Dr. Gregory Gray, a professor of Internal Medicine at the University of Texas Medical Branch, said that as at-home testing becomes increasingly popular, clinical- and hospital-gathered data about COVID-19 will become increasingly inaccurate as a measurement of the disease in the overall population. He suggested officials may have to move to conducting cohort studies where infection rates are determined through antibody testing of groups over time.

Faced with increased demand and dwindling supplies, the University of Texas Medical Branch is rationing an antibody treatment shown to be effective against COVID-19, restricting the medicine to the sickest and most at-risk people, including some who are unvaccinated. People eligible for the antibody treatment include those not expected to mount an adequate immune response and some unvaccinated people, including anyone 65 years of age or older, said Dr. Gulshan Sharma, the medical branch’s chief medical officer.

The University of Texas Medical Branch’s four-hospital network will likely run through its remaining 600 doses of sotrovimab in 10 days, said Dr. Gulshan Sharma, the system’s chief medical officer. “We’re just hoping and waiting to see what we get,” he said. “It’s anybody’s guess what would be the allocation.”

UTMB Health, anchored by the John Sealy Hospital in Galveston, had to close beds and assign more patients to each nurse. Elective surgeries that require a bed for recovery are being delayed, said Dr. Gulshan Sharma, vice president and chief medical officer, for UTMB Health. About 400 of UTMB’s employees — including 200 of the system’s 4,000 health care workers — tested positive for coronavirus, more than double the number who tested positive during the delta surge. “There is not a dedicated COVID staff or non-COVID staff. Patients still continue to have heart attacks or stroke complications from their chronic diseases, and they show up to our (emergency rooms),” Sharma said. “But our (emergency room) volume is up by almost 50 percent compared to last week.”

The holidays brought a huge demand for COVID tests, health officials said. But demand hasn’t led to delays at the University of Texas Medical Branch campuses, which have built up testing capacity during the most recent wave, said Dr. Janak Patel, the director of Infection Control and Healthcare Epidemiology at the medical branch. Hospitalizations and deaths haven’t increased significantly, he said. “Do not expect the illness to be mild,” Patel said. “You still can get prolonged high fevers. You still can get headaches and joint aches and fatigue that can last for several days. The outpatient illness is still pretty significant.”

The increase in cases is being felt across the county, including at its largest medical provider, the University of Texas Medical Branch, where hundreds of employees are out sick because of positive COVID-19 tests. About 300 of the medical branch’s 11,000 employees were quarantined as of Friday because they had tested positive for COVID-19, said Dr. Gulshan Sharma, chief medical officer. About half were front-line medical workers, and the number of quarantined is near that during the height of the delta variant surge, Sharma said.

While patient volume has remained steady during the pandemic, clinics are limited based on the number of providers and their caps on caseloads, UTMB officials said. UTMB Health Psychiatry Webster saw about 9,900 patients from September 2019 to August 2020; that number increased nearly 20% to about 11,800 patients seen from September 2020 to August 2021, according to UTMB data. while the introduction of telehealth has opened doors in terms of access, the demand is greatly outpacing the number of providers available for counseling, said Jeff Temple, a professor and licensed psychologist at UTMB. “There’s only so many hours and only so many people that an individual [provider] can see,” Temple said. “The increased access has helped, but the demand is so great that it still is leaving people lacking.

Dr. Prashant Rai, assistant professor, and associate director in the Neurology residency program at the University of Texas Medical Branch, wrote about researching brain fog in COVID-19 patients. “Our study showed the presence of brain fog/acute confusional state at admission or during hospitalization was associated with poorer outcomes overall, with these higher mortalities and increased need for intensive care support,” Rai wrote.