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After living through and reporting on COVID-19’s siege of New York and New Jersey, I held out hope that other regions of the country wouldn’t have to face the same horrors. But what's going on now in Houston looks disturbingly similar. Some observations 
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Houston (and Texas in general) didn’t really experience much COVID-19 in the spring. Hospitals delayed elective surgeries but the patients didn’t come. (graphic via @Covid19Tracking)
But now, by a variety of metrics, the Houston region is in trouble, as @mike_hixenbaugh and I have outlined in several stories in the past two weeks. Our latest, on the city’s overwhelmed hospitals: https://www.propublica.org/article/all-the-hospitals-are-full-in-houston-overwhelmed-icus-leave-covid-19-patients-waiting-in-ers 3/
Two weeks ago, Lyndon B. Johnson Hospital ran out of both space for new COVID patients & remdesivir, a key drug needed to treat them. @MDAndersonNews prepared to take in cancer patients with COVID-19 from the city’s overburdened public hospital system. https://www.propublica.org/article/internal-messages-reveal-crisis-at-houston-hospitals-as-coronavirus-cases-surge 4/
Then came word that deaths at home in Houston from cardiac arrest reached a three-year high in June. Some 300 patients were dead by the time paramedics arrived on the scene, up 45% from February. (graphic via @nbcnews) https://www.propublica.org/article/a-spike-in-people-dying-at-home-suggests-coronavirus-deaths-in-houston-may-be-higher-than-reported 5/
Here’s another way to visualize the deaths at home released by Houston’s health authority after our story.
https://twitter.com/jaspscherer/status/1281324389036892170?s=20 6/
https://twitter.com/jaspscherer/status/1281324389036892170?s=20 6/
It’s not clear that all of those patients died from COVID-19. Surely many of them did not. But data from the Harris County medical examiner showed an increasing number of these at-home deaths have been confirmed to be the result of the virus. 7/
One of those was Karen Salazar’s 54-year-old mother, Felipa Medellín. Salazar called paramedics when she noticed her mother’s chest rising and falling rapidly. Salazar attempted CPR but it was unsuccessful. https://www.propublica.org/article/a-spike-in-people-dying-at-home-suggests-coronavirus-deaths-in-houston-may-be-higher-than-reported 8/
NYC saw a surge in deaths at home, too, far more than usual. It was a mix of those with COVID-19 and those afraid or reluctant to seek medical care. https://www.propublica.org/article/dead-on-arrival-a-ny-fire-chiefs-covid-journal 9/
But Houston is seeing other disturbing parallels too. Hospitals are increasingly so full that they are diverting ambulances--nearly three times as often this year as during the same stretch last year. https://www.propublica.org/article/all-the-hospitals-are-full-in-houston-overwhelmed-icus-leave-covid-19-patients-waiting-in-ers 10/
Check out the % of hours Houston’s busiest hospitals spent on diversion during an eight-day period in late June and early July this year vs. last. (graphic via @NBCnews) 11/
It goes beyond that, though. Hospitals are so full that patients are backing up in the emergency room, unable to be transferred to inpatient units and ICUs. It’s something called boarding--and it’s been linked with worse outcomes in the past. 12/
NYC saw a similar phenomenon in the spring. This happens when the flow of patients coming in exceeds your ability to find room for them. 13/
This visualization from the regional coordinating council in Southeast Texas is telling. On June 9, 373 patients were in ICUs for COVID-19 in the Houston region. Yesterday, the figure was 1,044. They made up 48% of ICU beds in the region. 14/
Data from @cdcgov shows Texas saw excess deaths during the rough flu season of 2017-18 and is starting to see excess deaths again.(Note: death reports take time to roll in and the recent spike in cases aren’t reflected yet). https://www.cdc.gov/nchs/nvss/vsrr/covid19/excess_deaths.htm
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The @houstonchronicle has a good look at how the death toll from COVID-19 in Texas is higher than is being reported. By @jenny_deam and @zachdespart https://www.houstonchronicle.com/news/investigations/article/As-COVID-19-continues-to-slam-Houston-the-death-15400462.php 16/
In parts of Texas, morgues are filling up and refrigerated trucks are on the way, @texastribune reports. https://www.texastribune.org/2020/07/10/texas-coronavirus-deaths-morgues-capacity/ 17/
So this raises the question: Is this just like a bad flu season? Aren’t ICUs regularly near capacity? Doctors and hospital executives say this **is** different. THIS IS NOT THE FLU (sorry for screaming!) 18/
It’s not unusual for a small number of patients to be held in ERs on busy days, especially during flu season, but three Houston ER physicians said they have never seen so many patients receiving prolonged care in emergency departments, or for such long periods of time. 19/
“We are adding more capacity, but we are absolutely stretched now, and if it keeps going this way, we’re going to run out of room. We’re going to look like New York,” said an exec at @memorialhermann. https://www.propublica.org/article/all-the-hospitals-are-full-in-houston-overwhelmed-icus-leave-covid-19-patients-waiting-in-ers 20/
Do you have insight into what’s going on in Houston? Drop me a line or fill out our questionnaire: https://www.propublica.org/getinvolved/we-want-to-talk-to-people-working-or-living-on-the-front-lines-of-coronavirus-help-us-report /end
