Categories
Coronavirus

Texas ends mask mandate and limits on businesses

Gov. Greg Abbott announced Tuesday that he will end Texas’ statewide mask mandate next week and will allowall businesses to operate at full capacity.

“It is now time to open Texas 100%,” Abbott said from a Mexican restaurant in Lubbock, arguing that Texas has fought the coronavirus pandemic to the point that “people and businesses don’t need the state telling them how to operate” any longer.

Abbott said he was rescinding “most of the earlier executive orders” he has issued over the past year to stem the spread of the virus. He said starting March 10, “all businesses of any type are allowed to open 100%.” A spokesperson later confirmed that includes sporting events, concerts and similar events. Masks will no longer be required in public for the first time since last summer.

Meanwhile, the spread of the virus remains substantial across the state, with Texas averaging over 200 reported deaths a day over the last week. And while Abbott has voiced optimism that vaccinations will accelerate soon, less than 7% of Texans had been fully vaccinated as of this weekend.

Texans and Americans of color have been disproportionately affected by the pandemic. More than half of the deaths due to COVID-19 have been Black or Hispanic people, and advocates have reported that these communities have fallen behind in the vaccination efforts in Texas.

Texas will become the most populous state in the country not to have a mask mandate. More than 30 states currently have one in place.

Abbott urged Texans to still exercise “personal vigilance” in navigating the pandemic. “It’s just that now state mandates are no longer needed,” he said.

[Read more: Keep wearing your mask, health officials say after Gov. Greg Abbott lifts mask mandate]

Currently, most businesses are permitted to operate at 75% capacity unless their region is seeing a jump in COVID-19 hospitalizations. While he was allowing businesses to fully reopen, Abbott said that people still have the right to operate how they want and can “limit capacity or implement additional safety protocols.” Abbott’s executive order said there was nothing stopping businesses from requiring employees or customers to wear masks.

But soon after the announcement, the grocery chain H-E-B indicated in a statement that it won’t require customers to wear masks.

Acknowledging that some local leaders remain concerned about the spread of the virus in their communities, Abbott laid out a strategy that allows them to take matters into their own hands under certain circumstances. If COVID-19 hospitalizations in any of Texas’ 22 hospital regions rise above 15% of the capacity in that region for seven straight days, a county judge “may use COVID mitigation strategies in their county,” according to the governor.

However, Abbott specified that “under no circumstance” can a county judge jail someone for not following their orders. They also cannot impose penalties on people for failing to wear masks — or on businesses for not mandating that customers or employees wear masks. And if local restrictions are triggered, businesses still must be allowed to operate at 50% capacity at the minimum.

Texas public schools will be allowed to continue offering virtual learning under the new order, and some superintendents have said that they will continue to require masks unless they receive receive word that they can’t. Abbott’s executive order says schools must follow “guidance issued by the Texas Education Agency.” The TEA said Tuesday afternoon that it will provide updated guidance this week.

The order also lifts a previous mandate that halted inmate visitation at county and municipal jails, though it was not immediately clear how that would affect individual jails. The new order specifically kept in place, however, a controversial order to restrict who can be released from jail without paying cash bail during the pandemic.

Abbott’s announcement prompted outcry from local leaders in Texas’ biggest cities. The head of Texas’ most populous county, Harris County Judge Lina Hidalgo, responded to Abbott’s moves by saying “now is not the time to reverse the gains we’ve worked so hard to achieve.”

OtherDemocrats swiftly denounced Abbott’s announcement, with the state party chairman, Gilberto Hinojosa, calling his actions “extraordinarily dangerous” and saying they “will kill Texans.” Beto O’Rourke, a potential Abbott challenger in 2022, used similar rhetoric, calling Abbott’s moves a “death warrant for Texans” and claiming the governor is “killing the people of Texas.”

Abbott’s critics also noted the announcement was coming in the wake of the winter weather crisis that left millions of Texans in the cold and the dark, exposing deep flaws in Texas’ electrical grid under GOP leaders including Abbott.

“Unfortunately, Gov. [Abbott] is desperate to distract from his recent failures during the winter storm and is trying to change the subject,” state Rep. Chris Turner of Grand Prairie, chairman of the House Democratic Caucus, said in a statement.

In a radio interview after his announcement, Abbott said he had wanted to move even faster to fully reopen businesses and lift the mask mandate. He told Lubbock host Chad Hasty that he wanted to make the announcement over a week ago — the last Monday in February — but held off to allow the vaccination distribution process to get “back up and running at full speed” following the storm.

It is not just Democrats who have been critical of Abbott’s pandemic management. He has also faced criticism from some in his own party who say he has been too slow to reopen Texas, especially compared to other GOP-led states. Allen West, the Texas GOP chairman who has been critical of some of Abbott’s pandemic handling, reacted to the governor’s announcement by saying he was “glad Gov. Abbott is following the example of” Florida Gov. Ron DeSantis and South Dakota Gov. Kristi Noem. Both DeSantis and Noem are widely seen as potential 2024 presidential candidates; Abbott has not ruled out a White House bid of his own.

In Lubbock, Abbott defended his reopening decision by saying Texas is “far better positioned now” than when he issued his last executive order on the pandemic in October. That order set up a system under which business reopenings would automatically roll back in a hospital region if its COVID-19 patients went over 15% of capacity for seven consecutive days.

Abbott further argued that the state is in a “completely different position” than it was in when the pandemic first prompted him to take statewide action nearly a year ago. He said the state now has an “abundance” of personal protective equipment, the ability to do over 100,000 tests a day, medicines to treat coronavirus patients and wide awareness of protocols such as social distancing and hand-washing. Most importantly, he said, vaccines are available and the supply “will continue to increase rapidly,” with Texas preparing to expand the categories of people eligible to get vaccinated. Abbott told Hasty that “announcements will be made this week” about opening up the categories.

Despite Abbott’s optimism, only 6.5% of Texans had been fully vaccinated as of Sunday, and more broadly, the current trajectory of the virus has been difficult to measure in recent days due to last month’s winter storm, which forced many large counties to close their testing centers and not report any cases. Daily confirmed cases and deaths are clearly down compared to a statewide peak in January. Hospitalization data has been less disrupted, though, and has shown a consistent decline since late January.

When it comes to vaccinations, experts say Texas is a long way from reaching herd immunity. Hitting the 70% to 80% level that many estimate is needed would mean vaccinating some 22 million people, or nearly 100% of adults in the state, according to census numbers. The vaccines are currently not approved for children under 16, who make up about 23% of the population. More than 40,000 people have died in from the virus in Texas since the pandemic began.

Scientists do not yet know for sure whether or how well the vaccines prevent the spread of the virus, though some preliminary research has suggested that some vaccines might be able to do so to some extent.

The Centers for Disease Control recommends that people who have received two doses of the vaccine continue to avoid crowds, stay at least 6 feet away from people who live outside their households and wear masks to cover their nose and mouth.

Dr. Anthony Fauci, the nation’s top infectious-disease doctor, has repeatedly said that he does not know when Americans will be able to return to normal, but that they may still need to continue wearing face masks into 2022.

Texans have been under a statewide mask mandate since July of last year — and they have grown widely comfortable with it, according to polling. The latest survey from the University of Texas and Texas Tribune found that 88% of the state’s voters wear masks when they’re in close contact with people outside of their households. That group includes 98% of Democrats and 81% of Republicans.

The absence of statewide restrictions should not be a signal to Texans to stop wearing masks, social distancing, washing their hands or doing other things to keep the virus from spreading, said Dr. John Carlo, CEO of Prism Health North Texas and a member of the Texas Medical Association’s COVID-19 task force.

Carlo declined to react specifically to Abbott’s order, saying he had not had a chance to read it. He also expressed concern that new virus variants, specifically the U.K. variant, could still turn back the positive trends cited by Abbott.

“We’re facing unacceptably high rates, and we still hear every day about more and more people becoming sick. And it may be less than before, but it’s still too many,” Carlo said. “Even if businesses open up and even if we loosen restrictions, that does not mean we should stop what we’re doing because we’re not there yet.”

Abbott’s announcement Tuesday was not entirely surprising. He said Thursday that his office was looking at when it could lift all statewide coronavirus orders and that he would have announcements “pretty soon.”

Prior to the announcement, Hidalgo and Houston Mayor Sylvester Turner sent a letter to Abbott asking him to keep the mask requirement in place. Austin Mayor Steve Adler and Travis County Judge Andy Brown separately sent the same letter.

Reference

Read Gov. Greg Abbott’s full order lifting Texas’ mask mandate and business capacity limitations.(147.4 KB)

“We believe it would be premature and harmful to do anything to lose widespread adoption of this preventive measure. Scientific studies have shown repeatedly that the widespread wearing of face masks slows down the virus,” the letter reads. “Especially with the arrival of new variants of the virus to Texas and our cities, with the associated spike in cases, preserving the most effective of our existing safety measures is even more important.”

In Hidalgo County, where the hospitalization number has dropped from around 500 to under 200 in the last month, the eased restrictions could threaten the progress that has been made, said Dr. Ivan Melendez, Hidalgo County health authority and a local physician. The Rio Grande Valley community, which at one point was one of the nation’s hot spots, still has some of the highest rates of risk indicators in the country, Melendez said.

“All of a sudden, instead of having a scenario that facilitates what we’re trying to do, we have another scenario that causes us to have greater difficulty in our goal, which is to eradicate this disease,” Melendez said. “Although I believe the governor is well intended and I understand he has a lot more criteria that he has to filter through, I believe that this should have been the last step, not the first. … It’s too much, too soon.”

Aliyya Swaby, Karen Brooks Harper, Jolie McCullough, Chris Essig and Juan Pablo Garnham contributed reporting.

Disclosure: Steve Adler, a former Tribune board chair, the University of Texas and the Texas Medical Association have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune’s journalism. Find a complete list of them here.

 The Texas Tribune is a nonpartisan, nonprofit media organization that informs Texans — and engages with them – about public policy, politics, government and statewide issues.

Categories
Coronavirus

Are homeless people in your state being overlooked for coronavirus vaccinations?

Frank Galloway falls into the most vulnerable categories for COVID-19: He is 87, he is Black, and he is experiencing homelessness.

“It ain’t no joke,” Galloway said of the coronavirus, which has killed some of his friends in Greensboro, North Carolina. “I don’t mind taking something that will help my life to keep going.”

He’s waiting for a vaccine while staying in an emergency shelter. Although the state began vaccinating people age 65 and up in mid-January, Galloway, like many others without housing, doesn’t have access to the technology and transportation that people in many places need to get a shot.

Many homeless people have underlying medical conditions. They are more likely to be people of color, and many are older adults—all groups disproportionately at risk for serious harm from the virus. 

“If you look at the highest vulnerable population, it’s the homeless,” said Brooks Ann McKinney of Cone Health, a health care network that has provided regular coronavirus testing and medical care at the shelter where Galloway is staying. 

Yet at least 20 states don’t include people living in homeless shelters in their vaccine distribution plans, according to the National Academy for State Health Policy, a nonpartisan research organization with offices in Washington, D.C., and Portland, Maine. Few state plans even mention homeless people not in shelters.

And some states that did prioritize shelter residents in early plans changed tack, moving them further down the list.

Advocates for homeless people want states to put this group at the top of the vaccine distribution list. Prioritizing those experiencing homelessness would allow medical providers to bring vaccines directly to shelters, advocates say, creating a more efficient system that could inoculate more people, keep track of who has which shot and confront vaccine hesitancy. 

“There has been trust built with the shelters where we’ve been doing testing regularly,” said McKinney, director of vulnerable populations at Cone Health. “They’re more apt to take the vaccine because they trust the clinicians.”

Last week, the National Health Care for the Homeless Council, a Nashville, Tennessee-based membership organization for groups that provide health care to homeless people, sent a letter to governors and state and local health authorities urging them to make adults experiencing homelessness eligible for the vaccine and to begin targeted outreach.

Advocates for those experiencing homelessness are one of many groups petitioning state officials, though. That and the lagging vaccine supply put enormous pressure on state agencies.

When the federal Centers for Disease Control and Prevention offered guidance in December on vaccination priorities, it listed health care workers and long-term care residents at the top.

Separately, the agency issued interim guidance on Feb. 2 focusing on the logistics of vaccinating people experiencing homelessness. The guidance noted that some states have prioritized those residents, but it didn’t say that states ought to do so.

The CDC did not respond to a request for comment from Stateline on whether the February guidance was its first on homeless people. 

Hee Soun Jang, a University of North Texas associate professor who is studying care for homeless people during the pandemic, said the CDC was “silent on vaccinating homeless” until then and thinks the delayed guidance may have hindered states in prioritizing homeless people. “We waited so long to have any federal guidance for vaccinating the homeless population.” 

Changing Plans

Roughly half a million people are experiencing homelessness in the United States—two-thirds of whom are at emergency shelters or in transitional housing, according to a 2020 report from the U.S. Department of Housing and Urban Development. Little is known about how homeless people have been affected by the pandemic, aside from a patchwork of state and city research. 

Because of those knowledge gaps and the lack of federal guidelines, each state went its own way on where to place homeless people in the vaccine line. Researchers tracking states’ plans said they have seen the priorities change—but rarely in a way that benefits people experiencing homelessness. 

“We’ve seen a big wave of states moving populations around, moving elderly up, moving teachers and grocery store workers up,” said Ariella Levisohn, a research analyst with the National Academy for State Health Policy. “With individuals experiencing homelessness, there hasn’t been much of a pattern.”

In North Carolina, for example, an October distribution plan included people in homeless shelters in the first phase. But the current plan classifies homeless shelter staff as frontline essential workers, putting them in the state’s third group, and shifts people living in homeless shelters into group 4.

“We are further marginalizing an already marginalized population by moving them to a later category. That’s upsetting to me,” said Ryan Fehrman, director of Families Moving Forward, a short-term housing shelter for about 50 people in Durham. 

Fehrman also criticized the decision to place shelter staff before shelter residents. “To create a power disparity between folks providing a basic service and the folks receiving those services is completely unnecessary.”

Fehrman, along with almost 90 organizations and 300 individuals, sent a letter from the North Carolina Coalition to End Homelessness to the state’s secretary of Health and Human Services, Dr. Mandy Cohen. They asked for people experiencing homelessness to be prioritized for vaccines.

The state’s current prioritization of homeless people aligns with the CDC’s Advisory Committee on Immunization Practices, said North Carolina Department of Health and Human Services spokesperson Catie Armstrong in an email.

The state’s framework is “designed to save lives and slow the spread of COVID-19 by first protecting health care workers, people who are at the highest risk of being hospitalized or dying, and those at high risk of exposure to COVID-19.”

But the state’s decision doesn’t match with its generally good track record on homeless issues, said Trisha Ecklund, vulnerable population program coordinator at Blue Ridge Health Services in Hendersonville, North Carolina.

“They have made a lot of great decisions for the homeless, especially during the pandemic,” she said. “That’s why it’s so disappointing.”

Health and housing officials in Denver also don’t understand why Colorado moved people experiencing homelessness down the priority list. 

“It makes no sense that they would not be included early on,” said Bob McDonald, executive director of Denver’s Department of Public Health and Environment. “You can make an argument that it is very much like assisted living situations.”

Denver Mayor Michael Hancock has asked Gov. Jared Polis, a fellow Democrat, for more discretion in vaccine distribution to allow the city to inoculate people experiencing homelessness. 

But during a news conference earlier this month, Polis said that “it would cost lives to divert vaccine from people that are in their 70s to younger, healthier people just because they happen to be homeless.” Polis’ office did not respond to Stateline’s requests for comment.

In the meantime, Denver officials are sending teams to shelters to vaccinate homeless people age 65 and older—even though it’s inefficient, McDonald said, as they turn younger people away. 

About 4,200 people are experiencing homelessness in the city and county of Denver, according to a 2020 survey from the Metro Denver Homeless Initiative, an organization that coordinates services and housing for people experiencing homelessness.

“It’s not that many people,” said Britta Fisher, executive director of Denver’s Department of Housing Stability. 

Yet homeless people have been hospitalized at three times the rate of others who have tested positive for COVID-19, she said. “When you look at the numbers, it’s pretty compelling.

“We understand that it is very difficult to make decisions, as there is not enough vaccine,” Fisher said. “We are also persistent in our values around equity.”

Facing Vaccine Hesitancy

Even in places where the vaccine has been made available to homeless people of all ages, medical teams face logistical hurdles.

“It’s been a massive endeavor,” said Dr. Denise De Las Nueces, medical director for Boston Health Care for the Homeless, which provides health care to homeless people. Massachusetts included homeless shelters in the first round of its vaccine distribution. 

De Las Nueces’ team is working with about 40 shelters and as of early last week had vaccinated 1,076 people, or about 50% of eligible adults in shelters.

But many are hesitant to get the vaccine, she noted. During the first clinic in late January, the team vaccinated only about 90 people at a shelter with twice as many residents. De Las Nueces is hopeful the trend is changing with time: At one of their first clinics for second doses, a few dozen came looking for a first shot.

“There is still work to be done in terms of particularly supporting communities of color who are experiencing homelessness,” she said. “That’s not wholly unexpected, of course, because of all of the historical injustices, particularly against African American or Black communities in America.”

Her team is beginning a COVID-19 peer ambassador program for homeless people to encourage others to get vaccinated.

In Washington, D.C., city health officials are trying to overcome vaccine hesitancy by holding presentations at homeless shelters a few days before bringing vaccines. At these sessions, health experts answer questions and share stories like that of Dr. Kizzmekia Corbett, an African American scientist who helped develop the Moderna vaccine. 

“Compounding the need to offer the vaccine was the need to recognize the history of exploitation that some of these folks would have experienced … regarding vaccines or medical environments,” said Dr. Anne Cardile of Unity Health Care, which is working with Washington, D.C.’s Department of Health and Human Services to distribute the vaccine to those experiencing homelessness.

By last week, over 1,000 people in D.C. shelters had been vaccinated, Cardile said. Each person was offered a waterproof wallet to hold their vaccine record card. The district is starting a round of second shots this week.

“It is deeply powerful to watch the investment in making sure that they are the first, or among the first, to get the vaccine,” Cardile said.

North Carolina advocates have seen the same hesitancy, said Helen Mangum, who previously experienced homelessness and is a board member of Durham’s Families Moving Forward.

“Of course, there’s the lack of trust in our community,” she said of Black and low-income people. “Are you really surprised by that when you’ve been treating us this way?”

But not being a priority on the vaccine list feels like another hit, Mangum said. “The coronavirus vaccine is another message to us that ‘We’ll get to you. You’re not that important.’”

Still, Mangum, who is in her 50s, plans to get the vaccine when she can.

Stateline, an initiative of The Pew Charitable Trusts.