Updated: May 15, 2020
As you know, Governor Abbott's plan to reopen Texas began yesterday. He has ordered certain businesses to be able to open at 25% capacity, including restaurants, movie theaters, retail stores, and malls. A detailed report of the plan to reopen Texas is available here: https://gov.texas.gov/uploads/files/organization/opentexas/OpenTexas-Report.pdf
The best data I have seen for our local case load comes from the Texas Medical Center. This data is based on a collection of data from all the hospital systems throughout Greater Houston. Last week, we were started to see an overall decline in new daily cases, which was reassuring. The case load however has increased over the last few days. I expect that this may continue to rise as the re-opening plan begins. TMC data is available here: https://www.tmc.edu/coronavirus-updates/
A key aspect of Governor Abbott's plan is to continue to expand testing capabilities as well as the ability to trace contacts of positive cases so that they can self-quarantine and limit spread. This is vitally important to limiting the spread of disease while allowing most people to return to whatever will be our "new normal." Contact tracing has been a key aspect of controlling the pandemic in those countries that were able to do so earlier on, such as South Korea and New Zealand. However, our ability to trace contacts currently is still limited. According to the plan I linked above, the full force is planned to be initiated by May 11. It is therefore my professional opinion and recommendation to maintain distancing procedures as follows until this is fully in place:
1. Continue to avoid unnecessary trips into public places.
2. Continue to avoid gatherings with friends and family who do not live with you, especially in close quarters, and especially in groups of over 10 people. If you are choosing to expand your contacts to those outside of your home, I recommend that you limit this to only a few people who are only otherwise interacting with you.
3. Maintain at least 6ft of distance from others. Know that a 6ft distance does not 100% prevent spread, it only decreases it.
4. Continue to work remotely whenever possible.
5. If you must be out in public or are unable to perform your job remotely, please wear a face covering and insist that those around you do the same. You wearing a mask protects others, others wearing a mask protects you.
6. If you are of a vulnerable population (elderly, pregnancy, serious underlying health conditions including high blood pressure, chronic lung disease, diabetes, obesity, asthma, and those whose immune system is compromised such as by chemotherapy for cancer and other conditions requiring such therapy)- please avoid going out in public as much as possible. If you can, have a friend or relative deliver groceries to you.
Regarding testing: Antibody testing is still not reliable enough for widespread screening use. It may be useful in specific clinical situations, but the antibody test alone is not enough to give a diagnosis, and we certainly do not have evidence that the presence of antibodies on a test means that you are immune to the novel coronavirus. If someone is offering antibody testing to you for screening and is charging you money for it, I would be very suspicious, and I would also be sure that they explain to you the limitations of the test. LabCorp and Quest now have their antibody tests available, but I have not seen data that indicates the usefulness of ordering this at this time. The IDSA (Infectious Disease Society of America) is currently preparing guidelines for the use of this testing, I anticipate that they will release these early next week. I hope that this will provide additional information for me about when antibody testing may be useful. Once I have that information, I will be able to order testing for patients in an appropriate clinical situation through either LabCorp or Quest.
If you are having any respiratory symptoms and would like to be tested for COVID-19, this Texas government website provides links for a symptom checker and a map of testing sites performing the nasopharyngeal/oropharyngeal swab: https://texas.gov/covid19/ As I have mentioned previously, the test has approximately 70% sensitivity, so if you have symptoms you should behave as though you have the virus even if the test is negative. If you have any doubt about whether you should be tested or when you can loosen restrictions, please feel free to contact me directly.