Longview Mayor Andy Mack attributes early steps to control the spread of COVID-19 to initially keeping case counts low in the city.
Those counts have increased as Texas emerged from shelter-in-place orders and more testing became available, he said, and Mack predicted cases will surge if schools open as planned.
A number of schools in the East Texas area plan to return to classes in August.
"We're going to see spikes simply because of the reality of what's taking place. When you get kids together, they're going to spread this disease," he said. "It's just the way it is."
Mack spoke Tuesday to Rotary Club of Longview members, who had gathered through a method that numerous organizations have been using during the COVID-19 pandemic — virtually through the teleconference app Zoom.
The good news, Mack said, is that while children can get very sick with COVID-19, they don't appear to have the same troubles with the illness as adults and people who are immunocompromised. His bigger concern is that those children could spread the illness to their parents and grandparents — people who might suffer more than school-age children, he said.
"If and when school starts and kids get back in school, we're going to see a spike in these cases again," just as professional sports teams are starting to see as they resume play, he said.
He said he wasn't making a statement about whether it's right or wrong to send children back to school. That's a personal decision for parents, he said.
"I don't envy anyone who has school-age children right now. It would be a very, very difficult decision," he said. "You know that you're taking a risk sending your child into, basically, a group, which is what it is."
He said he knows, though, that all the schools and superintendents are doing everything they can to keep children, teachers and employees safe.
Gregg County logged its first case of COVID-19 on March 9.
Mack said that "as things progressed that week," it became apparent COVID-19 would be a bigger issue than originally anticipated. Local officials asked superintendents to extend spring break for two more weeks to provide time to learn more about the virus, how it's spread and how it is treated.
"Fortunately, our superintendents all agreed, and they all extended spring break. I think that was very instrumental in putting us where we are," Mack said.
Later in March, he and Gregg County Judge Bill Stoudt issued shelter-in-place orders when the second and third cases occurred.
"Smith County, at that point in time, had multiples of our numbers at that point and had really done nothing," Mack said. "They weren't being as active or as proactive as we were at that time, and we were taking criticism for that. Looking back, I think this is what kept us in a better place than Smith County the entire time."
The governor issued a statewide order March 31, when Longview had six cases, Mack said. The governor also ordered schools closed until May 4.
By May 1, when Texas began reopening, Longview had 61 cases, Mack said. By May 31, that number had grown to 234.
By June 26, he said, there were 17 coronavirus hospitalizations in Longview, with 270 cases by June 30.
By July 6, there were 49 hospitalizations, and that number grew to 77 hospitalizations by July 20.
Also, Longview had logged 930 COVID-19 cases by July 27 and 15 deaths. So far, 171 recoveries have been reported, though Mack said that number will always remain low because people don't return for a follow-up COVID-19 tests for a variety of reasons.
Mack said he watches the hospitalization rates because "that's where the fault is going to be if we get into a situation where we're having to make life-and-death decisions."
Longview's two hospitals have a combined 650 beds and 50 adult ventilators, along with some pediatric ventilators and anesthesia machines that could be used in the place of ventilators, he said.
That state requires that 25% of hospital beds be reserved for COVID-19 patients.
"We're doing well, but we're still pushing that hospitalization number up," Mack said.
He said the only thing people can do is try to prevent the disease in any way possible. Social distancing, staying at home, washing your hands, wearing a mask — they all work, he said.
"It lessens your chance of getting it," he said, and that's the whole goal, to lessen the spread of the disease and keep the hospitals from being overrun.