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Austin-Travis County Moves To Stage 4 COVID-19 Guidance, Urges Everyone To Wear Masks

A sign outside of a store on South Congress Avenue notifies patrons to wear masks.
Gabriel C. Pérez
A sign outside of a store on South Congress Avenue notifies patrons to wear masks. Austin Public Health is asking people to wear masks indoors, even if they're vaccinated.

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Austin and Travis County are moving into stage 4 ofAustin Public Health’s risk-based guidelines as coronavirus cases and hospitalizations continue to rise.

Hospitals in Central Texas are seeing an “incredible increase” in the number of people being hospitalized for COVID-19 and placed in ICUs, Austin-Travis County Health Authority Dr. Desmar Walkes said at a news conference Friday.

“These alarming numbers place us officially in stage 4 on our risk-based chart, less than a week after moving to stage 3,” Walkes said. “We are asking Austinites and community members in Travis County to take action. This is a call to action.”

Under stage 4, health officials recommend vaccinated people wear masks:

  • at private indoor gatherings
  • at private outdoor gatherings if unable to socially distance
  • while traveling
  • while dining and shopping

They recommend unvaccinated and partially vaccinated people:

  • avoid private indoor and outdoor gatherings
  • travel only if it's essential (with masks)
  • dine and shop only if it’s essential (with masks)

The area moved into stage 3 of the guidelineslast week, and the health agency began recommending people — vaccinated or not — startwearing masks indoors again earlier this week.

As of now, Travis County has a seven-day average of 148 new COVID-19 cases per day. It's a dramatic increase from the start of July, when that number was 34.

A spike has also been reflected in hospitalizations. About 35 people in the five-county region on average are being hospitalized with COVID each day. It was eight per day at the start of the month. COVID-19 patients in intensive care units are also on the rise. At the start of the month, 21 COVID-19 patients were in ICU in area hospitals; now 82 are.

Health officials point to two major reasons for the recent surge: low vaccination rates and highly contagious coronavirus variants.

Almost all the cases and hospitalizations are among people who are not vaccinated, according to Walkes. During a virtual town hall Thursday, she said APH is in the process of evaluating the data, but so far it shows that only around 7% to 8% of people hospitalized with COVID in the area are vaccinated.

“The large majority of people that are in the hospital, almost all the people in the hospital, are unvaccinated, so this still is a pandemic of the unvaccinated,” she said.

About 62% of those eligible for the vaccine (people 12 or older) have been fully vaccinated in Travis County. In Texas as a whole, that percentage is around 52%.

The last time Austin was in stage 4 was February. Guidelines were relaxed as more people got vaccinated and hospitalizations decreased. Over the last few months, new variants have been detected, including the highly contagious delta variant, which is now the dominant strain of COVID-19 in the U.S.

Walkes said delta is more severe and deadlier than previous variants.

“One big and concerning difference is we are now seeing younger people in our hospitals,” she said.

Dr. Brian Metzger, an infectious disease doctor at St. David’s Medical Center in Austin, said the pandemic is taking a toll on younger people right now. While last year, most people hospitalized with COVID-19 in the U.S. were over 60, now about half of those hospitalized with severe illness from COVID are under 60, he said.

At St. David’s Medical Center right now, he said nine patients are in the ICU with COVID-19. Seven of them are younger than 50, and three are younger than 40.

“That’s pretty devastating to us to see that happen, especially since it’s something that’s preventable,” Metzger said.

Health officials are doubling down on their push for people to get vaccinated. The COVID-19 vaccines are effective at preventing COVID-19, but not 100%. They are especially effective, though, at preventing severe disease and death.

Dr. Ghassan Salman of Baylor Scott & White, said misinformation about the vaccine has led to hundreds of unnecessary deaths.

Salman gave the following analogy: “Not taking the vaccine is very similar to your decision of jumping off a plane and deciding that you do not want to open the parachute because you’re worried the parachute is going to tangle with your feet."

He encouraged people who are unsure about the vaccine to talk with their doctor.

Walkes said it’s still important for those who are vaccinated to wear masks in public at this time.

“This is to protect others, including those who can’t get vaccinated,” she said.

Although cases have also been on the rise statewide, Gov. Greg Abbottsaid Tuesday he wouldn’t impose another statewide mask mandate.

Cities, counties and school districts are not allowed to require people to wear masks after Abbott issued anexecutive order in May prohibiting them from doing so. The Austin school district said it will recommend masks when classes begin in the fall, especially in elementary schools, where children can't get vaccinated.

At the end of the day, the move to stage 4 is a change in recommendations, not requirements.

“We’re making this plea to individual citizens,” Walkes said. “We’re asking them to get vaccinated number one, and we’re asking them to protect themselves and everyone around them and decrease the number of cases.”

People can find a vaccine provider near them at, or they can text their ZIP code to 438829 (822862 in Spanish).

Marisa Charpentier is KUT's assistant digital editor. Got a tip? Email her at Follow her on Twitter @marisacharp.
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