Friday, July 23, 2021

Austin Public Health Re-enters to Stage 4 of Risk-Based Guidelines

Delta Variant increases presence, younger population in hospitals compared to prior surges 

The level of risk for contracting COVID-19 in Austin-Travis County continues to increase, especially among unvaccinated individuals as confirmed cases have dramatically risen over the past two weeks. The 7-day moving average of new hospital admissions crossed the threshold of over 30 admissions per day marking progression to Stage 4 this week. 

The additional hospitalizations may take a toll on healthcare staff, which has been reduced from levels seen earlier in the year during the height of the pandemic. Local hospital systems are simultaneously seeing an increase in hospitalizations from other non-COVID diseases as more people go about their daily, pre-pandemic routines. 

"Each of us has a personal choice to make – will we do our part to stop disease transmission by getting vaccinated and taking the necessary precautions to protect ourselves and others, or will we be part of its continued spread?" said Dr. Desmar Walkes, Austin-Travis County Health Authority. "COVID-19 is still present and continues to burden our healthcare community and we need to end the cycle of transmission."  

In making the decision to move to Stage 4 of the Risk-Based Guidelines, Austin Public Health, Travis County and local hospital partners monitor several key indicators including the 7-day moving average of new hospital admissions, positivity rate, the doubling time of new cases, and current ICU and ventilator patients. Over the past three weeks these indicators have surged:  

  • The 7-day moving average for hospitalizations since July 4 have increased over 203% from 63 to 202 hospitalizations on July 22.

  • The positivity rate, the number of people who test positive out of the total number of people tested in a given week, has tripled from 3.2% to 9.6%. 

  • COVID patients in local ICUs have increased nearly 242% from 24 people on July 4 to 82 people on July 22.  

Stage 4 recommendations include the following:

  • Fully vaccinated individuals should wear a mask when participating in indoor private gatherings, traveling, and dining or shopping, and should wear a mask for outdoor gatherings, if they are unable to socially distance.
  • Partially or unvaccinated individuals should avoid private gatherings, travel, dining and shopping unless essential. Wear a mask when conducting essential activities.

The concern is the new variant spreading from those vaccinated to the unvaccinated, especially children unable to get the vaccine. The Risk-Based Guidelines correlate with five distinct stages of risk for Austin-Travis County and are not changes to local rules or regulations for businesses; they are guidelines and recommendations for individual actions and behaviors based on levels of risk of exposure in the community. It is important to note that everyone should continue to follow any additional requirements of local businesses, venues, and schools regardless of vaccination status or stage.  

"We ask people to be aware of their surroundings and potential risks when determining the best course of action to keep themselves and others safe," Interim APH Director Adrienne Sturrup said. "Vaccinations are the best tool we have in fighting COVID-19, but in public, we don't know who is vaccinated and who is not, so it is best to mask and, when possible, maintain social distance."  

COVID-19 vaccinations continue to prove extremely effective in protecting those who have completed the required series of shots for Moderna and Pfizer, or the single dose of Johnson and Johnson. However, with only 62.41% of residents fully vaccinated, our community continues to be vulnerable to new variants of the disease, especially the highly transmissible Delta variant.  

"I know this transition back to Stage 4 may be difficult, but we must follow our local health authority's recommendations to once again flatten the curve and to ensure we continue to protect ourselves and our most vulnerable," Travis County Judge Andy Brown said. "Getting vaccinated is by far the most effective way to prevent severe disease and death after exposure to the virus, and wearing a mask helps reduce spread of the disease to those who are not able, or not yet eligible, to receive the vaccine." 

The rapid spread of the Delta variant is cause for concern among public health experts, especially as children and teens prepare to return to in-person classes. It is important for parents to vaccinate their children who are 12 years of age and older. APH further recommends that those under the age of 12 wear a mask as the school year begins until a vaccine for their age range is approved. 

"I hate that once again we find our hospitals filling up.  We wanted so much for this to be over. But once again we must dig deep to protect our ICUs and our exhausted doctors and nurses and stop this delta variant. Please take the shot. After you are vaccinated, wearing a mask indoors is the least intrusive and most effective thing we can and must do to prevent further spread," City of Austin Steve Adler said. "If I could order all children and teachers to mask without ending up in court, I would do it in a heartbeat. It's up to each person and each business now to decide how badly we want to avoid a return to Stage Four, where unvaccinated people face further limits in activities like eating out and shopping. Let's wear masks indoors and avoid going there." 

COVID-19 vaccinations are free and require neither identification nor insurance. Residents can locate providers in their area using or they can text their zip code to 438829 (822862 in Spanish) to find a nearby clinic.  

For additional business guidance, visit for recommendations to help prioritize the well-being of employees and customers. 

For COVID-19 information and updates, visit