Governor Abbott ended the term of the Texas mask without the contribution of all his medical advisors COVID-19

AUSTIN – Governor Greg Abbott’s four medical advisers were not all on board with their action to end the state’s coronavirus restrictions – or even included in the decision.

“I don’t think this is the right time,” said adviser Mark McClellan, a former commissioner for the Food and Drug Administration, adding that he was not consulted before the decision.

“Texas has made some real progress, but it is too early to fully reopen and stop hiding from others,” said McClellan by email.

Since the beginning of the pandemic, Abbott said he would rely on data and doctors to guide state policy. But the conflicting opinions of his medical consultants about one of the biggest changes in state pandemic policy raise questions about how the choice – which has been widely criticized by public health experts – has been made.

State health commissioner Dr. John Hellerstedt did not explicitly respond on Wednesday whether he endorsed the plan in advance to end the mask’s mandate and allow companies to fully reopen on March 10. Under pressure from state lawmakers, Hellerstedt said he “did not have a conversation” with Abbott before the decision, but that his agency is in regular contact with the governor’s team.

A third consultant, Dr. Parker Hudson, of Dell Medical School in Austin, said “he was not involved in this decision”.

And a fourth said they agreed with the decision, explaining that it was initiated by Abbott and was based on the governor’s overall comfort level with the pace of vaccinations, other medical improvements and the notion that Texans know how to wear masks and will continue to wear them. even without a mandate – an idea refuted by public health research.

“He brought it to us, he talked to us about it, he talked about it,” said Dr. John Zerwas, vice president of the System at the University of Texas. “And he said, ‘Okay, that’s when I feel like it would be a good time to do that.'”

The country’s leading infectious disease experts and President Joe Biden criticized Abbott’s decision to end restrictions next Wednesday, saying it is premature and warning that the move could lead to a new outbreak that has killed more than 43,000 Texans.

Former director of the United States’ Center for Disease Control and Prevention, Tom Frieden, said reversing the application of the mask was particularly dangerous and could lead to a decline in its use.

“A masked mandate is about you not inadvertently killing someone,” said Frieden, who served during the Obama administration. “There is no argument for not having a masked mandate.”

When asked on Wednesday about how to challenge some medical consultants, Abbott said he spoke with Zerwas and Hellerstedt.

“Both agree that, because of all the metrics and numbers … now is a very safe time to open,” Abbott said on Wednesday during an interview with KFDX-TV in Wichita Falls. “Texans know how to stay safe and no longer need government mandates to warn them.”

Abbott’s decision

In making its announcement on Tuesday, Abbott offered no specific reason for the timing of the reversal; instead, he focused generally on increasing access to vaccines and the recent decline in the number of people hospitalized with COVID-19.

Abbott intended to reveal his plan even earlier, on February 22, but was forced to postpone it when the winter storm delayed vaccine shipments to Texas, he told a radio announcer on Tuesday.

“All of our decision-making processes depended on the distribution of these vaccines,” said Abbott, a Republican in his second term as governor, in an interview with KYFO.

Texas is one of several states that has removed requirements for the mask in recent weeks.

Discussions about the reversal had been ongoing for the past week and a half, said Zerwas, who is a former Republican state deputy and anesthetist.

The masks emerged as a point of discussion.

Abbott “pressed and said, ‘Do you really think that a state mandate to mask is what is really driving people to obey it,” “recalled Zerwas. “And I said personally, ‘No, I don’t, and the people I am with regularly don’t even mention it.'”

Zerwas said Abbott’s statewide request for facial coverage last year helped get the message across, and now Texas citizens are doing so because they are familiar with the benefits.

Abbott concluded, said Zerwas, that “the heavy hand of the state need not be doing this”.

Asked what evidence the Abbott administration had for this, Zerwas did not cite any specific examples.

“I can only speak for myself,” said Zerwas. “I think I am your normal person who is as attuned to this pandemic as anyone else.”

Freiden, however, said the data show the opposite. Mask mandates are effective, as are mandates for other security measures. For example, states have not repealed seat belt laws because people know the benefits of wearing them, he said.

“All the data we have on public health strongly indicates that prematurely ending the use of the mask will decrease the use of the mask,” said Frieden. “I think it is a political decision that will result in the loss of life.”

Application left to companies

Abbott’s new order leaves companies with a public health decision about whether their employees and customers should wear masks.

Some companies are now just “encouraging” customers to do so. Others are maintaining a mandate, although without a state policy, applying it can be more difficult.

“The advantage of a consistent expectation from the state is to set that expectation for everyone,” said Dr. James McDeavitt, senior vice president and dean of clinical affairs at Baylor College of Medicine. “We will certainly see people taking it off now.”

As for the timing of the decision, Zerwas said there was no medical limit or trigger for which the state was working.

“It was always an ongoing conversation,” he said. “And where could we all, when we talk about it, be comfortable with what we were going to, what we were doing.”

Last Wednesday, Abbott told KXAS-TV (NBC5) in Dallas that the timing of the reversal was linked to vaccination rates among Texas seniors. People aged 65 and over account for the majority of COVID-19 deaths in Texas and the country.

“We wanted to reach that 50% mark in vaccinations for the elderly,” said Abbott. “As soon as we received the extra doses last week and saw vaccination rates among the elderly rise, we knew that we could have more than half of the elderly vaccinated by the time we opened it again.”

Frieden said that many public health experts advocate reducing restrictions when new daily cases drop to about 1 per 100,000 inhabitants. Texas is currently over 25 years old, he said.

This week, federal public health experts warned states to remain on guard against the virus. Although the pace of vaccinations is expected to increase in the coming weeks, only about 2.2 million Texans are fully vaccinated against COVID-19 in a state of 29 million. Others are likely to have some natural immunity if they have been infected, but many Texans still have none.

Zerwas said he did not specifically remember whether Abbott discussed waiting a few weeks, or months, more to make the change. But Zerwas remembered reflecting on the matter himself.

He remembers to ask himself “what are you going to get if you expect, what are you going to get in 30 days?”

“I said, ‘Yes, you’re going to put another million vaccines in people’s arms in a week,'” he said. “That’s a good thing. And in two more weeks after that, you’re going to put a few million more there. ‘”

In the end, said Zerwas, it was Abbott’s decision.

“You could argue to do that later,” said Zerwas. “But I don’t know if it’s a good point.”

Masking message

Hellerstedt, who heads the Texas State Department of Health Services that oversees the state’s pandemic response and vaccination efforts, did not appear alongside Abbott in Tuesday’s announcement, which was carried out in a crowded restaurant in Lubbock .

On Wednesday, Hellerstedt emphasized the importance of still wearing masks and said that Abbott also believes that wearing masks is valuable. Asked by The Dallas Morning News If Hellerstedt supported Abbott’s decision to lift the restrictions at this point, a department spokesman did not respond directly.

“Dr. Hellerstedt agrees with what the governor said yesterday that COVID-19 is still with us and people must continue to take public health precautions to slow its spread as more and more people are vaccinated, ”said Chris Van Deusen in an announcement.

Zerwas said he told Abbott that if he was going to terminate the mask’s mandate, he needed to emphasize that it was still a good idea.

Although Abbott’s executive order requires Texans to wear masks, the governor did not emphasize this when he announced the changes on Tuesday. And Abbott’s social media posts on Tuesday emphasized the backlash of the mandate, not the need to continue using them.