Thanksgiving

Dear Members of the Baylor College of Medicine Community, 

I am preparing to celebrate Thanksgiving with my family. In addition to the usual activities – buying the turkey and cranberry sauce – this year our preparation has been far more elaborate. We have been preparing to celebrate for the past three weeks by forming our own holiday family bubble. We came together in a rented beach house, from three states (all with a relatively low disease prevalence). We range in ages from 5 months to 83 years, including two sweet-but-under-socialized pandemic infant granddaughters. Everyone self-quarantined to the greatest extent possible for the past two weeks. After much advance discussion, I am reasonably confident all of our family thoroughly understood the plan and were compliant. We all received negative PCR tests within the past several days. In the COVID-19 world, nothing is entirely safe, but I feel we have taken appropriate precautions and are acting responsibly.
 
That is my plea on the eve of Thanksgiving – that everyone has a responsible plan. It is too late to form a holiday bubble (although the December holidays are just around the corner). It is not too late to limit your celebration to your usual household, or to engineer your meal with limited guests, with appropriate masking and distancing.
 
The viral numbers for Houston and surrounding communities this week continue to paint a mixed picture – our situation is clearly deteriorating, but not to the extent that it might. Over the past week we have experienced about 1,444 new cases per day, compared to 412 six weeks ago, well over a three-fold increase.

In the same time period, our daily hospitalizations grew from 86 to 155, less than a two-fold increase. There continues to be a disconnect between new cases and hospitalizations. Part of this no doubt reflects the fact that new cases must incubate for a period of time before creating disease severe enough to result in hospitalization. But the lag has been persistent enough that there is probably something else at play. We currently have more-than-adequate hospital resources to manage COVID-19 patients and safely care for the other health care needs of our community. Encourage everyone you can to continue to focus on good masking and distancing practices. Continue to avoid large aggregations of people, especially indoors. Our individual actions are making a real difference. With vaccines on the horizon, now is not the time to allow our resolve to falter. 
 
Compare Houston to the rest of the nation, or to the rest of Texas, and the data show we are in relatively good shape. Over the past seven days, the new case rate in the state is 36.6 cases per 100,000 population. Compare that to the nation’s leading state – in a race no one wants to lead – North Dakota, with a rate of 160 per 100,000. If the United States were a pond, and you dropped a pebble in North Dakota, the ripples would essentially recreate the national epidemiological map. The mid-West states to the north are experiencing major surges, which attenuate as you move closer to the coasts (and to the Texan “third coast”).
 
A similar dynamic is at play in Texas – there is very high rate of new disease to the north and west, which attenuates as you move towards Houston. The new case rate is 12.2/100,000 in Harris County, and 137.4/100,000 in El Paso (which is now, thankfully, declining).
 
Given this is Thanksgiving, the last comparison I will highlight is with the Pilgrims. There were about 100 passengers on the Mayflower. Only about half of them survived to celebrate the first Thanksgiving, with half succumbing to – you guessed it – an epidemic.
 
What am I thankful for this year? Not that we are in better shape than West Texas, or North Dakota or the Pilgrims. I am thankful vaccines are coming. I am thankful our community has stepped up and done a good job dealing with our pandemic challenges. Mostly, I am thankful to be part of a group of extraordinarily committed people at the Baylor College of Medicine, who continue to play a multifaceted and critical role in combating this virus.
 
“Safe” and “happy.” These are two simple, common words that have taken on much more meaning in these times. I wish you all a safe and happy Thanksgiving holiday.
 
James T McDeavitt, M.D.
Senior Vice President and Dean of Clinical Affairs
 
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