Exposed: COVID-19 was spreading in Houston before the rodeo, records show



 
March 4

WORLD CASES: 95,272
WORLD DEATHS: 3,255 (92 percent in China)
CASES IN 81 COUNTRIES
U.S. CASES: 103
U.S. DEATHS: 11
TEXAS CASES: 1
HOUSTON-AREA CASES: 1
RODEO ATTENDANCE: 70,936

Lina Hidalgo arrived late and flustered to the rodeo grounds for Armed Forces Appreciation Day, missing the Apache helicopter flyover and a soloist’s rendition of “God Bless America.” The 29-year-old Democrat, who won the campaign for Harris County’s top government job two years ago, headed straight for the podium.

She’d just learned that Fort Bend County had confirmed the first COVID-19 case in the Houston area, linked to a river cruise in Egypt. Sixteen more passengers on the same cruise flew back to Houston on Feb. 20. Some went to work or church or Costco before realizing they might have been exposed. Public health workers were frantically trying to retrace their steps, estimating they could have infected dozens of friends, family members and medical workers.

Sporting a borrowed charcoal-hued cowboy hat, Hidalgo swore in a group of cadets and took her seat, scanning the crowd of thousands for her parents. Her mind raced. The virus’ timing was terrible. The rodeo was the region’s biggest event. And shutting it down was not just her call. The county owns the rodeo site, NRG Park, but it sits within the city’s public health jurisdiction. Still, she’d worried for days about the risk of keeping it going.

About this Series

When a novel virus first surfaced in China last year, it followed a path that public health experts in the U.S. had feared for years. But as COVID-19 quickly spread, it became clear that officials at all levels of government were unprepared — despite the warnings. This series documents how public officials failed to protect the public, leaving millions of people exposed.

Coming soon

Part 2:

Warned: Officials at all levels of government knew they were unprepared for a pandemic and cut funding anyway.

Part 3:

False assurances: Officials said the state could reopen early, citing a low death rate. It turned out to be wrong.

Hidalgo made eye contact with Mayor Sylvester Turner, knowing he must have heard about the Fort Bend case. A news alert announced it while they were on stage, popping up on cellphones in the crowd. After the ceremony ended, instead of strolling the rodeo grounds with her parents, she headed for her car. “I’m sorry we didn’t get to say hello,” she texted them in Spanish. “I have to go. Kisses.”

In the early days of the coronavirus outbreak, the public messaging from the federal level down to local was consistent: Risk to the public was low. More than 850,000 people passed through the NRG gates as officials insisted there was no evidence the virus was spreading unchecked. But a Houston Chronicle investigation based on thousands of pages of emails, texts and documents and more than 50 interviews shows that a cascade of failures starting at the federal level left local officials ill-equipped to confront the biggest public health threat in generations.

Local public health officials learned of the region’s first case of COVID-19 on March 4. But epidemiologists found that nearly three dozen people in Harris County who later tested positive said their symptoms started before that date — some as early as Feb. 10. Three of those patients died.

Records show early efforts to contain the virus were hamstrung by stringent U.S. Centers for Disease Control and Prevention guidelines on who could be tested. The federal agency had shunned the World Health Organization’s tests, then bungled its own attempt to produce them, leaving too few to go around. Houston-area doctors complained to local public health officials as early as January that they were sending home patients with COVID-like symptoms who had traveled to China, but not specifically Wuhan province.

Still, local officials kept the rodeo going for days after the region identified its first cases, reluctant to pull the plug until it became clear they could not contain the spread.

They finally shut it down two weeks after its kickoff celebration, when public health officials learned the virus was there from the beginning. They traced it back to the pre-rodeo BBQ cookoff, to tent C-706.

Feb. 1
 

WORLD CASES: 12,038
WORLD DEATHS: 259 (100 percent in China)
CASES IN 25 COUNTRIES
U.S. CASES: 8
TEXAS CASES: 0
HOUSTON-AREA CASES: 0

The papers were piling up on Dr. David Persse’s typically tidy desk. Colleagues at the health department were getting emails from him at odd hours. Lunch, when he got one, was turkey on toast from the deli across the street from his office. The squarely built 61-year-old was even skipping his Sunday night hockey league.

Persse was Mayor Turner’s point man on COVID-19, empowered by state law to enforce public health restrictions. It was his call, along with the mayor, to decide how to combat the virus.

An obsessive planner who thinks in worst-case scenarios, Persse sees it as his job to be “Dr. Downer.”

And there was bad news everywhere.

With the virus’ reported 2 percent fatality rate in China, Persse warned Turner that if even 10 percent of Houstonians became infected over the course of a year, hospitals would be overrun. Perhaps 4,600 city residents would die.

Suspicion among Chinese health officials that the virus could spread before patients showed symptoms also was bad news, he warned.

On Jan. 21, the day after the U.S. reported its first confirmed case, Persse had a false alarm. A girl was admitted to a hospital in Katy with flu-like symptoms after traveling from Wuhan, but her test came back negative.

Still, some doctors worried that they were missing cases because the CDC’s testing criteria were too strict. Prior to Feb. 1, doctors could test only people who had symptoms of COVID-19 and had either traveled to Wuhan, or been in contact with someone with a confirmed or suspected infection within the past two weeks.

Dr. Christian Tu, an emergency room physician at Houston Methodist Hospital, emailed Persse that three patients came into the ER on Jan. 31 after returning from Taiyuan or Beijing. All had coughs; some were feverish. The hospital discharged them without testing them for COVID-19 because they had not specifically traveled to Wuhan, Tu wrote.

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By then, Beijing had 156 known cases, World Health Organization records show. And Taiyuan had at least one case, too.

“We have had many cases presented to us that do not meet CDC criteria for testing,” Persse wrote to Tu, “and that has been frustrating for some. However, we cannot compel the CDC to test patients who do not meet criteria.”

The CDC broadened its criteria to include mainland China on Feb. 1, but kept its stringent requirements for symptoms and exposure.

Persse wanted to reassure doctors and the public, but he had concerns. Without more testing, there would be no way to contain it.

And once the cases were no longer directly traceable, Houston would have “community spread.” That, he knew, would be incredibly difficult to stop.

Feb. 28
 

WORLD CASES: 84,120
WORLD DEATHS: 2,873 (97 percent in China)
CASES IN 58 COUNTRIES
U.S. CASES: 16
U.S. DEATHS: 0
TEXAS CASES: 0
HOUSTON-AREA CASES: 0
RODEO ATTENDANCE: 73,433

Dr. David Persse, local health authority for the Houston Health Department, addressed the media about the region’s first presumptive positive case of COVID-19.

(Elizabeth Conley, Staff Photographer | Houston Chronicle)

Hidalgo arrived at Memorial Park just before 5 p.m. to greet roughly 2,000 trail riders who had come on horseback from across Texas to attend the rodeo. The judge, a vegan sporting faux-leather cowboy boots, couldn’t pick the winning brisket, but she was excited for her second rodeo season.

She had prepared a speech with a punch line about fried Oreos and failed New Year’s resolutions. And she looked forward to seeing Chance the Rapper’s rodeo performance the following Friday. But her concerns about the coronavirus were mounting.

Her communications team kept including a standard CDC talking point in her speeches — that the risk to the American public remained low. Hidalgo kept taking it out.

She was frustrated with the lack of information from county departments, and with having to ask repeatedly for the pandemic plan. “This is a hurricane that we see coming, and we have no excuse,” she had said in a meeting that morning. “I need you to get me the information I ask for.”

A test was pending for one suspected COVID-19 patient, and county staff were monitoring 30 others who potentially were exposed.

Persse sent Turner a direct and foreboding weekly update. California and Washington State officials had detected community spread. “As predicted, the U.S. strategy of ‘containment’ appears to begin to fail,” he wrote. “We should expect to have community spread in Texas shortly.”

The Houston area still had no laboratories capable of running tests, so samples had to be sent to the CDC in Atlanta. Tests were in short supply.

Seven miles away, the gates opened at NRG for the barbecue cookoff.

That night, Mary Menzel and her husband steered through the grounds on electric scooters, entering the “Cayenne Social Club” tent through swinging saloon-style doors. They socialized here each year as sponsors, often dancing. The brisket steamed.

Mary’s husband, Roger, accompanied her as she worked the crowd under the tent, which held up to 404 people. Mary Menzel always greeted everyone with a hug or a kiss. The 72-year-old engineering and political consultant, with perfectly coiffed short hair and Southern charm, never slowed down.

Roger noticed a man coughing.

Feb. 29
 

WORLD CASES: 86,013
WORLD DEATHS: 2,942 (96 percent in China)
CASES IN 62 COUNTRIES
U.S. CASES:
24
U.S. DEATHS: 1
TEXAS CASES: 0
HOUSTON-AREA CASES: 0
RODEO ATTENDANCE: 102,571

Philip Patrick Sun’s anxiety had been rising for months as news of the novel coronavirus got worse and worse. As leaders across the world reassured their citizens that the risk of exposure was low, his cousin in Wuhan told a different story.

The streets were closed, the markets empty. People who left their homes suited up in layers of clothing: Overcoats, galoshes, scarves, hats. Fearful the virus would infiltrate their ears, eyes and nose, they donned masks, earmuffs and goggles.

Then, the 70-year-old and his wife awoke in Houston to even more troubling news: A Taiwanese-American woman who reportedly became sick while traveling in Egypt on a Nile River cruise had tested positive for the virus. A number of Houstonians had been on board.

Sun, president and CEO of a health care nonprofit, started calling friends and colleagues, trying to track down who was sick and what was being done
about it.

His concern grew. A Rice University researcher who went on the trip was under investigation. A doctor friend told him a traveler from the cruise was ill, but couldn’t get tested, Sun said.

Oh my God, Sun thought.

The passengers didn’t know they’d been exposed until more than a week after they returned. Egypt was not a known hot spot for the virus. One passenger had gone to an urgent care in Fort Bend County on Feb. 24 with a fever but did not qualify for a test. Another attended a church service on Ash Wednesday at St. Cecilia’s in Hedwig Village.

Sun called the CDC, the state and the city and county health departments, he said. On March 2, he emailed the federal Department of Homeland Security, warning that Egyptian cruise members could be unknowingly spreading the virus in the Houston area.

“To our knowledge two couples in the Memorial area of Houston are sick (not tested), one from the Sugar Land area is sick (not tested), two from California have tested positive in California,” Sun wrote.

The email found its way to Persse, who responded that health officials were aware of what was happening. Emails show the CDC in Houston was still trying to get a copy of the cruise ship manifest to see who was on board.

Texans aboard the MS A’Sara cruise ship returned home on Feb. 20 without realizing they were exposed to COVID-19 during a Nile River cruise.

(AFP Via Getty Images | Houston Chronicle)March 2
 

WORLD CASES: 90,372
WORLD DEATHS: 3,085 (94 percent in China)
CASES IN 74 COUNTRIES
U.S. CASES: 52
U.S. DEATHS: 6
TEXAS CASES: 0
HOUSTON-AREA CASES: 0
RODEO ATTENDANCE: N/A

Dr. Kelly Larkin dreaded this afternoon meeting with rodeo executives. One of 35,000 volunteers, Larkin served as a vice president and the point person on the virus.

Rodeo staff already were fielding questions about whether they would cancel. A marquee Houston energy conference, CERA Week, was nixed the day before. And a petition was circulating to cancel Austin’s trendy music and tech conference, SXSW.

Larkin, 54, knew what was at stake. Last year, the rodeo generated an estimated $391 million. But for Larkin and other volunteers, it held a deeper significance.

She’d never heard of the rodeo before she moved to Houston from upstate New York for her medical residency in the 1990s. Then, one spring, cowboys kept landing in her emergency room with concussions and broken bones. Intrigued, she visited one night and stood feet from the chute door as a bull burst out. She was hooked.

Larkin had done what she could to promote the rodeo’s COVID-19 preparations. There were three times as many hand washing and sanitizing stations as last year. Signs featuring the rodeo’s mustachioed H-shaped mascot read: “Howdy says ‘Don’t forget to wash your hands!’”

She consulted with Persse, who was conflicted.

He knew local COVID-19 cases were inevitable and criticism would arise if someone who had it attended the rodeo. He already had warned Larkin and rodeo staff in late January that the virus could cut the show short. But with no confirmed cases, he didn’t want to foment panic.

“As of today, there is no reason not to go to the Rodeo,” he emailed the rodeo’s marketing chief, adding that he hoped to see Willie Nelson at NRG in a few days.

Still, Larkin felt rodeo CEO Joel Cowley, board chairman Jim Winne and chairman-elect Brady Carruth needed her blunt assessment:

“I have no crystal ball. I don’t know what’s going to happen,” Larkin said. “But my feeling is that we will not make it through the whole show.”

March 4
 

WORLD CASES: 95,272
WORLD DEATHS: 3,255 (92 percent in China)
CASES IN 81 COUNTRIES
U.S. CASES: 103
U.S. DEATHS: 11
TEXAS CASES: 1
HOUSTON-AREA CASES: 1
RODEO ATTENDANCE: 70,936

Dr. Paul Klotman, Baylor College of Medicine’s president, glanced at his fellow hospital executives around the table in the Texas Medical Center boardroom, wondering whether these meetings would do any good.

They were competitors, after all. Some of the executives, who together ran the largest medical center in the world, had never met until Mayor Turner asked the group to update him on their coronavirus preparations.

Now TMC CEO Bill McKeon wanted to hold regular talks. He called the 7 a.m. meeting to order.

So far, only about a third of the 103 known cases across the U.S. were travel related. Eleven Americans were dead. Federal officials warned it might be time to adopt social distancing measures.

The rodeo came up.

Klotman and a few dozen Baylor colleagues had attended the night before, high-fiving over the decision to sponsor hand sanitizer stations. They ate barbecue and cheered as a chuck wagon with the Baylor Medicine logo pulled ahead of fellow sponsors Ford and Shell.

Mark Wallace of Texas Children’s Hospital and Dr. Peter Pisters of M.D. Anderson argued that the group should encourage the mayor to close the rodeo. The public health risk of such an enormous gathering, they said, was simply too great.

Others, including Klotman, hesitated. Hell, he said, we’re a rodeo sponsor. I was there last night. Think of the economic hit.

Harris County Judge Lina Hidalgo, second from left, directed the county’s response to COVID-19 and met with other local leaders on March 5 as the first local cases were confirmed confirmed.

(Melissa Phillip, Staff Photographer | Houston Chronicle)March 5
 

WORLD CASES: 98,028
WORLD DEATHS: 3,348 (90 percent in China)
CASES IN 85 COUNTRIES
U.S. CASES: 172
U.S. DEATHS: 12
TEXAS CASES:
HOUSTON-AREA CASES: 5
RODEO ATTENDANCE: 60,911

Ana Zangeneh watched her 5-year-old daughter, Donna, climb atop a pony and ride around the rodeo ring.

Zangeneh, 36, had planned on joining Donna’s class field trip for months — but COVID-19 almost ruined it.

Zangeneh, who had worked at Harris County Public Health for eight years, supervised the agency’s contact tracers – workers tasked with interviewing infected people to find out where they’d been and who they may have exposed.

In the past, the agency used contract tracing to track down people potentially infected with Zika, H1N1 and SARS, a rare respiratory illness. It was now the main tool, along with social distancing, for fighting the coronavirus.

Zangeneh and her fellow epidemiologists had been pulling 14-to-16-hour days seven days a week, trying to get a handle on it.

By the time Zangeneh joined her daughter at the rodeo, regional health officials had spent days tracking down the passengers on the Egyptian river cruise.

She was grateful for the brief escape. But it ended abruptly when she returned to the office that afternoon. In addition to the Fort Bend case announced the night before, two Harris County residents had tested positive. At a community meeting that night, Turner stressed that all were tied to the same international trip.

“We cannot live our lives in fear,” he said. “I do encourage people to put on your hat, your boots, and go to the rodeo and enjoy.”

Ana Zangeneh, who supervises disease surveillance and epidemiology for Harris County Public Health, took her daughter, Donna, to the rodeo on March 5.

(Courtesy, Ana Zangeneh | Houston Chronicle)March 8
 

WORLD CASES: 109,993
WORLD DEATHS: 3,803 (82 percent in China)
CASES IN 100 COUNTRIES
U.S. CASES: 450
U.S. DEATHS: 21
TEXAS CASES: 11
HOUSTON-AREA CASES: 9
RODEO ATTENDANCE: 109,857

Lt. Chris Hernandez felt feverish. Nine days had passed since he attended the rodeo cook-off. He could barely walk up the stairs.

He lay on his bed, gasping.

“Daddy, are you OK?” his 6-year-old son asked.

“Go get your mom,” Hernandez told him.

Hernandez, 43, was one of seven full-time officers in Patton Village, a small city north of Houston, where he served largely in an administrative role. He had taken the week off, working extra jobs around the clock managing traffic on opposite sides of the city. He’d been to Buc-ee’s in Baytown, to a taco shop in Rosenberg with two other officers and to House of Pies in southeast Houston.

As the week progressed, Hernandez had developed a cough, body aches and a fever. Now, he felt like he was drowning.

His wife drove him to an urgent care clinic, then to CHI St. Luke’s Health in The Woodlands, where Dr. Amrew Al-Ahmad, 36, had been preparing for his first COVID-19 case.

Al-Ahmad specializes in pulmonary critical care. A decade earlier, as a resident, he treated patients with H1N1. Doctors at St. Luke’s were among the first in Texas to use artificial lungs during the outbreak to help oxygenate patients’ blood when they struggled to breathe.

Al-Ahmad had been studying how to treat the coronavirus since the start of the COVID-19 epidemic, trading ideas with more than 100 Houston-area doctors in a group chat.

He felt as prepared as anyone could be, but he knew there still was a lot to learn about the virus and how contagious it was. Around 4:20 p.m., Hernandez, the 251-pound police officer, struggled toward the hospital doors.

March 9
 

WORLD CASES: 113,946
WORLD DEATHS: 3,987 (78 percent in China)
CASES IN 103 COUNTRIES
U.S. CASES: 515
U.S. DEATHS: 22
TEXAS CASES: 13
HOUSTON-AREA CASES: 12
RODEO ATTENDANCE: 80,875

At the county’s emergency operations center, Hidalgo was fed up.

For days, she had asked public health staff to draw up guidelines that would allow her to force the closure of the rodeo and all other public gatherings. She had asked county attorneys what her powers were in a pandemic, planning to call Turner once she had a proposal. But no documents were ready.

She also had urged public health officials to track suspected COVID-19 patients’ movements before lagging test results confirmed their diagnoses. But contact tracers did not notify a Catholic church where a suspected COVID-19 patient had attended Ash Wednesday service until after the test results came back. Worse, staff had lied to her about it.

She demanded a firing and got one.

Hidalgo’s staff are accustomed to her peppering them with questions, even on trivial issues, and refusing to accept the answers until she deems them logical.

She applied that approach to public health officials’ insistence on waiting to close the rodeo until there was confirmed community spread. She decided it made no sense. Testing remained woefully inadequate. Contact tracing was slow.

County executives in Seattle and San Francisco, two hot spots ahead of Houston in their outbreaks, had advised her to take aggressive action while she could.

After Austin officials canceled SXSW, Turner argued it drew more international attendees than the rodeo. But Hidalgo didn’t find that comforting. The 1 percent of patrons visiting the rodeo from abroad last year amounted to 12,000 people.

“I’m concerned we’re just letting the virus in,” she told her staff.

And yet, she hesitated to override the public health officials.

Am I crazy? she wondered.

Then the judge spoke to Dr. Esmaeil Porsa.

The new Harris Health CEO hadn’t officially been on the job a week, but he’d been trying to schedule a meeting with Hidalgo for days.

Porsa, a physician with a master’s degree in epidemiology, wanted to update her on how the county hospital district was responding to COVID-19, and to share another pressing concern. The rodeo needed to close, he said.

Oh, thank you, she thought when they connected. Somebody finally agrees.

Porsa warned that community spread was already occurring. “We’re just not detecting it,” he said, “because we’re not looking hard enough.”

Dr. Esmaeil Porsa, Harris Health System president and CEO, second from left, privately urged Harris County Judge Lina Hidalgo to shutdown the rodeo to help contain the virus.

(Melissa Phillip, Staff Photographer | Houston Chronicle)March 10
 

WORLD CASES: 118,967
WORLD DEATHS: 4,267 (74 percent in China)
CASES IN 106 COUNTRIES
U.S. CASES: 713
U.S. DEATHS: 28
TEXAS CASES: 16
HOUSTON-AREA CASES: 14
RODEO ATTENDANCE: 65,960

Hernandez, still hospitalized, received the test results around 4:30 p.m. He was positive for COVID-19.

An epidemiologist called to ask where he’d been and whom he’d had contact with.

Did you leave the country?

No, Hernandez said.

He was having trouble focusing. What if I die? What about the kids?

The investigator asked: Were you with anyone who seemed sick?

No, he said.

After Hernandez hung up, he talked to his police chief, who encouraged him to think about everywhere else he’d been. Hernandez, struggling to speak, remembered he’d gone to the cook-off.

“Get off the phone with me and let them know what’s going on,” Chief Shannon Sharp said.

So Hernandez said he called the Montgomery epidemiologist back. He couldn’t remember the name of the tent, but said he shared the number of the friend who invited him.

Persse, carpooling back from testifying before lawmakers in Austin, took call after call.

He was worried. No one had found a connection to the Egyptian river cruise — and he feared they wouldn’t.

This guy lives on Lake Conroe? He thought. That’s nowhere near any of our cases.

“This is it,” he said to a colleague. “This is community spread.”

That night, doctors moved Hernandez to the ICU. He wasn’t sleeping well and struggled to breathe.

As soon as Persse heard that Hernandez hadn’t traveled anywhere, he called the mayor and then Larkin, who was attending a reception at NRG Center. She stepped into the hallway to answer.

“I have bad news,” Persse said, describing the case.

“Oh no,” Larkin said.

“And I have worse news,” Persse added. “He was at the barbecue cook-off.”

“Oh no,” Larkin said again, her voice falling.

Rodeo CEO Joel Cowley, sitting a few hundred yards away, near the bucking chutes in NRG Stadium, felt his phone buzz.

“Hold on a moment!” he shouted into the receiver, climbing out of the cacophonous bowl of the stadium, where the K-pop band NCT 127 was mid-set.

Cowley knew Larkin wouldn’t call so late just to chat.

Seeing Larkin’s name on her husband’s phone, Cowley’s wife, Tammy, followed him to a quiet corridor lined with horse stalls.

Cowley looked at his wife and swiped his fingers across his neck.

Fans cheered as the South Korean band NCT 127 performed on March 10 at NRG Stadium. Attendance that day was more than 64,000.

(Jon Shapley, Staff Photographer | Houston Chronicle)March 11
 

WORLD CASES: 126,675
WORLD DEATHS: 4,611 (69 percent in China)
CASES IN 112 COUNTRIES
U.S. CASES: 1,105
U.S. DEATHS: 33
TEXAS CASES: 19
HOUSTON-AREA CASES: 15
RODEO ATTENDANCE: About 18,000

Klotman was walking near his home in the Museum District when he dialed into the 7 a.m. Zoom meeting with the other TMC executives. The question about urging a shutdown of the rodeo came up again. When he heard McKeon ask for a virtual show of hands— “Is everyone in favor?” — Klotman joined the chorus answering “yes.” It was unanimous.

Klotman hung up, and felt a sense of sadness.

Houston’s in it, he thought, just like everybody else.

At a City Hall news conference just after noon, Mayor Turner announced the closure of the rodeo. Turner said bluntly: This is evidence of community spread.

Hidalgo took it a step further: There may have been other cases of community spread officials had missed because testing was limited.

In the barn at NRG Park, seventh-grader Lauren Bolcik called her mom, hysterical. They had been sixth in the endless line of trailers the day before, waiting from 10 a.m. until past midnight to tug their heifer into the best spot.

“What are you talking about? Have you lost your mind?” Nancy Machac-Bolcik asked her daughter, sprinting back from the hotel room where she was checking in.

High school senior Jenna Lloyd began to cry, heartbroken she wouldn’t get to show her heifer Sadie Kane.

When Larkin returned to NRG just after 2 p.m., the grounds had gone quiet.

She glanced up at the huge screen that normally shows highlights of bull riding or calf roping as she rode the long escalator up to the rodeo offices. “The Rodeo will close the grounds today at 4 p.m.,” it read. “Please remain calm and exit in an orderly fashion.”

Larkin had tasks to assign and people to call, but she couldn’t stop staring at that screen as the escalator hummed underfoot.

Across the Houston area, public health agencies all handled potential rodeo related cases differently. Some didn’t ask specifically about attendance, others did. Some didn’t follow up about what tents they visited, others did. Sometimes the cases were reported to another agency or organization, but rarely was it the same.

Harris County epidemiologists went back through interview notes to find people who had tested positive and mentioned they had attended the rodeo. They found 12.

As news of the impending rodeo closure rippled through NRG Center on March 11, many reacted with disappointment and disbelief.

(Mark Mulligan, Staff Photographer | Houston Chronicle)March 12
 

WORLD CASES: 132,450
WORLD DEATHS: 4,917 (65 percent in China)
CASES IN 114 COUNTRIES
U.S. CASES: 1,530
U.S. DEATHS: 43
TEXAS CASES: 23
HOUSTON-AREA CASES: 18

Hernandez couldn’t stop panting. His heart rate climbed.

“Things are getting worse,” Al-Ahmad told Hernandez. He asked if they could intubate.

It was a serious decision. Because a breathing tube is so uncomfortable to insert, Hernandez would have to be put to sleep.

“Let’s do it,” said Hernandez, desperate to feel better.

At 9:15 a.m., doctors induced a coma and threaded the breathing tube down his throat.

Since Hernandez tested positive, epidemiologists trying to retrace his steps had been running into problems. His employer for his side job directing traffic, a woman in her 30s under investigation in Galveston County, had also developed a fever and a cough. She was awaiting test results.

By that afternoon, contact tracers wrote that they couldn’t get the information or records they needed. Hernandez said he slept in his car because he had back-to-back shifts, but contact tracers suspected he also had stayed at his employer’s apartment.

“The employer and patient are not being compliant at this time making the trace back investigation extremely difficult,”according to an email shared among employees with the Galveston County Health District.

Hernandez’s infected lungs stiffened.

Al-Ahmad called Hernandez’s wife and told her he needed to hook her husband up to a machine to breathe for him — the same technique pioneered at St. Luke’s with H1N1. It hadn’t been used much yet on coronavirus patients in America, but Hernandez was young and relatively healthy.

They needed to buy time.

“This is his only chance,” Al-Ahmad told her.

Al-Ahmad’s wife, Dana Hailat, texted to check in. The 32-year-old dentist worried the coronavirus could kill her husband, whom she had known since childhood. She asked how his patient was doing.

“About to do ECMO,” he told her, referring to the life support for his heart and lungs.

“This is so awful!!!” she wrote. “Poor guy!”

After a 13-hour day, Al-Ahmad arrived home. He showered in the garage apartment and changed into the clothes Hailat left him. He avoided kissing her so as not to get her sick. They ate dinner with their kids, ages 4 and 2.

Al-Ahmad didn’t know how long Hernandez had to live. He got into bed with his laptop and stayed up reading about what else he could do.

Montgomery County Public Health District officials prepared a news release in case Hernandez died.

Patton Village police Lt. Chris Hernandez, who was hospitalized for than a more than a month, celebrated his release from the hospital with fellow officers and medical staff.

(Brett Coomer, Staff Photographer | Houston Chronicle)March 19
 

WORLD CASES: 245,633
WORLD DEATHS: 9,981 (33 percent in China)
CASES IN 155 COUNTRIES
U.S. CASES: 12,674
U.S. DEATHS: 265
TEXAS CASES: 324
TEXAS DEATHS: 6
HOUSTON-AREA CASES: 71
HOUSTON-AREA DEATHS: 1

Mary Menzel fell for the second time in two days.

“I’ve had real bad allergies and real bad bronchitis,” she told the 911 dispatcher around 1:30 p.m.

“Have the doctor or the health department told you to quarantine or isolate for the coronavirus?” the operator asked.

“No,” Menzel said.

She said she didn’t have a cough, fever or shortness of breath.

Roger Menzel, 85, followed the ambulance to the hospital.

“I’m not going to stay here,” she told her husband of nearly three decades from the gurney, sending him home to feed the dogs.

He knew to do what she asked; she was headstrong. Her nickname “The Hammer” stuck for a reason. She knew immediately they would marry when she first saw Roger at a local chamber of commerce meeting. He would tell anyone: She was one-of-a-kind.

Mary told Roger to come back later to take her home. That evening, a neighbor called 911 after she saw Roger standing by his car, swaying back and forth, struggling to breathe.

Mary Menzel with her husband, Roger, before they both caught COVID-19.

(Courtesy, Roger Menzel | Houston Chronicle)April 5
 

WORLD CASES: 1,265,377
WORLD DEATHS: 73,540 (5 percent in China)
Cases in 183 countries
U.S. CASES: 337,573
U.S. DEATHS: 12,429
TEXAS CASES: 7,209
TEXAS DEATHS: 222
HOUSTON-AREA CASES: 2,234
HOUSTON-AREA DEATHS: 60

Hernandez was off the ventilator, but was 42 pounds lighter. His legs felt weak; his speech sounded slow and slurred. When he looked at his cellphone, he saw more than 800 notifications.

A friend called to warn him that Hidalgo had said at a news conference that he was “not cooperating.” It was a lot to process. He was incensed as he read details of his private life dissected publicly. He started to learn to walk and talk again.

Roger Menzel spent more than two weeks in the hospital being treated for COVID-19. When he was discharged, his world had changed. Texas was under-stay-at-home orders. His son and grandson drove him home.

Mary Menzel was treated at a different hospital than he was. Her doctors had called him at the end of March. She was fighting COVID-19 too, breathing with the help of a ventilator. She’s unresponsive, they said.

She’d been that way for three days with no improvement. The doctors asked to take her off life support.

Roger Menzel asked them to wait one more day.

He couldn’t stand the thought of her suffering. When they called back the next day and said she hadn’t gotten better, he let her go.

EPILOGUE
 
Today
 

WORLD CASES: 32,712,009
WORLD DEATHS: 991,678 (0.47% in China)
CASES IN 188 COUNTRIES
U.S. CASES: 7,077,329
U.S. DEATHS: 204,486
TEXAS CASES: 757,614
TEXAS DEATHS: 15,723
HOUSTON-AREA CASES: 195,189
HOUSTON-AREA DEATHS: 3,421

The rodeo’s cancellation launched a wave of closures across Houston and startled the public into acknowledging the virus’ threat. School districts closed campuses. Churches suspended services. Panicked people emptied grocery market shelves. Doctors and nurses rationed masks and gloves.

As Hidalgo and Turner issued stay-at-home orders, the federal response remained sluggish. Days after the rodeo shut down, the CDC recommended canceling events of 50 or more people. With a shortage of federal testing supplies, it took until late March to get the city’s first public testing site running.

By early April, Harris County epidemiologists were so overwhelmed they stopped contact tracing every single case and instead focused on high risk groups, such as nursing homes.

Gains from the local lockdown were lost after the state’s reopening in May, as cases surged.

Hernandez returned to work, still unsure where he caught COVID-19 and resentful that he was blamed by some for shutting down the rodeo.

“What would have happened if they had continued going? Was Houston ready for it? Absolutely not,” he said. “So a lot of those people who were talking mad trash to me? I took a bullet for everybody. Without even knowing I did.”

At least three others who attended the cook-off caught COVID-19. How many people they infected is unknown.

The sun set on an empty Houston Livestock Show and Rodeo grounds on March 11.

(Elizabeth Conley, Staff Photographer | Houston Chronicle)A note about sourcing
 

To reconstruct the behind-the-scenes decisions that led to the shutdown of Houston’s biggest event, Houston Chronicle reporters sought to answer two critical questions: When did COVID-19 arrive in the nation’s fourth-largest city? And when did officials know it was spreading out of control?

A team of reporters spent six months scouring tens of thousands of pages of emails, memos, reports, internal documents and text messages obtained through public records requests from eight local agencies. They studied federal Centers for Disease Control and Prevention guidelines and World Health Organization reports.

They interviewed more than 50 people, including COVID-19 patients who attended rodeo events, elected officials, public employees and medical professionals. Whenever possible, they verified accounts with witnesses and documents. Direct quotations used in the story came from contemporaneous recordings, meeting notes, copies of text messages, or the recollections of participants who consented to interviews; in each case, those quotes have been verified by the people to whom they are attributed or a family member. Italics were used when people recalled their own thoughts.

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Mike Morris is a local government enterprise reporter for the Houston Chronicle who has covered City Hall or Harris County government since joining the paper in 2011. He won a Texas Associated Press Managing Editors’ annual Freedom of Information award and was a Livingston Award finalist for a series of stories documenting rampant mismanagement at the Harris County Housing Authority. You can reach him at mike.morris@chron.com and follow him on Twitter @mmorris011.

Emily Foxhall joined the Houston Chronicle in 2015 as a suburban reporter. She has documented the city’s sprawl while playing a key role in the paper’s breaking news and enterprise coverage. Her reconstruction of the Santa Fe High School shooting, along with two other colleagues, won first place for feature writing from the Texas Associated Press Managing Editors. She was part of the Chronicle team that was named a finalist for the Pulitzer Prize for breaking news in 2017 for coverage of Hurricane Harvey. Soon after, she began roaming the state as a storyteller and is now delving into the environment. You can reach her at emily.foxhall@chron.com and follow her on Twitter @emfoxhall.

Alex Stuckey is an investigative reporter for the Houston Chronicle and joined the paper in 2017. That same year, she won a Pulitzer Prize after unearthing the rampant mishandling of sexual assault cases at Utah colleges and universities while working at the Salt Lake Tribune. She is an Investigative Reporters and Editors award winner and a Livingston Award finalist. You can reach her at alex.stuckey@chron.com and follow her on Twitter @alexdstuckey.

Reporter Jordan Rubio contributed to this report.

Design and photo editing by Jasmine Goldband

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