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COVID update July 31, 2020

There is risk in appearing insensitive by providing you the information below. I understand and accept this risk. Please know that I care about and am concerned about the health, well-being, and safety of each of you reading this email. Thank you in advance for understanding. Please direct any objective, evidence-based responses to our office, I read and consider all of them. Thank you. 


Over the course of the last several weeks, we have been informed by news media outlets that COVID hospitals (especially in the Houston area) have been overwhelmed.  The ER’s have been overwhelmed, ICU’s have been overwhelmed, and morgues have been overwhelmed. According to NBC, “the region’s 12 busiest hospitals are increasingly telling emergency responders that they cannot safely accept new patients, at a rate nearly three times that of a year ago, according to data reviewed by reporters”. We have been told that the current COVID situation is raging out of control, a crisis that could have been controlled had Texas not “opened up too fast”. If only we had stayed shut down.


Unfortunately, none of the above statements can be validated.  


I have discussed previously about how the narrative of Texas opening too early was unsubstantiated. With COVID cases growing in 28 states, it’s hard to keep thinking that Texas “opened too soon”, especially when the vast sum of the new findings have occurred along the border with Mexico, which is experiencing a recent acceleration in  COVID cases.  With actively increasing COVID infections in California, Maryland, and Illinois, does this mean they opened “too soon” too? 


What about Belgium, Spain, France, and Netherlands, each one a European country that “locked down”, yet now experiencing recent acceleration in COVID cases? Did they all “open too soon”?  It appears that Texas and the US aren’t the only ones deserving of the current round of what some call “COVID shaming”. When considering the idea of “opening too soon”, perhaps we should ask Anders Tegness, chief epidemiologist of Sweden who directed that nation’s response in flattening Sweden’s curve without draconian lockdowns, closing schools, and imposing mask requirements.  Ironically, Sweden is experiencing no new wave of COVID cases. 


Speaking of lockdowns, I have discussed in previous emails how lockdowns and school closures have had no effect on COVID mortality.  Upon analyzing data from University of Maryland COVID-19 Impact Analysis and worldometers, I found that the ten US states with the highest  percentage of stay-at-homers had roughly double the rate of COVID deaths and almost 8 times the number of deaths per million than the ten lowest US states between March 1 to July 26, 2020. Keep in mind this information accounts for COVID death rates per hundred and per million population respectively, and not total population. 


While it is true that COVID cases and hospitalizations in Texas have been rising recently, it has largely peaked. Texas was, and is, nowhere near reaching hospital capacity in the hot spot of southeast Texas, according to the South East Regional Advisory council (SETRAC). Currently, 54% of available hospital beds are occupied, when you add in surge capacity, only 45% of available beds are currently occupied. Neither the Houston based Texas Medical Center (TMC)  hospital med/surg beds or ICU beds have spilled over to surge capacity. The Houston Methodist Hospital  CEO Mark Boom recently stated, “ The number of hospitalizations are being misinterpreted…and, quite frankly, we’re concerned that there is a level of alarm in the community that is unwarranted right now.”  


General med/surg COVID 7 day average SETRAC hospitalizations rate of growth increased 132% between June 1 (start of COVID “surge”) and July 14 (“peak” of COVID spike) compared to baseline (March 25-June 1). During the same time interval, overall general hospitalization rate of growth decreased by 72% compared to baseline.  In other words, most patients being hospitalized with COVID would have otherwise been hospitalized with another diagnosis had COVID diagnosis not existed. Being hospitalized with COVID is not the same as being hospitalized because of COVID. This is a very important distinction! 


At no time did COVID patients in SETRAC occupy more than 15% of available general medical beds and 50% of available ICU beds. Because of this, no overcrowding of hospital capacity existed in the past, or now. Although overall ICU occupancy is currently running at around 97% of base capacity (80% of surge capacity),only 38% of available beds contain COVID patients. Current ICU and general bed occupancy rates are not unprecedented, and no different than in other years.   


In an interview with our investigative team, Michelle Arnold, a spokesperson for the Harris County (Houston) medical examiner’s office stated that the Harris county morgues are not overwhelmed.  A separate report reveals that COVID accounts for 3% of all deaths processed at the facility. Murders and suicides each outnumber COVID deaths by 3:1. Fatalities are higher than last year at this time, but homicides are also up by 20% over the five year trend. There are no overcrowded morgues in Harris county, the 3rd largest county in the US, and one of the hottest spots for COVID activity. No refrigerated trucks were used to store those deceased by COVID. 


In a separate interview with our team, John Lopez, Director of acute and emerging infectious disease at the Texas Department of State Health Services (DSHS) stated that of all the COVID reported deaths, only about 20% had been investigated and confirmed as COVID positive deaths. The other 80% of COVID reported deaths were deemed “probable” but not confirmed COVID positive.  Interestingly, on July 27 Texas decided to change how deaths were being reported to only include what is listed on death certificates. County and state health departments no longer investigate to determine whether COVID deaths are confirmed or presumptive. Texas now lumps all confirmed and presumptive COVID deaths together into one number. Overnight on July 27, Texas added  675 COVID deaths to the total count. Some people look at this very suspiciously as proof of overcounting COVID deaths in Texas.  


We decided to dig deeper into the issue and verified 98 COVID deaths out of almost 3,000 deaths were recorded at Harris County Medical Examiner office since January 2020. As of July 29, 685 COVID deaths were reported on the Harris County Dashboard, while 1182 Harris county COVID deaths were reported on the Texas DSHS dashboard, showing a difference of 497 deaths between the two dashboards.  Multiple calls and emails to TMC do get hospital death counts in Harris county have been unanswered. 


Texas, California, and Florida have all had significant increases in cases, yet interestingly, they each rank in the top 4 states in the US for overall numbers of COVID testing. As Texas began testing more vigorously, more tests became positive. More tests naturally result in more positives which should result in more hospitalizations and deaths. In Texas, an acceleration in testing began around June 8, with a corresponding acceleration in positive cases beginning around June 15. Testing increased by around 65% between June 1 and July 25,  while positive cases increased by around 85% during the same time frame (adjusting for lag time in results). 


In light of all the new cases, the case mortality rate for COVID dropped significantly from 3.4% on May 15 to 1.9% on July 15, even despite the unconfirmed, and likely overcounted COVID death count. To support the claim of overcounted COVID deaths, we found that according to CDC, Texas currently has a 5% excess death rate over a seasonal 3-year average, including the 20% surge in homicides in Harris county. The US stands currently at an average of 7-8% excess deaths compared to the 3-year average. Neither figure includes adjustments for population growth over the past 3 years. 


What does all this mean? 


  1. The “crisis” reports about overwhelmed ER’s, hospitals, and morgues is completely unsubstantiated outside of very few temporarily crowded ER’s.  Refrigerated trucks were never used to store bodies of COVID victims. Most news outlets incorrectly assume that the very competent hospital administrators, doctors, nurses, medical staff, emergency personnelle, and county examiners aren’t able to plan and adapt to temporary strains on medical systems. Americans have shown time and again to be brilliant and resilient innovators, able to adapt to ever changing conditions. 
  2. People have not, and are not, being hospitalized mainly because of COVID, but because of other conditions who also happen to have COVID. We can now confidently say that COVID is not significantly exacerbating hospitalizations of those with other conditions when looking strictly at the available hospital data. 
  3. No evidence exists that Texas “opened too early”. 
  4. No real world evidence (a new AMA study is based on a model, and therefore completely unsubstantiated in the real-world) exists that closing schools made any difference in COVID outcomes. 
  5. The increase of COVID cases in Texas are more due to aggressive testing practices than any other reason. While increasing test positivity rates point to additional reasons (such as increased transmissibility in warmer weather), performing more tests increases costs and fuels the idea of a “worsening pandemic” that is in reality, unsubstantiated. 
  6. Confirmed COVID death counts in Texas have been overcounted by up to 4 times the actual confirmed death count, according to our latest research. Obvious discrepancies exist between Harris County Examiner’s Office, Harris County dashboard, and Texas DSHS dashboards, respectively. As citizens, we are owed a transparent explanation regarding this discrepancy.  
  7. COVID is more contagious, but much less lethal during warmer summer months. Since many people will get COVID at some point, it is much less problematic to have the infection during warm summer months.
  8. The idea of shutting and locking down economies and livelihoods to stop COVID is as absurd as trying to dam up the Pacific Ocean. Lockdowns were never meant to completely stop COVID, only to slow it down. Any competent epidemiologist will say this. Lockdowns in the US correlate positively to higher death rates in states with a higher percentage of people staying at home rather than states with lower stay at home rates, according to University of Maryland. Put simply, lockdowns (excluding social distancing) do not work and are more likely than not to be dangerous
  9. State and national medical associations, along with news outlets should bear some responsibility for refusing to evaluate all available objective fact-based perspectives surrounding COVID. 


I have never said COVID was a hoax. It is real, and it kills people. For those who take issue with the above information and ask why I’m not taking a public health concern seriously enough, I’d like to ask them:

  1. What about those suffering worsening depression, anxiety, and suicide because of COVID? Because you don’t hear about it in the news, it’s not a problem?
  2. What about those with advancing cancer because they had to wait for cancelled procedures to make way for COVID? Because you don’t hear about it in the news, it’s not a problem?
  3. What about the elderly and those with chronic disease who feel isolated, alone, and terrified from dying or suffering long term disability from COVID? Because you don’t hear it in the news, it’s not a problem?
  4. What about young, healthy people, terrified about accidentally killing a lonely and depressed parent or grandparent just by hugging them? Because you don’t hear about it in the news, it’s not a problem?


COVID is a problem, I have never said it’s not, but so are many other things! We MUST be able to provide perspective as a people, a society, and a culture. I hope that I have provided an appropriate perspective from a medical standpoint, so you can reach your own conclusions, and then act according to your free will, without feeling compelled, or compelling others to do the same. 




Dr. Hastings

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