Texas is breaking coronavirus case records as the holidays approach
The Texas Tribune is using data from the Texas Department of State Health Services to track how many people have tested positive for the novel coronavirus in Texas each day. The state data comes from 57 city and county health departments, about 600 hospitals and 340 laboratories and the state vital records registration. It may not represent all cases of the disease given limited testing.
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What you should know:
- On Nov. 23: The seven-day average of new cases has surpassed 10,000 for the first time. COVID-19 hospitalizations have more than doubled since the beginning of October, and Texas has reported over 20,500 coronavirus deaths since the pandemic began. The situation is particularly dire in El Paso, where officials plead for more morgue workers as coronavirus fatalities climb. Experts say widespread fatigue has hastened viral transmission and worry the holidays could exacerbate an already dangerous situation.
- How we got here: Under Gov. Greg Abbott’s plan to revive the economy, businesses started reopening in May. But Abbott paused further reopening plans and scaled back others in June, telling one TV station he regretted reopening bars too quickly.
- As hospitalizations increased dramatically in June and July, Abbott issued a statewide mandate requiring most Texans to wear masks in public spaces, which experts say may have led to a plateauing of cases and hospitalization levels. In September, the numbers dropped to levels not seen since June, leading Abbott to loosen restrictions on restaurants, bars and other businesses. As the numbers have soared again in the last two months, Abbott has said he will not issue any more lockdowns.
Where are most of the cases in Texas?
As of Nov. 23, the state has reported 1,100,979 confirmed cases in 254 counties since the pandemic began. DSHS only reports cases of confirmed coronavirus cases in each county — the state does not include probable cases which are found with rapid-result antigen tests. These totals may differ from what county and city health departments report. The Tribune is measuring both the number of cases in each county and the rate of cases per 1,000 residents.Coronavirus’ spread across TexasThe rate of cases per 1,000 residents is high in the Panhandle’sMoore County, where early outbreaks were tied to a meatpacking plant, and in counties with state prisons such as Childress, Walker and Jones. South Texas and the Coastal Bend emerged as hot spots in July, and counties with college towns, like Lubbock and Brazos, saw cases surge as students returned to campus in late August. The latest surge in October has been felt acutely in El Paso, Lubbock and Amarillo, with experts saying widespread fatigue has hastened viral transmission statewide.Fort WorthCorpus ChristiAustinAmarilloEl PasoLaredoSan AntonioDallasHouston4.39112.37+Cases per 1,000 residentsNo reported casesBosque CountyCases per 1,000: 27.98
| Cases | 507 |
| Deaths | 15 |
| County | Total cases | Per 1,000 People | In last 14 days | Deaths |
|---|---|---|---|---|
| Harris | 182,192 | 39.59 | 11,241 | 2,965 |
| Dallas | 118,962 | 45.99 | 16,873 | 1,468 |
| Tarrant | 81,600 | 40.40 | 15,823 | 987 |
| El Paso | 81,511 | 97.31 | 14,562 | 980 |
| Bexar | 61,263 | 31.81 | 4,172 | 1,476 |
| Hidalgo | 40,085 | 47.19 | 3,399 | 1,802 |
| Travis | 36,436 | 30.28 | 3,268 | 467 |
| Lubbock | 28,873 | 95.78 | 6,239 | 306 |
| Cameron | 25,507 | 60.48 | 909 | 1,005 |
| Collin | 23,784 | 25.19 | 3,294 | 239 |
| Statewide | 1,100,979 | 38.36 | 130,037 | 20,588 |
How many people are in the hospital?
On Nov. 23, there were at least 8,353 hospitalized patients in Texas with confirmed coronavirus infections. This data does not account for people who are hospitalized but have not gotten a positive test, and the Texas Department of State Health Services says some hospitals may be missing from the daily counts.
These numbers do not include beds at psychiatric hospitals or other psychiatric facilities, according to DSHS. They do include psychiatric and pediatric beds at general hospitals, and pediatric beds at children’s hospitals.
Total current hospitalizations
The state says roughly 2% to 6% of Texas hospitals do not report hospitalizations data each day. The average number of hospitalizations reported over the past seven days shows how the situation has changed over time by de-emphasizing daily swings.
- 9% or more of hospitals reported incomplete data, falling outside of the typical range of missing data
May 1June 1July 1Aug. 1Sep. 1Oct. 1Nov. 12,0004,0006,0008,00010,000Reopening began May 1Mask order issued July 27-day averageNov. 238,353 in hospitals
- Note: From July 23 to July 28, between 9% and 18% of hospitals reported incomplete hospitalization numbers due to changes in reporting to meet federal requirements.
On Nov. 23, the state reported 12,437 available staffed hospital beds, including 923 available staffed ICU beds statewide. COVID-19 patients currently occupy 12.4% of total hospital beds.
Hospitalized COVID-19 patients by region
The percentage of hospital beds being used by COVID-19 patients in each trauma service region shows how the virus is currently impacting hospitals in different parts of the state. In October, Abbott said many businesses could reopen further if the percentage of COVID-19 patients was 15% of the region’s hospital capacity or below. Regions that are above this mark for seven consecutive days are disqualified.Fort WorthCorpus ChristiAustinAmarilloEl PasoLaredoSan AntonioDallasHoustonPercent of hospital beds occupiedby COVID-19 patients0%15%+
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How many people have died?
The first death linked to the coronavirus in Texas occurred March 16 in Matagorda County. As of Nov. 23, 20,588 people who tested positive for the virus have died.
On July 27, DSHS began reporting deaths based on death certificates that state the cause of death as COVID-19 instead of relying on counts released by local and regional health departments. On that date, the state added more than 400 previously unreported deaths to the cumulative total. This does not include the deaths of people with COVID-19 who died of an unrelated cause. Death certificates are required by law to be filed within 10 days.
Because of this change, it’s impossible to compare the rate of deaths before and after July 27.
Experts say the official state death toll is likely an undercount.
New deaths from coronavirus reported each day
The average number of deaths reported over the past seven days shows how the situation has changed over time by de-emphasizing daily swings.Apr. 1June 1Aug. 1Oct. 1501001502002503003507-day averageNov. 2332 deaths
- Note: On July 27, the state began reporting deaths based on death certificates that state COVID-19 as the cause of death. On that day, more than 400 previously unreported deaths were added to the total death toll due to the reporting change. See notes about the data.
How have the number of cases increased each day?
When looking at trends, the state relies on confirmed cases of the coronavirus, not probable cases, based on criteria published by the Centers for Disease Control and Prevention. However, DSHS may still accidentally include probable cases for certain counties. When found, they are removed.
Because the state does not include probable cases, these numbers don’t include the results from tens of thousands of rapid-result antigen tests. Antigen tests are taken by nasal or throat swab like other viral tests, but results are much faster. DSHS reports statewide results from these tests on a separate dashboard.
Delays and backlogs in reporting can also create one-day surges when cases from multiple days are added on the same day.
New cases of coronavirus each day
The average number of cases reported over the past seven days shows how the situation has changed over time by de-emphasizing daily swings. The number of new cases reported drops on weekends, when labs are less likely to report new data to the state.Apr. 1June 1Aug. 1Oct. 12,0004,0006,0008,00010,00012,000Reopening began May 1Mask order issued July 27-day averageNov. 236,576 cases
- Note: On March 24, the state changed how it reported numbers resulting in a sharp increase in cases. See notes about the data.
How has the positivity rate changed?
The seven-day average positivity rate is calculated by dividing the average of positive tests by the average of total tests conducted over the last seven days. This shows how the situation has changed over time by de-emphasizing daily swings. Public health experts want the positivity rate to remain below 6% — and, ideally, to fall much lower.
In early May, Abbott said a rate over 10% would be a “warning flag.” The state doubled that mark in July before it dropped in August. The rate exceeded 10% again in late October.
The state began using only molecular tests to calculate its positivity rate, excluding “probable” cases detected by antigen tests, in early August.
7-day average for the positivity rate
The state released a new, more accurate version of the positivity rate in September, which is calculated by dividing positive molecular tests by total molecular tests. Because this new formula relies on the date on which the test was administered, the rates for previous days will be recalculated as more test results from those dates come in.
- State did not release testing data
Apr. 1Aug. 110%20%30%40%Reopening began May 1Mask order issued July 27-day averageGoal: Below 6%
- Note: Antibody tests were included in the new total tests counts for each day before May 14. Previously, the state had counted about 50,000 total antibody tests as virus tests, artificially deflating the positivity rate. See notes about the data.
On Sept. 14, DSHS began publishing a new version of the state’s positivity rate, which takes into account the date a coronavirus test was administered. Previously, the state’s rate relied on the date a test was reported to health officials and verified as a case, which sometimes caused the rate to swing wildly after officials input large numbers of older, backlogged test results.
The positivity rate calculation change revealed that the figure was higher in the spring than originally disclosed.
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How many people have been tested?
As of Nov. 22, Texas has administered at least 11,247,875 tests for the coronavirus since March. We do not know the number of Texans who have gotten a test because some people are tested more than once. The state’s tally also does not include pending tests.
Coronavirus test results reported to the state each day
The average number of tests reported over the past seven days shows how the situation has changed over time by de-emphasizing daily swings. In April, Abbott set a goal of 30,000 daily tests in the state.
- Viral tests (molecular and antigen)
- Antibody tests
- State did not release the breakdown of tests
Apr. 1June 1Aug. 1Oct. 150,000100,000150,0007-day averageGoal: 30,000 testsNov. 2199,683 tests
- Note: Antibody tests were included in the new total tests counts for each day before May 14. The state separately reported the number of new daily antibody and viral tests after that date. See notes about the data.
Since mid-May, state officials have separately reported the number of antibody tests. Antibody tests detect whether someone was previously infected, while standard viral tests determine whether someone currently has the virus.
Antibody tests are typically reported a day late.
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How is this impacting Texans of color?
The limited data released by state health officials offers a murky glimpse of the virus’ impact on Texas communities of color. Race and ethnicity are reported as unknown for a significant portion of the completed case reports. (Agency officials said some people prefer not to provide the information.)
Case data gathered in various parts of the state shows the disproportionate impact of the virus on Black and Hispanic neighborhoods. The areas with the highest positivity rates in Harris County are predominantly Hispanic, according to a UTHealth School of Public Health analysis. In Dallas County, lower-income Black communities have also reported some of the highest positivity rates.
And some regions of the state with the highest mortality rates have a large Hispanic share of the population, particularly in the Rio Grande Valley in South Texas.
What else should I know about this data?
These numbers come from the Texas Department of State Health Services, which typically updates statewide case counts by 4 p.m. each day. The data is from the same morning, and it may lag behind other local news reports.
In order to publish data quickly, the state has to bypass what is normally a monthslong process of reviewing the COVID-19 data and performing quality checks before publishing. That’s why all of these numbers and information are provisional and subject to change.
The state’s data includes cases from federal immigration detention centers, federal prisons and starting in mid-May, some state prisons. It does not include cases reported at military bases.
From March 13 through March 24, the Tribune added cases from Lackland Air Force Base in San Antonio, where hundreds of American evacuees from China and cruise ships were quarantined.
Those case counts came from the Centers for Disease Control and Prevention.
Notes about the data:
On March 24, the state changed how it reported numbers resulting in a sharp increase in cases.
Antibody tests were included in the new total tests counts for each day before May 14. Previously, the state had counted about 50,000 total antibody tests as virus tests, artificially deflating the positivity rate.
After a system upgrade on June 7 resulting in incomplete test data, the state revised the test numbers for June 6 to show a decrease in total viral tests. The testing numbers for June 6 are not shown in the test results by day chart.
On June 16, the state included 1,476 cases previously reported by the Texas Department of Criminal Justice from Anderson and Brazoria counties in its cumulative case count. The new cases for June 16 do not include those cases.
On July 17, the state received about 5,268 additional cases from Bexar County. The state only included 608 of those cases as new confirmed cases for that day and added the rest to the cumulative count.
On July 19, the state removed 3,676 duplicate antibody tests from the previous day’s total.
From July 23 to July 28, between 9% and 18% of hospitals reported incomplete hospitalization numbers due to changes in reporting to meet federal requirements.
On July 25, the state removed 2,092 probable cases from the Corpus Christi-Nueces County Public Health District that had been previously included in the cumulative case count.
On July 27, the state began reporting deaths based on death certificates that state COVID-19 as the cause of death. On that day, more than 400 previously unreported deaths were added to the total death toll due to the reporting change.
On July 30, the state said an “automation error” caused approximately 225 deaths to be incorrectly added to the overall death count; a subsequent quality check revealed COVID-19 was not the direct cause of death in these cases. We updated the cumulative numbers for July 27-29 to account for this error. The automation error also caused us to incorrectly state the percentage of Hispanics who have died of COVID-19 and the number of previously unreported deaths on July 27. These have been corrected.
On Aug. 3, the state removed 536 duplicate confirmed cases from the overall cases count for Bexar County. Bexar County reported 471 new confirmed cases on this date.
On Aug. 7, DSHS started dividing viral tests into molecular and antigen tests on their site. We’ve combined the two to come up with the total number of viral tests.
On Aug. 7, DSHS reported that some molecular tests had been miscoded, inflating the number of antibody tests over the previous couple of days. This was corrected, resulting in the number of antibody tests to decline from the 6th to the 7th. Because a breakdown of these tests is not available, the charts are showing the inflated numbers on those days.
On Aug. 10, the number of new cases reported did not include new cases from Nueces County due to a “large backlog of positive lab reports” that the county was working through.
In mid-August, several labs submitted large backlogs of tests to the state, which could not have been added untilcoding errors were fixed and a system update was complete. Because of this, the state reported a record number of tests on Aug. 13. Of those 124,000 tests, approximately 95,000 were from one lab serving several hospitals.
At the same time, DSHS started reporting backlogged cases during their daily updates. They are listed below. In all instances, these cases were added to the cumulative statewide total, as well as the cumulative count for the county listed. They were not added to the new cases reported for the state that day:
| Date | Cases |
|---|---|
| Nov. 23 | Harris (104), Madison (10), Llano (9), El Paso (4) and Waller (1) |
| Nov. 22 | Aransas (8), Bee (41), Brazoria (5), Duval (15), El Paso (45), Harris (79), Jim Wells (1), Matagorda (1), Refugio (1) and Wharton (1) |
| Nov. 21 | Brazoria (3), Burnet (1), Callahan (1), Clay (2), Deaf Smith (1), Ellis (4), El Paso (55), Erath (1), Fannin (2), Galveston (2), Gonzales (1), Gray (1), Harris (86), Hood (6), Hutchinson (2), Jackson (1), Johnson (24), Jones (2), Kaufman (2), Kendall (2), Kleberg (8), Oldham (1), Palo Pinto (3), Parker (7), Rockwall (1), Runnels (1), Swisher (1), Waller (2), Wilbarger (3), Young (2) and Zavala (1) |
| Nov. 20 | Archer (2), Brazoria (3), Clay (1), Coleman (1), Collin (6), Cottle (3), Dimmit (3), Eastland (2), Ellis (7), El Paso (123), Galveston (14), Gray (1), Harris (70), Hood (1), Jim Hogg (4), Johnson (5), Jones (1), Kendall (1), Liberty (3), Parker (1), Throckmorton (1), Wilbarger (13), Young (4) and Zavala (4) |
| Nov. 19 | El Paso (119), Galveston (1), Harris (49), Childress (2), Collingsworth (2), Dallam (1), Deaf Smith (1), Hall (2), Archer (1), Clay (1), Collin (1), Comanche (1), Johnson (5), Montague (2), Parker (1), Wise (1), Young (1), Camp (1), Cass (1), Franklin (2), Morris (1), Nacogdoches (1), Titus (4), Matagorda (1), Wharton (1), Brooks (3) and Jim Wells (1) |
| Nov. 18 | El Paso (184), Carson (4), Castro (6), Crosby (1), Deaf Smith (2), Gray (22), Hall (2), Hansford (1), Lipscomb (4), McMullen (1), Moore (4), Archer (1), Clay (1), Collin (5), Comanche (1), Johnson (5), Montague (2), Parker (1), Wise (1), Young (1), Trinity (1), Galveston (3), Harris (95), Liberty (2), Matagorda (4), Walker (1), Atascosa (5), Bandera (2), Gillespie (1), Gonzales (1), Guadalupe (7), Karnes (1), Kendall (1), Kerr (2), Lavaca (2), Wilson (4), Zavala (1) and Frio (1) |
| Nov. 17 | Collin (1), El Paso (108), Harris (659), Briscoe (1), Collingsworth (1), Deaf Smith (2), Lipscomb (7), Moore (3), Clay (1), Eastland (1), Ellis (1), Johnson (3), Rockwall (1), Wilbarger (1), Wise (1), Morris (1), Upshur (2), Atacosca (1), Dimmit (1), Gillespie (1), Wilson (1) and Loving (1) |
| Nov. 16 | El Paso (83), Harris (30), Bailey (1), Childress (1), Cochran (1), Dallam (1), Deaf Smith (5), Donley (1), Floyd (6), Gray (1), Hemphill (3), Hockley (19), Hutchison (17), Lamb (31), Lipscomb (8), Moore (6), Ochiltree (80), Parmer (1), Roberts (1), Sherman (1), Swisher (3) and Wheeler (10) |
| Nov. 15 | El Paso (121), Harris (49) and Galveston (1) |
| Nov. 14 | El Paso (151), Harris (136), Galveston (1), Clay (1), Johnson (2), Montague (1), Parker (1) and Wilbarger (3) |
On Aug. 24, the state was unable to update its testing numbers because of a power outage affecting multiple state agencies. The numbers, however, were added retroactively.
On Sept. 9, TDCJ reported 453 fewer cases among inmates in a state prison in Walker County. These were removed from the county’s total case count, as well as the statewide total.
On Sept. 12, the state said a data entry error caused 91 cases to be incorrectly added to the Sept. 11 statewide and Colorado County total case counts. We updated the cumulative numbers for Sept. 11 to account for this error.
On Sept. 14, the state published a new, more accurate version of the state’s positivity rate, which relies on the date a coronavirus test was administered. We changed our positivity rate chart to use this version. The numbers of tests used to calculate this new positivity rate do not match the numbers of tests shown in the test results by day chart.
The same day, the state started deduplicating their test results, causing a drop in overall tests. This made the seven-day average of tests incalculable for one week.
Also on Sept. 14, Lamar County overstated their case count by 41 cases. These were removed on Sept. 15. The statewide cumulative case count was also adjusted to reflect this change.
On Sept. 16, case counts decreased in 12 counties. TDCJ reported reduced case counts in Bee and La Salle counties. Cases were deduplicated in Calhoun, Gonzales, Guadalupe, Kerr, Lavaca, Orange, Roberts and Wharton counties. Shackelford and Swisher counties saw decreases after updating case information.
On Sept. 17, case counts decreased in 13 counties. TDCJ reported reduced case counts in Bee, Childress, Houston, Karnes, Madison and Walker counties. Cases were deduplicated in Bandera, Kendall, Titus and Zavala counties. Archer, Swisher and Yoakum counties saw decreases after updating case information.
On Sept. 18, case counts from TDCJ decreased in Anderson County by 1,070, which decreased the total number of cases for that county. Most of these cases were added back on Sept. 21. Also, TDCJ reported reduced case counts in Duval, Fannin, Grimes and Liberty counties. Bailey County saw a decrease after updating case information.
On Oct. 16, El Paso reported 1,555 new cases, which included cases from Oct. 15 and Oct. 16. The county previously did not report any new cases on Oct. 15.
On Oct. 20, some counties could not update their case counts because of an issue assigning cases to the correct jurisdiction in Texas Health Trace, an online system for contact tracing. These were added on Oct. 21.
On Oct. 29, the state removed 273 probable cases from Hays County that had been previously included in the cumulative case count.
On Oct. 30, the state removed 120 positive antigen cases from several counties that had been previously included in the cumulative case count.
On Oct. 31, the state removed 25 duplicate cases from several counties that had been previously included in the cumulative case count.
On Nov. 6, the state adjusted statewide and El Paso County cases after 1,563 cases that should have been reported Nov. 2 and 3 were instead reported Nov. 4.
On Nov. 9, the state removed 2,363 probable cases from Bexar County that had been previously included in the cumulative case count.
On Nov. 11, the state removed 260 overreported cases from Brazoria County’s cumulative case count and the statewide cumulative case count.
On Nov. 14, the state removed 108 overreported cases from McCulloch County’s cumulative case count and the statewide cumulative case count.
On Nov. 14, older cases were incorrectly added to the daily case counts in the following counties: Atascosa, Bandera, Calhoun, Dimmit, Frio, Gillespie, Gonzales, Guadalupe, Jackson, Kendall, Kerr, Lavaca, Medina, Wilson and Zavala. The statewide new case count for that day was adjusted on Nov. 16.
On Nov. 16, the state was unable to update its testing data because of technical difficulties. The issue was resolved, and testing data reported for that date includes laboratory tests from both Nov. 15 and 16.
On Nov. 18, the state removed 2 overreported cases from Loving County’s cumulative case count and the statewide cumulative case count for Nov. 17.
Carla Astudillo, Mandi Cai, Darla Cameron, Chris Essig, Anna Novak, Emily Albracht and Alexa Ura contributed to this report.
Correction: Due to an editing error, the Nov. 21 version of this tracker included incorrect death counts for 19 counties: El Paso has 949 deaths, not 106; Ellis has 106 deaths, not 949; Deaf Smith has 36 deaths, not 44; Delta has one death, not 36; Denton has 200 deaths, not one; DeWitt has 44 deaths, not 200; La Salle has 14 deaths, not 10; Lamar has 66 deaths, not 14; Lamb has 35 deaths, not 66; Lampasas has 10 deaths, not 35; Madison has 12 deaths, not two; Marion has 15 deaths, not 59; Martin has 176 deaths, not 169; Mason has two deaths, not six; Matagorda has 59 deaths, not 175; Maverick has 169 deaths, not one; McCullouch has six deaths, not 12; McLennan has 175 deaths, not 15 and McMullen has one death, not 7.
Previously, The Texas Tribune incorrectly stated our formula for calculating the average daily positivity rate. This tracker also included incorrect numbers for cumulative statewide tests on Sept. 14, 15 and 16. On Sept. 14, 15 and 16 there had been 5,671,966, 5,729,318 and 5,780,424 tests, not 5,637,040, 5,671,966 and 5,729,318 tests, respectively. In addition, the tracker included an incorrect number of total cases on Sept. 21 because of a Department of State Health Services error in reporting Bexar County’s backlogged cases. There were 1,742 cases statewide, not 1,732, and 2,078 backlogged cases in Bexar County, not 2,088. The tracker also included the incorrect number of cumulative cases and daily cases statewide on Oct. 13 because the state overreported the number of cases in Brazoria County by 159. There had been 800,256 cumulative cases, not 800,415, and 5,050 daily cases statewide, not 5,209. These have been corrected.
