Last night I said that Texas is already in a “soft” lockdown, with Gov. Greg Abbott strongly encouraging — but not formally ordering — people not to leave their homes amid a “massive” outbreak of COVID-19. The psychological and political pressure on Abbott not to issue that formal order and institute a “hard” lockdown is tremendous. Psychologically it would require him to all but admit that the state wasn’t ready to reopen when he said it was. It’s hard to admit that sort of error, especially when lives are on the line. Politically it would no doubt be seen as a massive act of “disloyalty” by Trump. The president’s concluded that his path to reelection lies through a massive economic comeback. If a state as populous as Texas shuts down again, it’ll be a double whammy: Not only will the economy take a hit from the loss of productivity, other states struggling with outbreaks right now might treat it as political cover to lock down again too.

We might have a cascade effect across the south, replete with tens of thousands of layoffs. Next month’s jobs number might erase the gains made this past month. Trump and Congress would suddenly come under (greater) pressure to put together a new relief package for unemployed workers. Even if the lockdown only lasted a few weeks, it might set back the economy enough to erase all possibility of a strong trend towards recovery by November to help Trump at the polls.

But Abbott may be left with no choice. The state set a new daily record for confirmed cases today with nearly 6,000. Houston’s ICUs are already close to capacity. If the health-care systems in the state’s major cities begin to buckle over the next week and cases keep rising, he might have to go nuclear to avoid calamity — assuming it won’t be too late to do it. Until then, though, he’s putting the brakes on the state’s reopening plans:

Gov. Greg Abbott announced Thursday morning that he will pause any further phases of reopening Texas and that he is once again putting a stop to elective surgeries to preserve bed space for coronavirus patients in certain counties.

Abbott’s latest action does nothing to reverse any of the reopening phases he’s already allowed for — meaning that bars, restaurants, malls, bowling alleys and other businesses are still allowed to remain open with some capacity limitations. “The last thing we want to do as a state is go backwards and close down businesses,” he wrote in a press release on Thursday, but the “pause will help our state corral the spread.”

The latest ban on elective procedures only applies to Bexar, Dallas, Harris and Travis counties, four areas where the number of patients hospitalized with virus is quickly progressing.

That last paragraph, with its use of the word “only,” makes it sound like the four counties named are podunk areas covering a tiny part of Texas. They’re the counties where San Antonio, Dallas, Houston, and Austin are located, respectively. All of the major population centers are now facing enough of a crunch for hospital beds that they’re having to stop elective procedures. The medical director of a hospital system in Houston warned residents that, although he can manage the crunch right now with the surge capacity they have, that will become untenable within weeks. “[I]f this trajectory is what it was the last 10 days,” he said, “when we literally had almost a tripling of our cases — we can’t do that for a couple of weeks at all.”

Remember that it typically takes two to three weeks for a new COVID infection to develop to the point where hospitalization is needed, which means that the die is probably already cast in Houston as to whether hospitals will end up overwhelmed. People are being infected today who’ll end up at the hospital a few weeks from now. Abbott is gambling that a new lockdown wasn’t needed because the many informal warnings to Texans this past week have penetrated well enough to begin slowing the spread by convincing them to social distance aggressively. If he gambled wrong about that, Texas will have quite a situation on its hands by mid-July.

This morning on CNN, Sanjay Gupta was left marveling that the richest, most powerful country in the world is handling its outbreak about as well as Brazil while first-world nations in Europe are Asia are getting back to business:

JUST NOW: "I cannot believe we're in the position that we're in in right now. We're the greatest country on Earth. We should have been able to figure this out."

Wow…I have never heard @drsanjaygupta so frustrated.@NewDaypic.twitter.com/ForyHvqI8T

— John Berman (@JohnBerman) June 25, 2020

Believe it, my man:

The United States.

Source: https://t.co/AH3KJdUd0U pic.twitter.com/G3wjnc3GuV

— Nicholas Carlson (@nichcarlson) June 24, 2020

Fun fact for Gupta: In the capital of Texas, the records system is so outdated and cloddish that COVID test results are being typed out, then *faxed* to the local public health authorities, whereupon the info on the fax needs to be retyped into the authorities’ computer system. “It’s archaic,” said the local county commissioner. “It is so crude I am horrified to hear this.” In Arizona, demand for tests right now is so huge relative to testing capacity that appointments in Phoenix for drive-through testing by the state’s largest lab are booked solid for the day within seven minutes of opening for business in the morning. Per the Times, last Friday the lab ended up with fully twice as many samples as it can process.

I’m still slightly hopeful that we’ll have outperformed Brazil when this is all over. Probably some third-world countries too. Maybe.

I’d say no less than 50 percent of the clamor for more mask-wearing by me and others is driven by exasperation that the country just can’t seem to get a handle on the pandemic already. Trumpers have their magical cure in hydroxychloroquine, people like me have our magical preventive in masks. Just wear the mask and everything will be fine. Eh, not really. But there is an important difference between HCQ and masks. While the evidence that HCQ works against COVID remains paper thin, the evidence that universal mask-wearing would put a dent in the outbreak is abundant. In fact…

Over the last 2 weeks, cases have risen by 84% in states that don't require wearing masks in public. In states where mask wearing is mandatory, cases have fallen by 25%. https://t.co/VJkKe7yEQ3 pic.twitter.com/2iXgg3ZwZ8

— John Duchneskie (@jduchneskie) June 24, 2020

Nate Silver thinks there may be something to that. Maybe we’ve reached a point of sufficient desperation, though, that it’s time to think beyond conventional approaches like more mask-wearing. Robert Gallo, the famous researcher who helped discover HIV in the early 80s, argued in a letter to the Times today that we should strongly consider dosing out the polio vaccine to Americans because its ability to stimulate the immune system may end up heightening our defenses to the coronavirus. Any immunity it provides would be short-lived, but a series of short-term “boosters” against the virus is better than watching Houston’s hospital system collapse.