Austin Mayor Steve Adler said Tuesday he wished the state had given cities and counties more time to get to a better place with testing, tracking and personal protective supplies before rolling back stay-at-home mandates meant to curb the coronavirus pandemic.

But with Gov. Greg Abbott’s action Monday, Adler said local leaders must look to the future and prepare for the worst.

"No one knows what is going to be the result on the virus spiking or peak of what’s happened," Adler said. "We know that it’s going to increase, it has to by definition because interactions are increasing. We don’t know whether that’s going to put us in a position of a New York-like spike or not."

As statewide rules to reopen businesses go into effect later this week, Austin leaders are emphasizing a need to protect vulnerable populations from increased human contact ahead of an anticipated spike in cases that could overwhelm local hospitals by mid-summer.

The latest models from the University of Texas show such a spike could result in up to 6,500 deaths in the greater Austin area without a return to isolation orders as cases begin to mount, and efforts to isolated the most vulnerable fall short.

Adler said he’s particularly concerned about the time it will take to see the result of the new changes on the ground. He said local leaders won’t know the real effect from Abbott’s orders for about four weeks, based upon previous data collection and experience.

"What we’re seeing today in terms of new cases is the result of the policies that we had in place two weeks ago. In two weeks when the governor and all of us look at what we’re seeing happening, it’s going to be a result of what we’re doing today, not what we’re doing over the next two (weeks)," Adler said.

Interim Austin-Travis County Health Authority Dr. Mark Escott said an added concern is many who will be called back to work as businesses reopen will be members of vulnerable populations, including low-wage earners with large numbers of personal contacts, such as cashiers, clerks and anyone else with a public-facing role.

"Their employers have to provide them protection. If they can't provide it right now, they should not be opening their doors," Escott said.

Adler said regardless of the governor’s orders, the community still has the ability to set its own norms and expectations.

"There are a lot of behaviors that I think, culturally and in our city, we expect of one another. And I think we should consider establishing, still, those guidances and those norms of our city and then (recognize) businesses or places that are living to our community standards," he said.

Adler floated the idea of the city creating signs that businesses can use to inform customers which businesses are going beyond the governor’s orders to meet the city expectations, and which aren’t.

Researchers from the University of Texas estimate the greater Austin area’s social distancing efforts yielded a 94% reduction in the transmission of the coronavirus through April 19, though uncertainty in the figure remains high. Models showed researchers believe about 13.6% of symptomatic cases are detected.

Adler said at the beginning of shelter-in-place orders, city leaders thought the Austin area could get to about a 75% reduction. But as the new state rules go into effect, that number is expected to drop considerably.

UT researcher Lauren Ancel Meyers presented several models outlining potential outcomes of relaxing social distancing orders. Should the city indefinitely relax the orders while still successfully isolating the most vulnerable, estimates show they could see 2,900 local deaths. But other models show local deaths could hit 6,500 through September 2021.

The final number, she said, will depend on what actions local leaders take to implement social distancing protocols as cases spike, and efforts to isolate the most vulnerable populations, known as cocooning, including those in nursing homes and people who are homeless.

Meyers presented best and worst case scenarios, the first of which was based off firm shelter-in-place orders lasting a total of 555 days, through September 2021. Under that model, hospitalizations would have already peaked in Travis County, and the total number of deaths would top out at around 80. That would also require schools to remain closed through the same time frame.

On the opposite end of the spectrum, an indefinite relaxation of shelter-in-place orders would result in a spike in cases that overwhelms the area’s hospitals in the mid-summer, roughly from July through mid-September. That model would result in an estimated 2,900 deaths, most of which would happen by the end of the year, with schools reopening in the fall as scheduled. That model also assumes transmission is reduced by around 40% through increased testing, contact tracing and isolation, and that local officials’ efforts to cocoon vulnerable populations are 95% effective. If those efforts drop to 80%, the death toll is expected to rise dramatically.

Both models consider the city and county reintroduce social distancing orders as the number of confirmed cases and hospitalizations reaches a particular threshold to trigger a new temporary lockdown.

"There are no easy choices with this virus. The hard truth is we need a vaccine or an effective treatment and nothing short of that will save us from having to make choices that we don’t like," Adler said in a message to council members Monday. "We are going to be taking risks. We will be transparent and honest with our community about the science, and those choices and risks."

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