Last week, Texans had to endure two crises at once: the ongoing COVID-19 pandemic and the devastating impact of a severe winter storm that paralyzed the state’s power grid. Indoor social visits may have been inadvisable for the past year, but taking in friends, family, and neighbors who lost power and heat amid subfreezing temperatures became necessary. At the same time, the challenge of distributing vaccines in hopes of at last bringing the pandemic under control was greatly disrupted.
In North Texas, the storm resulted in the cancellation of nearly 200,000 appointments at vaccination sites such as the hub in Dallas’s Fair Park, which had to shut down because of the weather. Harris County couldn’t operate its vaccination sites from Monday through Thursday of last week, and had to rush to deliver 8,400 doses that were at risk of spoilage—to institutions including hospitals, Rice University, and the Harris County Jail. In Travis County, Austin Public Health halted vaccinations the Saturday before the Presidents Day storm that dumped several inches of snow and ice.
Public health officials are attempting to make up for the lost time, but they remain limited by the vaccine supply on hand. Additional doses that were supposed to arrive last week couldn’t because of the winter freeze and the widespread electrical outages. The result is that Texas—in the middle of the pack early on—now lags far behind most other states in terms of the percentage of its population to receive an initial dose of the Pfizer or Moderna vaccines, ahead of just Tennessee and Utah. (The state fares slightly better in the percentage fully vaccinated.)
COVID-19 numbers in Texas had generally been trending in a positive direction in the weeks leading up to the storm. The number of new hospitalizations seems to indicate that the situation continues to improve—but how the storm’s disruption to both personal behaviors and vaccinations will affect the pandemic is an open question. To get a better understanding of the potential fallout, Texas Monthly spoke with Baylor College of Medicine infectious disease expert Dr. Peter Hotez, who explained what he’s worried about—and what signs of hope he’s looking for.
Texas Monthly: What are your concerns about the vaccine rollout in Texas, after the week we’ve just had?
Dr. Peter Hotez: Well, it set us back a week at a point when you don’t want to lose time. We don’t know where this epidemic is heading in the U.S. On the one hand, you’re seeing the steep decline nationally. And if you look at the numbers in Texas, it’s looking really good. On the other hand, you’ve got the [more contagious] U.K. variant now responsible for 10, 15 percent of the cases in Florida and in Southern California, and you worry that the next big wave is coming. The big question everyone wants to know is whether it’s going to be like the situation in the U.K., where it went from being a rare variant to becoming the dominant strain in matter of months. Or is there something else seasonal going on, where it won’t be that big a role? A number of us are concerned enough about the U.K. variant that we’ve called for the Biden administration to accelerate its vaccination program. You know, the business of saying we’ll fully vaccinate the American people by the fall was a good idea in the beginning. But now, with the U.K. variant rising, we’ve got to accelerate that. So losing a week is not good.
TM: Are you concerned that the weather had so many people sheltering in place, sometimes in public warming centers, or in their homes with neighbors and friends in need? Will that have an impact on the spread of the disease in Texas?
PH: It could, but it could also work the other way as well. With all the businesses shut down, and all the stores and restaurants shut down, people stayed at home and didn’t go to bars and restaurants and things. So maybe the two will cancel each other out. It’s hard to know, but there’s no question that losing a week of vaccination put us at the bottom of state vaccination rates. Alaska is at 21 percent, New Mexico’s at 20 percent, and then you get down to Texas and we’re still at 11 percent. So we’re ranked with Georgia, Utah, and Tennessee at the bottom of states. And it’s the consequence of that week lost. We haven’t moved the needle at all in the last week.
TM: How hard is it to make up what we’ve lost?
PH: The questions are what happens to the supply we didn’t get last week? Is it use it or lose it? Do we now not get that supply back, or will we get double the amount? Will we expand operating hours? That I don’t know.
TM: If the supply evens out, are there logistical reasons why we wouldn’t be able to accelerate vaccinations to make up some of the lost time?
PH: The only logistical holdup would be if you didn’t have the personnel and staff to do it, or didn’t have all the hubs in place that you need. With FEMA opening up the NRG Center and doing a couple of these big hubs in Dallas [at AT&T Stadium and Fair Park], that will help.
TM: What are the implications of being set back by this storm? Is it more than just freezing everything at the same point where we were a week ago?
PH: Yes. If the variants are really going to loom large, then that’s a problem. This is more than just a delay—it’s a delay in the face of an advancing enemy. If the enemy were staying in place and you lost the week, then you lost the week. But if the enemy is advancing on you and you lost a week, the consequences are far greater.
TM: How serious is it that our reporting and testing capacity was also basically shut down for a week?
PH: I mean, none of this is good, right? Hopefully we will recover and get back on track and sort of accelerate the process now, make up for lost time.
TM: Right now the focus in parts of the state is making up appointments for people who had previously scheduled the first dose, then scheduling second doses for those who are ready for them, before adding new appointments. Is that how you would try to get back on track?
PH: Yeah, we need to do both first and second doses. We’re getting more first doses of the vaccine done, which is important. But it’s important to get to complete the vaccination series as well. We don’t know how good a single dose of the vaccine is against the U.K. variant. That’s an unknown. These are some data that we have to collect. Mike Osterholm from [the University of Minnesota’s] Center for Infectious Disease Research and Policy is putting out a white paper on this—it may already be out there—where he’s going to push hard for just getting as many people as possible the first dose. I understand his arguments, but have mixed feelings about it at this point, given that there’s still a lot of unknowns.
TM: If Texans were feeling optimistic about vaccinations expanding and the situation improving before the storm hit, how should they feel now?
PH: It is a setback. There’s no doubt about it. How quickly we can recover and redouble our efforts is going to be really telling. I don’t know what the plan is at this point, but I do know that we rank at the bottom now of percentage of our population vaccinated, and that is not a good thing. It’s not good for the country, given how large our state is.
TM: What should Texans be looking for, if they want to see if the situation is recovering from the setbacks of the past week?
PH: Availability of vaccines and vaccination hubs and knowing that you’re on a list and being prioritized, I think that’s going to make a big difference. And seeing the number of cases continue to go down and hospitalizations go down, and looking out for that variant, and making certain that we know there’s an alarm that triggers if the U.K. variant is here in a big way. Hopefully we can redouble our efforts, but it is a setback.
This interview has been edited for length and clarity.