“What’s been disheartening over the past week or two has been that it feels like we’re back at square one,” Dr. Mir M. Alikhan, a pulmonary and critical care specialist, said to his medical team before rounds. “It’s really a terrible kind of sinking feeling. But we’re not truly back at square one, right? Because we have the last three months of expertise that we’ve developed.”

Houston’s hospitals have some advantages compared with New York’s in the spring. Doctors know more now about how to manage the sickest patients and are more often able to avoid breathing tubes, ventilators and critical care. But one treatment shown to shorten hospital stays, the antiviral drug remdesivir, is being allocated by the state, and hospitals here have repeatedly run out of it…

“We are having to pioneer the way of trying to understand a different curve with some very good characteristics versus the last curve,” said Dr. Marc Boom, Methodist’s president and chief executive.

But he cautioned, “What I’m watching really closely is whether we see a shift back in age — because if the young really get this way out there and then start infecting all of the older, then we may look more like the last wave.”