhibitions; Dr. Ellen R. Gritz and Milton D. Rosenau and Wells Fargo, Presenting Sponsors of Performing Arts and Culture; and Mitsubishi Corporation (Americas), Presenting Sponsor of the Japan Series. General support of programs and exhibitions is provided by The Brown Foundation, Inc., The Hearts Foundation, Inc., Houston Endowment, Inc., the City of Houston through Houston Arts Alliance, McKinsey & Company, Inc., National Endowment for the Arts, Texas Commission on the Arts, Vinson & Elkins LLP, and Mary Lawrence Porter, as well as Friends of Asia Society.
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With 13 locations throughout the world, Asia Society is the leading educational organization promoting mutual understanding and strengthening partnerships among the peoples, leaders, and institutions of Asia and West. Asia Society Texas Center executes the global mission with a local focus, enriching and engaging the vast diversity of Houston through innovative, relevant programs in arts and culture, business and policy, education, and community outreach.