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Speaker 1: Welcome to Prognosis. I'm Laura Carlson. It's day one hundred

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Speaker 1: and six since coronavirus was declared a global pandemic. Our

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Speaker 1: main story the city of Houston is staring down the

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Speaker 1: barrel of an exponential increasing cases over the next few weeks,

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Speaker 1: and its hospital system is on the verge of being overwhelmed.

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Speaker 1: But first, here's what happened in virus news today. In

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Speaker 1: the United States, the pandemic is tearing through the heartland.

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Speaker 1: The U saw one of its highest ever increases in

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Speaker 1: cases yesterday, more than thirty four thousand, five hundred new infections,

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Speaker 1: close to the peak in April. New modeling predicts the

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Speaker 1: virus will kill a hundred and eighty thousand Americans by October.

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Speaker 1: It's causing some states that were previously lays a fair

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Speaker 1: about IRIS restrictions to take more stringent measures like face

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Speaker 1: mask orders and internal quarantines. The virus is now ravaging

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Speaker 1: some states that hadn't been hit as hard in previous months,

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Speaker 1: states that were slow to enforce lockdowns or quick to

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Speaker 1: lift them. One of those states is Texas. Cases and

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Speaker 1: hospitalizations there are surging as a result. Texas Governor Greg

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Speaker 1: Abbott announced and in an executive order today that it

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Speaker 1: was putting the brakes on its phase reopening. While businesses

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Speaker 1: that were already permitted to open can stay open, the

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Speaker 1: next phases of reopening have been put on hold. The

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Speaker 1: situation is most dire in Houston, where some experts expect

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Speaker 1: the virus outbreak to swamp the city's medical infrastructure by

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Speaker 1: July four, and Houston is the subject of our main

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Speaker 1: story today. Bloomberg reporters and the Court and Joe Carroll

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Speaker 1: report that if cases keep rising at their current pace

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Speaker 1: in Harris County, which includes Houston, they will triple or

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Speaker 1: quadruple by mid July. I spoke with Emma and Joe

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Speaker 1: today about how the city's hospital system expects to manage

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Speaker 1: the crisis. How did we get to Texas being the

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Speaker 1: new hot spot of COVID? You know, Texas shut down.

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Speaker 1: The governor was reluctant to shut anything down back in

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Speaker 1: back in March and April, as we saw COVID erupting

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Speaker 1: in places like New York and Chicago. Eventually did did

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Speaker 1: did order a lockdown of sorts um you know, and

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Speaker 1: it seemed like it was it was working. The case

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Speaker 1: load stayed low, relative to what were hot spots at

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Speaker 1: that time. Hospitals were fine. And after after a few

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Speaker 1: weeks so they reopened surgeries to you know, reopened doctor's

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Speaker 1: offices and and and then at the beginning of May

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Speaker 1: just began reopening the entire state. It was phased, you know,

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Speaker 1: you know, if you were owned a restaurant, maybe you

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Speaker 1: could go to your occupancy. You know, it wasn't a

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Speaker 1: full on reopening, but but the numbers stayed low and

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Speaker 1: and things really didn't sort of explode here until right

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Speaker 1: around Memorial Day, late May, the cases started to really

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Speaker 1: take off positivity rate with through the roof, and that

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Speaker 1: has continued and we we get to where we are now.

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Speaker 1: We're in the Houston area. Anyways, the intensive care units

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Speaker 1: are all used up. They're going to have to convert

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Speaker 1: some other beds over to to make some space, and

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Speaker 1: the projections are of the case load world, we'll just

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Speaker 1: continue higher. You know, what has been the response of

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Speaker 1: of health workers, of physicians, of hospital workers to this development.

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Speaker 1: We've heard a lot of understandably concerned from medical providers, um,

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Speaker 1: you know, saying we don't really know what the coming

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Speaker 1: days and weeks will bring, and you know, in particular

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Speaker 1: for them, you know, as for I think everyone. You know,

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Speaker 1: the example of New York City and what happened to

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Speaker 1: our hospitals. You know, that example really looms large and

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Speaker 1: cast kind of a dark cloud over you know, medical

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Speaker 1: providers all around the country. You know, they don't want

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Speaker 1: to see the same thing happening in their own emergency departments,

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Speaker 1: in their intensive care units. And and yet you know,

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Speaker 1: as these intensive care unit beds fell up, hospitals can

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Speaker 1: of course expand their capacity, right um, But the concern

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Speaker 1: here is really you know, once you start exceeding those

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Speaker 1: traditional I see you beds, you know how much further

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Speaker 1: can you expand capacity? Right? So I spoke with the

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Speaker 1: head of the Texas Medical Center, which you know describes

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Speaker 1: itself as the largest medical city in the world. It's

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Speaker 1: based in Houston, and Bill McKeon said to me, do

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Speaker 1: we think that we can care for those patients and

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Speaker 1: provide them a bed and provide them and do we

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Speaker 1: have the proper amount of personal protection equipment? Do we

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Speaker 1: have the proper amount of ventilators? Yes? On all accounts,

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Speaker 1: So in that sense we feel but remember, capacity is

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Speaker 1: like a giant bathtub that at sooner or later if

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Speaker 1: water goes unchecked and the faucets are filling, then at

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Speaker 1: some point any place, even the biggest medical city in

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Speaker 1: the world, will overflow. And Joe, you know, what is

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Speaker 1: the the sense on the ground in Texas? Are people

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Speaker 1: wearing masks? Are people getting a sense that, you know,

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Speaker 1: this pandemic is not over yet? What what is the

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Speaker 1: feeling in say Houston? For many weeks there was a

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Speaker 1: sort of an undercurrent that a lot of the precautions

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Speaker 1: that have been taken, we're overkilled, that masks were silly,

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Speaker 1: um and and and there's also there is a deep

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Speaker 1: strain of of you know, this this las fair approach

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Speaker 1: where the government doesn't get to tell me what to do.

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Speaker 1: That's very, very ingrained here, even in the metropolitan areas.

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Speaker 1: Over the last couple of days, that has taken quite

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Speaker 1: a hit because the numbers coming out of the medical

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Speaker 1: center in other places of and so alarming. There seems

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Speaker 1: to be a little more acceptance there. There's there's a

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Speaker 1: lot of fear when you when you know, when you

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Speaker 1: hear that that the all the I c U ben

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Speaker 1: are are taken up, or most of them are taken up.

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Speaker 1: I mean it frightens people, and so the community is

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Speaker 1: pretty divided. There are still folks who saying, look, mask

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Speaker 1: won't help, you know, who sort of sneer at the

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Speaker 1: formal recommendations, and then of course their neighbors are angry

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Speaker 1: with them because they'd really like to see you wearing

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Speaker 1: a mask. This morning, the governor surprised everybody when he

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Speaker 1: came out and he said, the reopening is on hold.

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Speaker 1: You know, it had been set to be a phase reopening,

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Speaker 1: and so we're you know, depending on the line of

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Speaker 1: business you were in, you were open to maybe fifty capacity,

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Speaker 1: you're uh, and then on a certain date in the

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Speaker 1: next few weeks you were going to be allowed to

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Speaker 1: go to seventy some to that. So he froze all

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Speaker 1: of that, which nobody saw coming. Is there any sense

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Speaker 1: from from the medical community that perhaps with the new

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Speaker 1: drugs and the new therapies that have started to become available,

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Speaker 1: like from desevere and whatnot, that even though there is

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Speaker 1: a high or case count, that perhaps you know, the

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Speaker 1: death rate will not correspondingly rise as well in safe

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Speaker 1: places like Texas if you think about it, like in

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Speaker 1: the start of this pandemic, we were talking a lot

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Speaker 1: about building, you know, creating more ventilators. You know, we're

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Speaker 1: still kind of talking about, you know, producing more testing supplies,

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Speaker 1: things like that. So we've had some time to prepare,

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Speaker 1: and a lot of the hospitals I spoke to in

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Speaker 1: Texas as well as in Arizona, where there's also you know,

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Speaker 1: a rising hospitalizations, have said we are better prepared than

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Speaker 1: we were before. We have personal protective equipment, Whereas at

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Speaker 1: the start of this pandemic, I mean, there were some

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Speaker 1: really horrifying reports coming out about what, you know, frontline

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Speaker 1: medical providers were wearing to go to work at this

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Speaker 1: with this really highly infectious disease on the loose. But

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Speaker 1: you know, across the board, preparation is better. But I

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Speaker 1: think what's important to note, and I spoke with a

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Speaker 1: really wonderful doctor and professor in New York UM who said,

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Speaker 1: you know, there's a lot of things you can do

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Speaker 1: to prepare UM now that we have all this information

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Speaker 1: about the virus, but until you're in it, it can

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Speaker 1: be hard to know if you're really prepared. And I

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Speaker 1: think we've heard that also from you know, hospitals in

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Speaker 1: Texas and Arizona saying we think we're prepared, but reasonably,

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Speaker 1: there's only so much stuff we have, right There's a

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Speaker 1: limit to how many doctors we have. You can't stockpile

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Speaker 1: respiratory therapists the way you can, you know, mask, So

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Speaker 1: this is just something to keep in mind. You know,

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Speaker 1: there we have a lot of medical infrastructure in this country,

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Speaker 1: and we have the ability to to bring in volunteers

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Speaker 1: or even travel providers from other parts of the country,

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Speaker 1: but there are going to be some serious limits. And

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Speaker 1: I think it's worth pointing out that in some of

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Speaker 1: the parts of the country where we're seeing these cases

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Speaker 1: take off, it's also extremely hot outside. I'm not a

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Speaker 1: field hospital expert, but I think what we did in

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Speaker 1: New York when putting a field hospital in Central Park

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Speaker 1: kind of most iconically. I don't know how feasible that's

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Speaker 1: going to be in other parts of the country where

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Speaker 1: it's just so hot outside. What are either some lessons

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Speaker 1: perhaps Texas can take from some of the former hotspots

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Speaker 1: like New York in kind of charting a path forward,

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Speaker 1: or alternatively, what are some new factors that people are

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Speaker 1: going to have to take into account, like the heat

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Speaker 1: in Texas in the summer that is going to necessarily

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Speaker 1: mean a new roadmap that people are going to have

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Speaker 1: to start writing a new guide book of how to

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Speaker 1: deal with a COVID outbreak In a state like Texas,

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Speaker 1: the heat has been a real challenge and and and

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Speaker 1: there's there's no blueprint for for how to deal with it.

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Speaker 1: I mean, it's it's it's in the nineties fahrenheit here

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Speaker 1: every day now, it's especially in South Texas, and it's

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Speaker 1: extremely humid, and that strives everybody indoors. Everybody's got an

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Speaker 1: air conditioning running. And the question, the unanswered question, is

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Speaker 1: that actually contributing to the to the sort of the

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Speaker 1: bloom and cases we're seeing because indoors it's transmitted more

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Speaker 1: easily and you just don't stay outside all afternoon like

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Speaker 1: like you might if you were, you know, in Chicago

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Speaker 1: or Detroit or someplace. And it's sort of counterintuitive because

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Speaker 1: when you think about a quarantine, certainly don't think about

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Speaker 1: you need to get outside in the sunshine. Um when

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Speaker 1: they set up a field hospital here, they did set

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Speaker 1: up one for Harris County. That's the third wild third

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Speaker 1: largest county in the in the country, and it's where

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Speaker 1: Houston is. It was at a at the pro football

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Speaker 1: stadium turned out not to need it because we just

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Speaker 1: didn't have the caseload then. So we spoke with county

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Speaker 1: officials yesterday and they are getting ready to re establish

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Speaker 1: it within forty eight hours when they see sort of

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Speaker 1: the overflow. I see you beds that we talked about,

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Speaker 1: If they'll start to fill up, then they're gonna they're

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Speaker 1: gonna go open this field house and it is it

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Speaker 1: is air conditioned. You said you could not do it

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Speaker 1: outside and at this climate. Something we're also hearing out

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Speaker 1: of Texas has been this tendency towards you know, the

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Speaker 1: cases that are new are a lot in younger age groups.

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Speaker 1: Are young people inadvertently spreading the virus in the community,

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Speaker 1: you know, thinking that they're young and healthy, not taking

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Speaker 1: precautions because they don't think that they're at risk. Folks

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Speaker 1: were starved of of of of a social life for

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Speaker 1: more than a month, and so when when clubs and

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Speaker 1: taverns and restaurants started to reopen, especially here in Houston,

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Speaker 1: in places like Austin, Dallas, uh, young people predictably flocked

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Speaker 1: to them. The medical authorities do think that played a

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Speaker 1: big role in our surge here as much as the

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Speaker 1: younger folks aren't tend not to be fragile. They're also

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Speaker 1: really hard to scare. And so you could talk about

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Speaker 1: this virus being out there and there there is a

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Speaker 1: certain segment of community that thinks, well, that's you know,

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Speaker 1: I get the flu every year and I'm not I'm

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Speaker 1: not eighty years old. I don't need to worry about it.

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Speaker 1: And so it seems that the folks trying to trying

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Speaker 1: to convince everybody to mask up have a challenge on

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Speaker 1: their hands. I mean, what would you say, is is

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Speaker 1: something that can be done or should be done on

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Speaker 1: the ground in these states right now? I think going

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Speaker 1: forward in the in the next two weeks, maybe three weeks,

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Speaker 1: what we that will determine the path States like Texas

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Speaker 1: take what they're gonna watch. You know, we are seeing

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Speaker 1: the sort of expected rise in in case in caseloads,

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Speaker 1: you know, due to so many weeks after after the

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Speaker 1: state reopened. Question is is COVID nineteen is lethal this

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Speaker 1: time around, as say it was when it when it

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Speaker 1: ravaged New York. We don't know that it's not yet.

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Speaker 1: We're not seeing those kind of fatality numbers, and I

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Speaker 1: really think that will drive what what the politicians do

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Speaker 1: if we see that sort of tragedy, I think that

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Speaker 1: they will rethink how how hard they want to go

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Speaker 1: on businesses and on residents. Frankly, with the next when

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Speaker 1: we have our next pandemic, if it is not as lethal,

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Speaker 1: I I don't think there'll be the political will to

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Speaker 1: change things. That was Ema Court in New York and

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Speaker 1: Joe Carroll in Texas, And that's our show today. For

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Speaker 1: coverage of the outbreak from one and twenty bureaus around

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Speaker 1: the world, visit Bloomberg dot com slash Coronavirus and if

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Speaker 1: you like the show, please leave us a review and

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Speaker 1: a rating on Apple Podcasts or Spotify. It's the best

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Speaker 1: way to help more listeners find our global reporting. The

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Speaker 1: Prognosis Daily edition is produced by Topher foreheads Jordan Gaspore,

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Speaker 1: Magnus Hendrickson and me Laura Carlson. Today's main story was

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Speaker 1: recorded by Emma Cort and Joe Carroll. Original music by

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Speaker 1: Leo Sidron. Our editors are Rick Shine and Francesca Levi.

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Speaker 1: Francesco Levi is Bloomberg's head of Podcasts. Thanks for listening.