A second county in the Rio Grande Valley has issued an unenforceable stay-at-home order to reduce transmission of the coronavirus. Its one overwhelmed hospital will implement a triage system to determine which patients to treat and whom to reject.
Planetizen readers may recall the recent warning made by public health expert, William Haseltine, about Arizona activating the "Crisis Standards of Care" in late June to deal with the onslaught of COVID-19 patients at some hospitals in the state. The standards provide hospitals a framework for deciding who to treat and who to turn away.
"It means that if you're old, you get sent home without care, and you die..., Haseltine, chair and president of ACCESS Health International and a former Harvard Medical School and Harvard School of Public Health professor, told CNN on July 8. "We are on the brink of not treating people. There's a whole equation they are going to put into effect which says, "Are you worth treating or not?"
As he predicted, it would appear that another state, Texas, will soon activate the crisis standards of care to allow the one rural hospital that serves Starr County to refuse COVID-19 patients in order to preserve resources for those that show the best chance of survival.
"Unfortunately, Starr County Memorial Hospital has limited resources and our doctors are going to have to decide who receives treatment, and who is sent home to die by their loved ones," Starr County Judge Eloy Vera wrote on the county's Facebook page on Thursday morning, reports Li Cohen for CBS News on J
"The reality is that science and statistics are against those people with multiple medical conditions," he said. "We have to start making a triage evaluation and realizing who has a better chance. For all of those patients who most certainly do not have any hope of improving, we believe that they are going to be better taken care of within their own family in the love of their own home, rather than thousands of miles away dying alone in a hospital room."
Vasquez told The Monitor on July 19 that the ethics committees, to include "a patient’s primary care physician, the emergency room doctor or the hospital doctor taking care of the patient, a social worker, and one of the hospital administrators... are expected to be set by end-of-day Monday."
The agenda [pdf] for the Starr County Hospital District's meeting on July 23 included, "Adoption of North Texas Mass Critical Care Guidelines."
“We have a very difficult situation here,” Dr. Vazquez told Texas Standard host David Brown on July 21. “We do not have specialty services, we are just […] a rural health hospital.”
The COVID unit only has 49 beds, but the nearest facility with a higher level of care is about 45 miles away in McAllen, Texas.
McAllen is the largest city in neighboring Hidalgo County. On July 22, the county's shelter-at-home order took effect to suppress community spread of the virus, the first time in the pandemic a county has issued a second such order. However, the order is unenforceable under Gov. Greg Abbott's current statewide orders.
Starr County became the second county to re-issue it's stay-at-home order on July 23 despite being unenforceable with the exception of the mask mandate due to the statewide mandate on facial coverings.
Like Hidalgo County, Starr is also overwhelmingly Latino. "According to the Census Bureau, Starr County had the highest percentage of Hispanic residents of any county in the United States, and the lowest percentage of non-Hispanic white residents," per Wikipedia.
Reopening blamed
"Vasquez said that when the pandemic began, the county was able to keep the situation under control," adds Cohen. "But after the state started to reopen, Vasquez said, cases increased 'in an exponential and alarming way.'"
As if the pandemic wasn't enough, both Hldalgo and Starr counties lie in the path of the Atlantic's first hurricane, Hanna, which made landfall just south of Corpus Christi, Texas, on Padre Island on Saturday night.
Additional reading:
- National Geographic: "Who gets to live? How doctors make impossible decisions as COVID-19 surges," July 24, 2020
- Fort Worth-Star Telegram: "COVID-19 patients will be ‘sent home to die’ if deemed too sick, Texas county says," July 23, 2020
- The Guardian: "Texas border county had 'model' Covid-19 response – then the governor stepped in," July 10, 2020
Related in Planetizen:
- Texas County First in Nation to Issue Second Stay-at-Home Order, July 23, 2020
- COVID Crisis Triggers Unprecedented Medical Measure in Arizona, July 9, 2020
- Texas Hits Pause as Hospital Beds Fill Up, June 26, 2020
FULL STORY: A Texas county's only hospital forced to choose "who is sent home to die" as ICU beds near capacity
The Pandemic's Most Critical Health Metric Just Shut Down Most of California
Gov. Gavin Newsom, who issued the nation's first stay-at-home order to mitigate the spread of the coronavirus, issued a new order to prevent hospitals in the nation's most populous state from being overwhelmed with COVID patients.
'We are Entering the Steep Slope of the Epidemic Curve'
Dr. Scott Gottlieb, President Trump's former Food and Drug Administration commissioner, warned CBS viewers recently that the U.S. was at a "dangerous tipping point" in the pandemic. "We are on the cusp of exponential growth," he added later.
Texas County First in Nation to Issue Second Stay-at-Home Order
The first shelter-at-home order issued in the pandemic's resurgence in the U.S. took effect Wednesday morning in the Rio Grande Valley in South Texas, an overwhelmingly Latino region that has been disproportionately affected by the coronavirus.
Analysis: Cybertruck Fatality Rate Far Exceeds That of Ford Pinto
The Tesla Cybertruck was recalled seven times last year.
National Parks Layoffs Will Cause Communities to Lose Billions
Thousands of essential park workers were laid off this week, just before the busy spring break season.
Retro-silient?: America’s First “Eco-burb,” The Woodlands Turns 50
A master-planned community north of Houston offers lessons on green infrastructure and resilient design, but falls short of its founder’s lofty affordability and walkability goals.
Test News Post 1
This is a summary
Analysis: Cybertruck Fatality Rate Far Exceeds That of Ford Pinto
The Tesla Cybertruck was recalled seven times last year.
Test News Headline 46
Test for the image on the front page.
Urban Design for Planners 1: Software Tools
This six-course series explores essential urban design concepts using open source software and equips planners with the tools they need to participate fully in the urban design process.
Planning for Universal Design
Learn the tools for implementing Universal Design in planning regulations.
EMC Planning Group, Inc.
Planetizen
Planetizen
Mpact (formerly Rail~Volution)
Great Falls Development Authority, Inc.
HUDs Office of Policy Development and Research
NYU Wagner Graduate School of Public Service