Texas hospitals are treating fewer than 1,000 patients with COVID-19 for the first time in two years. According to the Texas Department of State Health Services, hospitalizations totaled 993 on Sunday. The last time COVID-19 patients in Texas numbered less than a thousand was April 4, 2020, before the state's initial surge in hospitalizations, which rose to nearly 11,000 by late July that year.
"Less than a thousand [hospitalizations] is a good place to be and this is what we've kind of been waiting for and watching really closely," said Chief State Epidemiologist Dr. Jennifer Shuford.
Fewer people are getting severely ill and needing medical care, said Dr. Shuford, because nearly the entire Texas population has now developed at least some immune response to SARS-CoV-2, the virus that causes COVID-19.
"We expect, based on some antibody studies that we've done, that about 99% of our population has some antibodies to COVID-19, either from vaccination or from prior infection."
Other infectious disease experts are also cautiously optimistic that vaccinations, combined with four waves of widespread infections – the most recent of which was driven by the omicron variant – will help minimize future surges in cases and hospitalizations.
"I do think that the antibody seroprevalence does have something to do with the declining severity of the illness that we're seeing in terms of decreased hospitalizations," said Dr. Robert Atmar, an infectious disease expert who teaches at Baylor College of Medicine.
Dr. Atmar said while he was not aware of how DSHS estimated Texas' overall immune response, the high rate is possible, especially if infection rates for the virus have been under reported.
"It wouldn't be surprising if a large percentage of the population had been infected and/or vaccinated. 99% just seems high, but it's certainly not unreasonable that that might be the case," he said.
He added the prevalence of more transmissible variants of the coronavirus, such as omicron, which spread faster but generally produce less severe symptoms, has also helped increase the population's overall resistance to the virus.
That includes the BA.2 subvariant of omicron, which the Centers for Disease Control and Prevention reports is now the dominant strain of the virus in the U.S. DSHS's most recent data available on coronavirus variants in Texas, shows BA.2 accounted for 45% of all new infections reported in the week ending March 19.
Atmar warned, however, that during the two years of the pandemic, the virus has continually surprised medical experts.
"One thing that could lead to a surge – an increase in hospitalizations – would be the emergence of a variant that transmits well from person to person and is different enough from the strains that have circulated previously that the existing immunity doesn't recognize it," he said.
The BA.2 does not appear to have those characteristics, said Dr. Atmar. The best practices for Texans in the months ahead, he said, include staying current on COVID-19 vaccinations and following local public health guidelines.