As coronavirus increases in the MLB markets, so does the scrutiny of health experts.

Now that Major League Baseball has a start date for its pandemic-shortened season, it faces tough realities in markets where the coronavirus is skyrocketing, especially Houston, where a senior health official says he could oppose the games if current trends are not reversed – and so on.

The rate of coronavirus cases is increasing in 15 of the 27 US markets that have teams, with significant increases in Phoenix and Houston, according to COVID-19 Case Mapper, a collaborative project led by Stanford University that tracks national trends. The accelerated spread increases pressure not only on MLB’s plan to protect players and staff, but also on government officials who could shut down meetings, including baseball.

In Texas on Friday, Governor Greg Abbott again imposed limits on companies that reopened in May. Your order closes bars and limits restaurants to 50% of their capacity. In California, Governor Gavin Newsom ordered a county adjacent to San Diego to stay home on Friday. In two other critical states, Florida and Arizona, governors are pushing their reopening plans.

Abbott’s office did not respond to questions about how baseball might be affected. His order, which says outdoor gatherings of 100 or more people “must be approved by local governments,” appears to exempt professional and college sports. But Dr. David Persse, the city of Houston’s public health authority, told ESPN that he won’t be shy with his opinion if he thinks it’s too dangerous for MLB to proceed.

“If the public’s health is threatened, I will take a stand,” Persse said. “From an operational point of view, I am in the position where it will have to be me, that if I think it is going in the wrong direction, take a position.”

According to the Texas Medical Center, the rate of positive coronavirus tests for the Houston region, from 3% earlier this month, reached 14% this week. The medical center, which houses about 70% of beds in intensive care units in the metropolitan area, reported that its usual allocation of 1,330 beds, not including surge capacity, was full.

“That tells you that the virus is spreading rapidly,” said Persse. “I want us all to do the right thing and for the right reasons, and I’m trying to be realistic about it.”

In Arizona, home of the Diamondbacks, Governor Doug Ducey has the authority to restrict sports and other activities. As of Friday, he had not moved to do so. An official from Maricopa County, where Phoenix is ​​located, told ESPN this week that the public health department had not been asked to review the MLB’s 101-page safety plan.

“The department has not contacted the D’backs,” the official wrote in an email. “And honestly, he doesn’t have time to review any business’s reopening plans.”

In a statement to ESPN on Friday, MLB reiterated that it will resume across the country “only when it is safe to do so and is consistent with public health problems.”

“For us, this means that, at a minimum, we will play in a particular place only when we have the approval of all relevant government authorities,” the statement read. “To date, all government authorities have favorably inclined to allow gambling, at least in empty stadiums, in accordance with our extensive protocols. This situation may change as evolution from the virus occurs. If that happens, We will make adjustments to comply with any changes in government policy.

“Regardless of any government regulation, MLB will continuously monitor the development of the pandemic with our experts. We will consult with the Players Association and make operational decisions with the safety of our players and staff as the most important consideration.”

A major MLB source also told ESPN that if baseball and government officials decide that it’s not safe to play in a critical city, the teams will be moved to other stadiums.

Will Humble, executive director of the Arizona Public Health Association and a former state director of health, said the situation quickly deteriorated after the state’s order to stay home expired on May 15. Now, he said, “We are on the New York growth curve in terms of cases.”

“It is bad, and in my opinion, we will run out of hospital capacity, existing capacity without surge for the Fourth of July, and we will be in a surge state,” Humble said.

Still, he said he is not concerned that teams playing in empty stadiums could further jeopardize public health, assuming they all follow safety protocols and that teams control infections.

“I think it’s a threat to worker safety for players and coaches and whatnot, but I’m not concerned that this is going to make Arizona go off the cliff. We’re doing [that] fine on our own, “said Humble.

Florida, which has teams in Miami and St. Petersburg, recorded nearly 9,000 new cases of coronavirus on Friday, the highest to date.

“I don’t think my idea of ​​having games here has changed,” said Miami-Dade County Mayor Carlos Giménez, adding that the county’s health resources are not stressed now. “We have hundreds of ICU beds. We have thousands of critical care beds. We have the ability to add more, pretty quickly.”

In California, infection rates vary widely, with the hardest hit regions in the southern part of the state, home to the Angels, Dodgers, and Padres. But the hospital systems in the counties that host those teams, as well as the Giants and Athletics to the north, are not under the same stress as those in Phoenix or Houston.

Persse and other health officials say Houston is on track to deplete the hospital’s capacity at around the same time MLB has scheduled for Opening Day, or near July 24.

“What I fear is that by the end of July, we are going to have to assume that there will be so many viruses in the community that someone affiliated with the ball team, be it a player, a coach, someone, who will unknowingly become infected and then run the risk of infecting everyone else, “he said.

“I think this is an opportunity for major league sports of all denominations, if you like, to demonstrate that it really is about the community. This is where we must continue to put public safety and public health above all appearances. it has to do with profit. “

The comments came a day after Astros owner Jim Crane told reporters he wanted not only the players but also the fans to return to Minute Maid Park this summer and “sell some tickets, some merchandise, some cold beer. ” Crane Kenney, president of business operations for the Chicago Cubs, said this week that the team hopes to bring “a part of our fan base back to Wrigley Field.” Unlike Houston, Chicago has seen the virus decline steadily for more than six weeks.

In a statement to ESPN on Friday, Crane said the Astros “will not open our stadium to fans if it is not safe.”

“We would love to host fans at some point, however we will only do so with the approval of the city, county and state,” he said.

MLB sources told ESPN that any decision about admitting fans to the games would be made by the commissioner’s office, along with local officials.

Some public health experts interviewed by ESPN fear that even games without fans may increase the chances of spreading the virus, despite MLB protocols.

“What concerns me … is not actually the sporting event itself, but what is happening around the sporting event, especially in states that have not instituted social distancing requirements,” said Tara Kirk Sell, principal investigator for the Center. Johns Hopkins for Health Safety.

“If you have an event like a baseball game and you have bars that are open, you are going to have congregations in bars in states that have increasing rates of disease. And then you will see people in these bars that are sick, who give it to other people Those are overlapping opportunities. “

Dr. Carlos del Río, professor of global health and epidemiology at Emory University in Atlanta, said that if it were up to him, he would not allow games in Houston. Based on the New York experience, it will take months to control the epidemic, he said. “You don’t want to disturb a city that is having an emergency,” he said. “Houston has to control its epidemic before something like that happens.”

Persse said Houston’s best chance to avoid closing the season before it starts is for residents to be involved in reducing the spread of the virus.

“I would say to sports fans: ‘We can control this,'” he said. “Don’t wait for the government or anyone else; you’re the one in control. Wear a mask, social distance. Make everyone you know do the same.”

“But if you put your heels on and say, ‘This is a bunch of bad guys,’ I’m sorry, we are all going in the wrong direction, and big league sports will pay a price they don’t pay. ‘You don’t have to pay.’