Health officials issue dire warning as Texas sees its worst COVID-19 outbreak

Average new cases

decreased
by 273 cases compared with the seven-day average a week ago. On Jan. 16, 20,530 new confirmed cases and 3,473 new probable cases were reported.

Hospitalizations

decreased
by 6 patients compared with a week ago. As of Jan. 16, 13,929 Texans are hospitalized for the coronavirus.

Average new deaths

increased
by 45 deaths compared with the seven-day average a week ago. On Jan. 16, 381 new deaths were reported.

The Texas Tribune is using data from the Texas Department of State Health Services to track how many people have tested positive for the novel coronavirus in Texas each day. The state data comes from 57 city and county health departments, about 600 hospitals and 340 laboratories and the state vital records registration. It may not represent all cases of the disease given limited testing.

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What you should know:

  • On Jan. 16: State officials are warning the COVID-19 pandemic is now at its worst in Texas after 1,231 deaths were reported for the state in just three days. “Every life lost impacts countless more. These are loved ones, neighbors, fellow Texas. Not statistics,” said the Texas Department of State Health Services in a tweet on Friday.
  • The latest on vaccines: Texas is the first state to administer 1 million doses of the COVID-19 vaccine, but many eligible Texans are struggling to get answers about how and where they can get the shot. On Monday, Gov. Greg Abbott promised to ramp up vaccinations across the state. Health officials expect to eventually be giving shots to at least 50,000 people per day.
  • How we got here: After businesses started reopening in May, hospitalizations increased dramatically in June and July. In response, Abbott issued a statewide mandate requiring most Texans to wear masks in public spaces. In September, the numbers dropped to levels not seen since June, leading Abbott to loosen restrictions on restaurants, bars and other businesses in regions of the state with steady hospitalization levels.
  • But as cases and hospitalizations continue to increase after the holidays, public health experts and local officials are worried that loopholes allowing bars to reopen as restaurants, as well as widespread fatigue, have contributed to the most recent dramatic surge.

Where are most of the cases in Texas?

As of Jan. 16, the state has reported 1,837,552 confirmed cases in 254 counties and 260,008 probable cases in 223 counties since the pandemic began. Confirmed cases are detected through more accurate molecular tests, while probable cases are detected through rapid-result antigen tests.

These totals may differ from what county and city health departments report. The Tribune is measuring both the number of cases in each county and the rate of cases per 1,000 residents in the last two weeks.

New confirmed and probable cases reported in the last two weeks
The number of cases reported in the last two weeks shows where outbreaks are occurring. Because some counties aren’t reporting probable cases, not all counties are comparable to one another.
CountyNew cases last 14 daysPer 1,000 PeopleTotal confirmed casesTotal probable casesDeaths
Harris36,5577.94278,3120*3,777
Dallas37,12114.35203,89726,5422,397
Tarrant37,85918.74162,38625,4771,752
Bexar27,57914.32118,96824,5352,008
El Paso6,7288.03106,3120*1,929
Travis9,4897.8960,0840*610
Collin12,55613.3054,2098,362467
Lubbock3,06910.1845,2030*640
Hidalgo5,6316.6339,83516,6202,013
Fort Bend7,3389.9338,7284,934436
Statewide312,79910.791,837,552260,00831,831

How many people are in the hospital?

On Jan. 16, there were at least 13,929 hospitalized patients in Texas with confirmed coronavirus infections. This data does not account for people who are hospitalized but have not gotten a positive test, and the Texas Department of State Health Services says some hospitals may be missing from the daily counts.

Total current hospitalizations

The state says roughly 2% to 6% of Texas hospitals do not report hospitalizations data each day. The average number of hospitalizations reported over the past seven days shows how the situation has changed over time by de-emphasizing daily swings.
  • 9% or more of hospitals reported incomplete data, falling outside of the typical range of missing data

On Jan. 16, the state reported 10,119 available staffed hospital beds, including 588 available staffed ICU beds statewide. COVID-19 patients currently occupy 20.4% of total hospital beds.

ICU beds available statewide

On April 9, the state started reporting the number of intensive care unit, or ICU, beds available in Texas hospitals. These specialized beds cater to patients with the most life-threatening conditions and include equipment such as ventilators and heart rate monitors. ICU units also have staff who are trained to care for the critically ill.
  • 9% or more of hospitals reported incomplete data, falling outside of the typical range of missing data

These numbers do not include beds at psychiatric hospitals or other psychiatric facilities, according to DSHS. They do include psychiatric and pediatric beds at general hospitals, and pediatric beds at children’s hospitals.

Hospitalized COVID-19 patients by region

The percentage of hospital beds being used by COVID-19 patients in each trauma service region shows how the virus is currently impacting hospitals in different parts of the state. In regions where this is 15% or below, businesses are allowed to reopen further, if their county government opts in. Regions above this mark for seven consecutive days are disqualified.

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How many people have died?

The first death linked to the coronavirus in Texas occurred March 16 in Matagorda County. As of Jan. 16, 31,831 people who tested positive for the virus have died.

On July 27, DSHS began reporting deaths based on death certificates that state the cause of death as COVID-19 instead of relying on counts released by local and regional health departments. On that date, the state added more than 400 previously unreported deaths to the cumulative total. This does not include the deaths of people with COVID-19 who died of an unrelated cause. Death certificates are required by law to be filed within 10 days.

Because of this change, it’s impossible to compare the rate of deaths before and after July 27.

Experts say the official state death toll is likely an undercount.

New deaths from coronavirus reported each day

The average number of deaths reported over the past seven days shows how the situation has changed over time by de-emphasizing daily swings.

How have the number of cases increased each day?

For most of the pandemic, the state only reported confirmed cases of the coronavirus based on criteria published by the Centers for Disease Control and Prevention. Confirmed cases are detected using molecular tests, such as PCR tests, which are taken with a nasal swab and are highly accurate according to the U.S. Food and Drug Administration.

In November, the state started reporting probable cases detected through rapid-result antigen tests, which are taken by nasal or throat swab like other viral tests, but the results are much faster and less accurate. These cases can also be detected through other means. Before the state reported probable cases separately, probable cases that were accidentally included in cumulative case counts were removed.

The number of new cases reported drops on weekends, when labs are less likely to report new data to the state.

New confirmed cases of coronavirus each day

The state has reported 1,837,552 confirmed cases in 254 counties. The average number of confirmed cases reported over the past seven days shows how the situation has changed over time by de-emphasizing daily swings. Confirmed cases are detected through molecular tests.

New probable cases of coronavirus each day

So far, there are 260,008 known probable cases in 223 counties. The state has reported daily probable cases, which can be detected through antigen tests, dating back to November. A total of 31 counties, including Harris, Travis, and El Paso, are not reporting probable cases.

How has the positivity rate changed?

The seven-day average positivity rate is calculated by dividing the average of confirmed cases by the average of molecular tests conducted over the last seven days. This shows how the situation has changed over time by de-emphasizing daily swings.

States where the rates are over 10% are in the “red zone”, according to the The White House Coronavirus Task Force. Texas doubled that mark in July before it dropped in August. The rate started exceeding 10% again in October.

7-day average for the positivity rate

The state calculates the positivity rate by dividing confirmed cases by total molecular tests. Because this formula relies on the date on which the test was administered, the rates for previous days are recalculated as more test results from those dates come in.
  • State did not release testing data

DSHS released another positivity rate based only on rapid-result antigen tests on Dec. 11. As of Jan. 15, the rate was 11.39% out of 1,459,365 tests.

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How many people have been tested?

As of Jan. 15, Texas has administered at least 17,906,336 tests for the coronavirus since March. We do not know the number of Texans who have gotten a test because some people are tested more than once. The state’s tally also does not include pending tests.

Coronavirus test results reported to the state each day

The average number of tests reported over the past seven days shows how the situation has changed over time by de-emphasizing daily swings.
  • Molecular tests
  • Antigen tests
  • Antibody tests
  • State did not classify the type of test
  • Viral tests were not broken down by molecular or antigen

State officials are separately reporting the number of antibody tests, which detect whether someone was previously infected. Standard viral tests like molecular and antigen tests determine whether someone currently has the virus.

Testing data is typically reported a day late.

How many Texans have been vaccinated?

As of Jan. 15, 1,200,755 doses have been administered, with 1,038,890 people receiving one dose and 161,865 people — 0.6% of Texas’ population — fully vaccinated. Both vaccines currently available — Pfizer and Moderna — require two doses.

Coronavirus vaccine doses administered each day

Vaccination data is typically reported a day or two late. Abbott has said he expects the reported number of vaccine doses administered each day to increase by 50,000 to 75,000 doses. As of Jan. 15, 1,200,755 doses have been administered. Both vaccines currently available — Pfizer and Moderna — require two doses.

Texas received its first shipments of the COVID-19 vaccine on Dec. 14. Initially, only front-line health care workers and long-term care facility residents and staff were eligible for vaccination. On Dec. 23, state health officials announced that providers should also begin vaccinating Texans 65 and older and people age 16 and older with a qualifying health condition, even though vaccine doses are in short supply. Providers were caught off guard and are now facing tough decisions about who will get shots.

After the state’s rocky start rolling out vaccinations, Gov. Abbott promised to ramp up access, stating that he expected the reported number of vaccine doses administered each day to increase to at least 50,000 doses.

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How is this impacting Texans of color?

Some regions of the state with the highest mortality rates are predominantly Hispanic. Hidalgo and Cameron counties, both along the state’s southern border, have seen death tolls that rival larger and more urban parts of the state like Dallas and San Antonio. In El Paso County, more than 1,900 residents have died of COVID since the pandemic began, placing El Paso far ahead of other major urban counties in deaths per 1,000 residents.

Similarly, case data gathered earlier in the pandemic in various parts of the state shows the disproportionate impact of the virus on Black and Hispanic neighborhoods. Over the summer, the areas with the highest positivity rates in Harris County were predominantly Hispanic, according to a UTHealth School of Public Health analysis. In Dallas County, lower-income Black communities have also reported some of the highest positivity rates.

A Texas Tribune analysis showed the distribution of the vaccine is also unequal. In Texas’ larger counties, distribution sites receiving the first batches of the vaccine are mostly in whiter, more affluent areas, worrying advocates that vaccines will be out of reach for Black and Hispanic neighborhoods devastated by COVID-19. The state has since announced the launch of dozens of vaccination hubs, including some located in the Rio Grande Valley and more rural areas, that will focus on the most vulnerable communities in those regions.

What else should I know about this data?

These numbers come from the Texas Department of State Health Services, which typically updates statewide case counts by 4 p.m. each day. The data is from the same morning, and it may lag behind other local news reports.

In order to publish data quickly, the state has to bypass what is normally a monthslong process of reviewing the COVID-19 data and performing quality checks before publishing. That’s why all of these numbers and information are provisional and subject to change.

The state’s data includes cases from federal immigration detention centers, federal prisons and starting in mid-May, some state prisons. It does not include cases reported at military bases.

From March 13 through March 24, the Tribune added cases from Lackland Air Force Base in San Antonio, where hundreds of American evacuees from China and cruise ships were quarantined.

Those case counts came from the Centers for Disease Control and Prevention.

Notes about the data:

On March 24, the state changed how it reported numbers resulting in a sharp increase in cases.

Antibody tests were included in the new total tests counts for each day before May 14. Previously, the state had counted about 50,000 total antibody tests as virus tests, artificially deflating the positivity rate.

After a system upgrade on June 7 resulting in incomplete test data, the state revised the test numbers for June 6 to show a decrease in total viral tests. The testing numbers for June 6 are not shown in the test results by day chart.

On June 16, the state included 1,476 cases previously reported by the Texas Department of Criminal Justice from Anderson and Brazoria counties in its cumulative case count. The new cases for June 16 do not include those cases.

On July 17, the state received about 5,268 additional cases from Bexar County. The state only included 608 of those cases as new confirmed cases for that day and added the rest to the cumulative count.

On July 19, the state removed 3,676 duplicate antibody tests from the previous day’s total.

From July 23 to July 28, between 9% and 18% of hospitals reported incomplete hospitalization numbers due to changes in reporting to meet federal requirements.

On July 25, the state removed 2,092 probable cases from the Corpus Christi-Nueces County Public Health District that had been previously included in the cumulative case count.

On July 27, the state began reporting deaths based on death certificates that state COVID-19 as the cause of death. On that day, more than 400 previously unreported deaths were added to the total death toll due to the reporting change.

On July 30, the state said an “automation error” caused approximately 225 deaths to be incorrectly added to the overall death count; a subsequent quality check revealed COVID-19 was not the direct cause of death in these cases. We updated the cumulative numbers for July 27-29 to account for this error. The automation error also caused us to incorrectly state the percentage of Hispanics who have died of COVID-19 and the number of previously unreported deaths on July 27. These have been corrected.

On Aug. 3, the state removed 536 duplicate confirmed cases from the overall cases count for Bexar County. Bexar County reported 471 new confirmed cases on this date.

On Aug. 7, DSHS started dividing viral tests into molecular and antigen tests on their site. We’ve combined the two to come up with the total number of viral tests.

On Aug. 7, DSHS reported that some molecular tests had been miscoded, inflating the number of antibody tests over the previous couple of days. This was corrected, resulting in the number of antibody tests to decline from the 6th to the 7th. Because a breakdown of these tests is not available, the charts are showing the inflated numbers on those days.

On Aug. 10, the number of new cases reported did not include new cases from Nueces County due to a “large backlog of positive lab reports” that the county was working through.

In mid-August, several labs submitted large backlogs of tests to the state, which could not have been added until coding errors were fixed and a system update was complete. Because of this, the state reported a record number of tests on Aug. 13. Of those 124,000 tests, approximately 95,000 were from one lab serving several hospitals.

At the same time, DSHS started reporting backlogged cases during their daily updates. They are listed, by month, on the DSHS site. In all instances, these cases were added to the cumulative statewide total, as well as the cumulative count for the county listed on their site. They were not added to the new cases reported for the state that day.

In December, DSHS also began reporting the number of backlogged probable cases. Here’s the total number of backlogged cases reported each day, broken down by case type.

DateTotal backlogged cases
Jan. 16Confirmed: 487; Probable: 167
Jan. 15Confirmed: 647; Probable: 223
Jan. 14Confirmed: 140; Probable: 170
Jan. 13Confirmed: 290; Probable: 245
Jan. 12Confirmed: 637; Probable: 114
Jan. 11Confirmed: 180; Probable: 3
Jan. 10Confirmed: 236; Probable: 27
Jan. 9Confirmed: 502; Probable: 90
Jan. 8Confirmed: 449; Probable: 125
Jan. 7Confirmed: 507; Probable: 153

On Aug. 24, the state was unable to update its testing numbers because of a power outage affecting multiple state agencies. The numbers, however, were added retroactively.

On Sept. 9, TDCJ reported 453 fewer cases among inmates in a state prison in Walker County. These were removed from the county’s total case count, as well as the statewide total.

On Sept. 12, the state said a data entry error caused 91 cases to be incorrectly added to the Sept. 11 statewide and Colorado County total case counts. We updated the cumulative numbers for Sept. 11 to account for this error.

On Sept. 14, DSHS began publishing a new version of the state’s positivity rate, which takes into account the date atest was administered. Previously, the state’s rate relied on the date a test was reported to health officials and verified as a case, which sometimes caused the rate to swing wildly after officials input large numbers of older, backlogged test results. The positivity rate calculation change revealed that the figure was higher in the spring than originally disclosed.

The same day, the state started deduplicating their test results, causing a drop in overall tests. This made the seven-day average of tests incalculable for one week.

Also on Sept. 14, Lamar County overstated their case count by 41 cases. These were removed on Sept. 15. The statewide cumulative case count was also adjusted to reflect this change.

On Sept. 16, case counts decreased in 12 counties. TDCJ reported reduced case counts in Bee and La Salle counties. Cases were deduplicated in Calhoun, Gonzales, Guadalupe, Kerr, Lavaca, Orange, Roberts and Wharton counties. Shackelford and Swisher counties saw decreases after updating case information.

On Sept. 17, case counts decreased in 13 counties. TDCJ reported reduced case counts in Bee, Childress, Houston, Karnes, Madison and Walker counties. Cases were deduplicated in Bandera, Kendall, Titus and Zavala counties. Archer, Swisher and Yoakum counties saw decreases after updating case information.

On Sept. 18, case counts from TDCJ decreased in Anderson County by 1,070, which decreased the total number of cases for that county. Most of these cases were added back on Sept. 21. Also, TDCJ reported reduced case counts in Duval, Fannin, Grimes and Liberty counties. Bailey County saw a decrease after updating case information.

On Oct. 16, El Paso reported 1,555 new cases, which included cases from Oct. 15 and Oct. 16. The county previously did not report any new cases on Oct. 15.

On Oct. 20, some counties could not update their case counts because of an issue assigning cases to the correct jurisdiction in Texas Health Trace, an online system for contact tracing. These were added on Oct. 21.

On Oct. 29, the state removed 273 probable cases from Hays County that had been previously included in the cumulative case count.

On Oct. 30, the state removed 120 positive antigen cases from several counties that had been previously included in the cumulative case count.

On Oct. 31, the state removed 25 duplicate cases from several counties that had been previously included in the cumulative case count.

On Nov. 6, the state adjusted statewide and El Paso County cases after 1,563 cases that should have been reported Nov. 2 and 3 were instead reported Nov. 4.

On Nov. 9, the state removed 2,363 probable cases from Bexar County that had been previously included in the cumulative case count.

On Nov. 11, the state removed 260 overreported cases from Brazoria County’s cumulative case count and the statewide cumulative case count.

On Nov. 14, the state removed 108 overreported cases from McCulloch County’s cumulative case count and the statewide cumulative case count.

On Nov. 14, older cases were incorrectly added to the daily case counts in the following counties: Atascosa, Bandera, Calhoun, Dimmit, Frio, Gillespie, Gonzales, Guadalupe, Jackson, Kendall, Kerr, Lavaca, Medina, Wilson and Zavala. The statewide new case count for that day was adjusted on Nov. 16.

On Nov. 16, the state was unable to update its testing data because of technical difficulties. The issue was resolved, and testing data reported for that date includes laboratory tests from both Nov. 15 and 16.

On Nov. 18, the state removed 2 overreported cases from Loving County’s cumulative case count and the statewide cumulative case count for Nov. 17.

On Nov. 27, the state removed 87 duplicate cases that had been previously included in the cumulative case count in the following counties: Concho, Mason, McCulloch and Winkler.

On Dec. 1, the state removed 270 overreported cases from Galveston County’s cumulative case count and the statewide cumulative case count for Nov. 30.

On Dec. 4, the state removed 112 cases that had been previously included in the cumulative case count for counties in Region 2/3 due to incorrect addresses. The state also removed 33 cases that had been previously included in the cumulative case count for counties in Region 9/10 due to ongoing quality assurance processes.

On Dec. 5, the state removed 30 cases that had been previously included in the cumulative case count for counties in Region 9/10 due to ongoing quality assurance processes.

On Dec. 8, the state removed 1,228 probable cases from Lamar County’s cumulative case count and the statewide cumulative case count. Those counts only include confirmed cases.

On Dec. 9, the state removed 8 overreported cases from Pecos County’s cumulative case count and the statewide cumulative count for Dec. 8.

On Dec. 10, the state removed 88 cases that had been previously included in the cumulative case count for counties in Region 9/10 due to ongoing quality assurance processes.

On Dec. 11, the state removed 96 cases that had been previously included in the cumulative case count for counties in Region 9/10 due to ongoing quality assurance processes.

On Dec. 14, the state removed 14 confirmed cases and 258 probable cases that had been previously included in the cumulative case count for counties in Region 9/10 due to ongoing quality assurance processes.

On Dec. 17, the state removed 14,220 probable and suspected cases that were previously included in the confirmed cases total.

On Dec. 30, the state added roughly 80,000 backlogged antibody tests from Carter BloodCare.

On Jan. 14, the state removed 1,403 overreported cases from Henderson County’s total case count for Jan. 13. The state also added 142 cases back to Fannin County’s total case count for Jan. 13 that were accidentally not included. This led to an adjustment of the total statewide count.

Carla Astudillo, Mandi Cai, Darla Cameron, Chris Essig, Anna Novak, Emily Albracht and Alexa Ura contributed to this report.

Correction: The tracker incorrectly said on Dec. 23 the average number of people who reportedly died from coronavirus within the previous seven days was at its highest since July. It was at its highest since August. Also due to an editing error, the Nov. 21 version of this tracker included incorrect death counts for 19 counties: El Paso has 949 deaths, not 106; Ellis has 106 deaths, not 949; Deaf Smith has 36 deaths, not 44; Delta has one death, not 36; Denton has 200 deaths, not one; DeWitt has 44 deaths, not 200; La Salle has 14 deaths, not 10; Lamar has 66 deaths, not 14; Lamb has 35 deaths, not 66; Lampasas has 10 deaths, not 35; Madison has 12 deaths, not two; Marion has 15 deaths, not 59; Martin has 176 deaths, not 169; Mason has two deaths, not six; Matagorda has 59 deaths, not 175; Maverick has 169 deaths, not one; McCullouch has six deaths, not 12; McLennan has 175 deaths, not 15 and McMullen has one death, not 7.

Previously, The Texas Tribune incorrectly stated our formula for calculating the average daily positivity rate. This tracker also included incorrect numbers for cumulative statewide tests on Sept. 14, 15 and 16. On Sept. 14, 15 and 16 there had been 5,671,966, 5,729,318 and 5,780,424 tests, not 5,637,040, 5,671,966 and 5,729,318 tests, respectively. In addition, the tracker included an incorrect number of total cases on Sept. 21 because of a Department of State Health Services error in reporting Bexar County’s backlogged cases. There were 1,742 cases statewide, not 1,732, and 2,078 backlogged cases in Bexar County, not 2,088. The tracker also included the incorrect number of cumulative cases and daily cases statewide on Oct. 13 because the state overreported the number of cases in Brazoria County by 159. There had been 800,256 cumulative cases, not 800,415, and 5,050 daily cases statewide, not 5,209. These have been corrected.

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