Surge Response: How the Panhandle Handled One of the State’s Biggest COVID-19 Outbreaks
By Sean Price Texas Medicine August 2020

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In Texas, COVID-19 outbreaks have been especially pronounced in three types of facilities: nursing homes, jails or prisons, and meatpacking plants. The Amarillo area has plenty of all three.

But it was the meatpacking plants that drew national attention to Amarillo’s COVID-19 problems. The city, which straddles Potter and Randall counties, has numerous plants that employ 12,000 to 15,000 people. In early April, Amarillo’s two hospitals began filling up with COVID-19 patients who worked at a plant in neighboring Moore County. Two weeks later, workers from a plant in Potter County flooded in.

So many workers became sick at U.S. meatpacking plants that consumers rushed to buy meat amid fears the plants would close and cause shortages. In April, President Donald Trump declared meatpacking plants “critical infrastructure” to keep them from shutting down.

Concerns over the loss of meatpacking also prompted Gov. Greg Abbott in May to send in surge response teams made up of members from the Texas Army National Guard and the Texas Military Department, coordinated by the Texas Department of State Health Services and the Texas Division of Emergency Management.

Meatpacking operations create almost perfect conditions for spreading COVID-19, says Rodney Young, MD, chair of family medicine at the Texas Tech University Health Sciences Center (TTUSHC) School of Medicine in Amarillo. Workers typically stand close together on a production line, and they share a locker room to change into and out of work clothes.

“A packing plant is a dream come true for a virus,” he said.

Despite growing numbers of sick and absentee workers, some of these plants initially resisted the idea of improving the social distancing of employees on their production lines, says infectious disease specialist Scott Milton, MD, the public health authority for Potter and Randall counties as well as the city of Amarillo. He is also associate professor of internal medicine at TTUHSC in Amarillo.

“A lot of the people we talked to were not receptive to us asking to slow down their plants because it’s a huge economic issue,” he said. “And we understood that.”

Other plants started making changes even before health officials showed up, Dr. Milton says. They spaced out workers, provided masks and eye shields, and put plastic dividers between workers in some places.

Pandemic in the Panhandle

In the spring of 2020, Potter County had one of the highest rates of COVID-19 cases and deaths in the state – far outstripping the rates in more populous counties like Harris and Dallas.

The governor’s surge response teams tested people and helped identify COVID-19 hotspots, says Gerad Troutman, MD. He’s an Amarillo emergency physician who helped oversee the testing operations, ensuring teams used appropriate personal protective equipment and administered tests properly. He is also medical director for Amarillo and Lubbock Emergency Medical Services, head of the Panhandle region’s Texas Emergency Medical Task Force, and a member of the Texas Medical Association’s Council on Legislation.

“As you can imagine when you start testing thousands of people, coordination becomes a big issue,” he said. “How do we gather all that stuff and get it from point A to point B to be tested? Who’s going to [process the tests]? Where do those results go?”

The testing itself went quickly. The teams tested about 3,500 people in four days, Dr. Milton says.

But getting the results back proved slow. Many of the testing centers were either overwhelmed with requests or still coping with how to get up and running, Dr. Troutman says.

As a result, many people had to wait up to two weeks to get results back.

“There were folks [who had been tested] who were anxious for several days, wanting to know the results,” Dr. Milton said. “The testing was delayed at first, but it’s gotten better as time went on [and] as the capacity increased.”

Despite those headaches, testing was helpful in isolating disease hotspots, he adds. “We knew that there was a problem [with COVID-19 spreading]. The question is how much of a problem and how much control did we have in trying to mitigate that.”

 Pressure from public opinion and Governor Abbott’s office helped persuade some meatpacking companies to change their procedures, Dr. Milton says. Amarillo’s spring outbreak peaked in the first week of May. Hospitals were crowded, but they weren’t yet overwhelmed.

“We weren’t out of [hospital] beds, but we were worried that we may be if [COVID-19] were to surge anymore,” he said.

Fortunately, that never happened. Meatpacking plants, nursing homes, jails, and prisons improved their safety efforts, and testing became more available, Dr. Milton says.

The path forward

Governor Abbott’s office did not return phone calls from Texas Medicine seeking comment about the use of surge response teams. In late May, he said at a press conference in Amarillo that in the event of another similar wave of COVID-19 outbreaks, the state was prepared to “send in these surge response teams that will be able to tamp down any flare up, using the model we have seen in Amarillo,” the Texas Tribune reported.

The spring outbreak had the unintended consequence of providing certain populations – like big groups of meatpackers – with some level of community-acquired immunity from COVID-19, though it’s still unclear how much immunity, Dr. Young says. That and the new precautions in place should make further outbreaks among those groups less likely in the near future.

But mass viral spread in churches, schools, and other places where people gather seem inevitable, Dr. Young says. Many in the Panhandle still have a “frontier” attitude, and the “idea of wearing a mask to hide from some virus just doesn’t sit well with them,” he said.

That’s worrisome because Amarillo’s two hospitals serve as the medical hub for a huge chunk of territory, which includes the Texas Panhandle as well as parts of New Mexico, Colorado, Kansas, and Oklahoma.

However, with the regional hotspots under control, Amarillo’s medical professionals now have the same goal as other Texas cities – making sure the community spread of COVID-19 doesn’t overwhelm local resources.

“There’s one of two paths forward,” Dr. Young said. “We’ll either have enough exposures that we start to get more natural immunity within the population. Or, we’ll get a vaccine and immunize broadly. I presume it will be a combination of those two things, but we still aren’t sure just how long it will take to reach those broader levels of immunity, or how long they will last.”

Tex Med. 2020;116(8):30-31
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Last Updated On

August 03, 2020

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Sean Price

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Sean Price is a reporter for Texas Medicine and Texas Medicine Today. He grew up in Fort Worth and graduated from the University of Texas at Austin. He's worked as an award-winning writer and editor for a variety of national magazine, book, and website publishers in New York and Washington. He's also helped produce Texas-based marketing campaigns designed to promote public health. Sean lives in Austin and enjoys hiking, photography, and spending time with his wife and two sons.

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