When Gov. Greg Abbott announced the beginning of restarting the Texas economy he short-circuited a plan already developed by teams appointed by Mayor Ron Nirenberg and Bexar County Judge Nelson Wolff.
There’s no question that under state law Abbott has the power to trump local plans with his plan. Still, it’s useful to look at how the two plans compare, both as to what they contain and how they were put together. I’ll call them the San Antonio Plan and the Abbott Plan. Today we’ll look at who our leaders sought out to develop a hugely important strategy to restore our health and our economy. Next week I’ll discuss the plans in more detail, including the remaining importance of the San Antonio Plan.
The San Antonio Plan was developed by two separate task forces, one made up of medical experts and the other of business leaders. Both developed lengthy, detailed reports that can be found at the City’s web site, here for the medical report and here for the business report. And both came out of lengthy, detailed meetings attended by all members of the task forces.
The medical team reads like an all-star line-up. It’s chaired by Dr. Barbara Taylor, associate professor of infectious diseases and the assistant dean for the MD/MPH Program at UT Health San Antonio. She attended Princeton University and Harvard Medical School and has spent much of her career dealing with HIV/AIDS.
I don’t have room to list all 14 other members of the widely representative team, but consider just the credentials of the first three members listed in alphabetical order.
Dr. Bryan Alsip, chief medical officer for University Health System, attended Cornell University and Georgetown University School of Medicine. He has a masters in public health from Johns Hopkins University. He is a fellow of the American College of Preventive Medicine.
Dr. Ruth Berggren also got her medical degree from Harvard and is board certified in internal medicine. She spent much of her early career working on HIV/AIDS and hepatitis C, including working on vaccines. She directs the Center for Medical Humanities & Ethics at UT Health San Antonio and annually takes a group of medical students to Ethiopia to work as school nurses.
Dr. Caroline DeWitt is an infectious diseases specialist and the managing partner of San Antonio Infectious Diseases Consultants. The group provides infectious diseases consulting expertise to the Methodist, Baptist, and Christus health care systems. She formerly was the director of the infectious diseases clinic at Wilford Hall Medical Center, and received the Air Force Commendation Medal for her work in bioterrorism response.
The San Antonio Plan’s business task force is also impressive. One co-chair is Kevin Voelkel, president of Toyota Motor Manufacturing Texas. The other is Julissa Carielo, owner of Tejas Premier Building Contractor, a midsized construction company.
The other 18 members include leaders in a variety of industries, including hotels, restaurants, professional services, education, and insurance.
Now let’s look at the team that is given credit for the Abbott Plan. At the top of its report it lists:
- Lt. Gov. Dan Patrick, who recently suggested that grandparents are ready to risk death to restart the economy for their grandchildren. Patrick also has his own economic recovery team, headed by Brint Ryan, who runs the state’s largest firm helping businesses avoid or lower their tax payments. Another qualification is that Ryan has donated $500,000 to Patrick’s campaigns in the past five years.
- Speaker of the House Dennis Bonnen, who is not running for reelection after a scandal in which he was recorded secretly asking a right-wing lobbyist to help defeat 10 Republican House members whose votes on a single issue did not please Bonnen.
- Attorney General Ken Paxton, who has indicated his concern for public health by appealing a judge’s ruling that anyone concerned about contracting the coronavirus at the polls can vote by mail.
The governor’s “strike force” is chaired by James Huffines, a financier who has served on various boards for Republican governors Abbott, Rick Perry, and Bill Clements. Its chief of staff is Mike Toomey, a leading lobbyist who was chief of staff for Perry and Clements.
The Abbott Plan has a Special Advisory Council of about three dozen business leaders, many of whom are campaign contributors, and the executive director of the conservative Texas Public Policy Foundation.
The Abbott Plan lineup does include four doctors to go along with three of the most conservative Republican politicians, a lobbyist, and several dozen business executives. They include two experts in infectious diseases and public health, a former pediatrician, and a former anesthesiologist.
Dr. John Hellerstedt is commissioner of the Texas Department of State Health Services. He attended the University of Pittsburgh Medical School and did his residency in pediatrics here in San Antonio. His background includes seven years working in the state’s Medicaid program.
Dr. Parker Hudson is an assistant professor of internal medicine and infectious disease at the Dell Medical School at the University of Texas at Austin. He trained at the University of Pennsylvania and completed his master’s in public health in epidemiology at the University of North Carolina.
Dr. Mark McClellan is a professor of business, medicine, and policy, and founding director of the Duke-Margolis Center for Health Policy at Duke University; former administrator of the Centers for Medicare & Medicaid Services; and former commissioner of the U.S. Food and Drug Administration.
The fourth, Dr. John Zerwas, is an anesthesiologist who now serves as executive vice president for health affairs for the University of Texas System. He was a Texas legislator for seven terms.
Not surprisingly, the Abbott Plan did not indicate much influence from the medical world. When Abbott partially opened businesses May 1, the state had not yet met a number of milestones that had been recommended to the governor. On April 30, the state reported a record number of deaths at 50 and its second highest number of new cases at more than 1,000. Since then, there have been only two days on which the case count has been below 1,000.
There had not been 14 days of falling numbers. A benchmark of daily testing had been set at 30,000, about double what it was on May 1. It was also clear that the state didn’t have close to enough “contact tracers” to find and quarantine people exposed to persons with COVID-19.
By contrast with the politician-driven state process, the San Antonio Plan gave the job of setting the criteria for opening to the medical experts. The business leaders saw their task as helping businesses do a good job when they were allowed to open.
“We have two crises, a health crisis and an economic crisis,” said Toyota’s Voelkel. “Both together are monumental. But we shouldn’t make people choose between health and business. How do we create a balance to give the consumers the confidence to make things work?”
Under the San Antonio Plan, most businesses would still be waiting to reopen, but likely not for much longer. The city has reached three of its four milestones. The number of cases has been declining for two weeks and the hospitals have more than enough capacity to deal with a surge. We are however, only about halfway to being able to test the benchmark 3,000 people a day, although about 1,000 more are about to be added. And the Metropolitan Health District says it has enough contact tracers available.
Next week we’ll look at details of the San Antonio Plan – both parts – in more depth, because much of it is relevant even in the wake of the governor’s early opening.