A unique partnership helped Austin outperform the rest of Texas on COVID-19

Hospitals, local officials and academics united to create a novel system to monitor hospital capacity in Austin, Texas, that helped the capital city keep COVID-19 deaths lower than in other Texas cities. The initiative also limited disruptions caused by pandemic restrictions on the local economy.

Rising COVID-19 admissions led to longer hospital stays and mounting fatalities in Austin last winter, as it did in regions across Texas and the nation. But insiders say collaborations between the public and private sectors set Austin apart, and the numbers seem to support that contention.

Travis County, where Austin is located, experienced the lowest per capita COVID-19 death rate among Texas counties at 73 per 100,000 population. That compares to 161 per 100,000 statewide and 335 per 100,000 in Cameron County, which suffered the worst mortality rate in the state. Austin had 881 deaths from COVID-19 among its 2.2 million residents. By contrast, San Antonio—population 2.4 million—experienced more than 3,000 deaths from the virus. More than 50,000 Texas residents died of COVID-19 between March 2020 and March 2021.

The Austin region also spent less time under strict “lockdown” conditions than the other 21 such trauma service areas in the Lone Star State.

Authorities around the world employed a variety of means to track caseloads and use that information to route patients and make determinations about whether restrictions on public activity were needed. Austin went further by getting political leaders, health systems and academics to work together.

“We had this really unique task force guiding the city that was really good at aligning the various parties and what our goals were,” said Lauren Meyers, the University of Texas at Austin researcher who developed the alert model and managed it as part of the UT Austin COVID-19 Modeling Consortium, a group of researchers and healthcare professionals.

The initiative came about as political leaders in Washington, D.C., and Texas were calling for COVID-19 restrictions to be lifted even as cases grew. Authorities in Austin wanted a better way to contain the virus.

Austin’s collaborative system alerts authorities to changing conditions, enabling them to quickly shift their COVID-19 response based on the needs of vulnerable areas. One major challenge to adopting this model elsewhere is that the necessary data isn’t always available from hospitals in a region, a problem the Austin consortium overcame.

The Austin initiative uses ZIP code-based data on poverty, unemployment, income and level of education to determine which locations were most vulnerable to COVID-19 surges. That information, combined with caseload data, helps officials categorize the risk of a big surge that could threaten hospital capacity in specific locations.

In addition to the mayor and the city’s Public Health Authority, participants include the CEOs of Ascension Seton, St. David’s HealthCare and Baylor Scott & White Health, as well as University of Texas at Austin Dell Medical School Dean Clay Johnston. The UT COVID-19 Modeling Consortium also includes researchers from the University of Texas and Northwestern University.

“The spirit was: This is our community that we have to save right now. We have to be working together,” Johnston said.

A federally led partnership that collected COVID-19 mortality data to project where cases would rise had a significant shortcoming, said Dr. Georges Benjamin, executive director of the American Public Health Association. Because deaths can lag behind cases for weeks, the numbers are never fully up to date.

Another reason for Austin’s success is clear and separate communications from political leaders, who make decisions about economic decisions, and the researchers running the project, who are responsible for informing the public about the state of the pandemic, Benjamin said.

“What they did was depoliticize the process,” Benjamin said. “That’s worth its weight in gold.”

The Austin model could be applied to other kinds of health emergencies, like natural disasters, and to track EMS capacity on an ongoing basis, Benjamin said.

The Texas Health Department is using the UT model to track cases and variants statewide but, to date, no other municipality has copied what Austin did. Harris County, where Houston is located, brought in Meyers and her team to investigate establishing a similar model there last year. But the discussions faltered amid a lack of political will and a surge in COVID-19 cases that demanded authorities’ attention. Likewise, talks with leaders in Dallas and El Paso also did not come to fruition.