HOUSTON — In recent days, Gov. Greg Abbott of Texas commemorated the anniversary of India’s independence with a crowd in his office. He mingled with hundreds of Republican supporters at a packed campaign event. He posed with the brother of the famed guitarist Stevie Ray Vaughan.
Photographs from the events show that few of those who met with the governor wore masks, and neither did Mr. Abbott, who has prohibited local governments from mandating them.
So when Mr. Abbott tested positive for the coronavirus this week, Texans began questioning the circumstances that may have led to his infection and the efforts to identify those who may have been in close contact with the governor, who was fully vaccinated.
At least 10 other sitting governors — four Democrats and six Republicans — have contracted the virus since the pandemic began, but Mr. Abbott’s diagnosis landed in the middle of a pitched battle between the governor and his largest cities over public health measures in schools and as Covid-19 patients are again packing hospitals.
In its announcement on Tuesday, Mr. Abbott’s office said the governor, 63, is tested daily and began receiving monoclonal antibody treatment after his positive result. The treatment is used to help prevent hospitalization and is usually reserved for those who have compromised immune systems or other underlying conditions, or those older than 65.
Mr. Abbott’s age alone would place him at greater risk for progression to severe Covid-19, said Dr. Jessica Justman, an infectious-disease specialist and epidemiology professor at Columbia University’s Mailman School of Public Health. That Mr. Abbott is paralyzed from the waist down — he was injured by a falling tree in 1984 and uses a wheelchair — adds medical complexity because it increases the risk of other infections, she added.
Mr. Abbott’s aides declined to elaborate further on his condition, except to say that monoclonal antibody treatment must be approved by a doctor. The governor received his first vaccine dose in December.
His aides also would not provide Mr. Abbott’s schedule or describe his activities in recent days. Hours before his positive test, however, Mr. Abbott spoke before a crowd of several hundred people in a small golf and retirement community north of Dallas called Heritage Ranch. The governor could be seen in images posted by his campaign speaking on a stage and shaking hands with members of the local Republican club.
It was not immediately clear what efforts had been made to identify and quarantine those who were in close contact with the governor. His office referred questions back to its statement on Tuesday, which said all of Mr. Abbott’s close contacts “today” had been notified.
Collin County, where the event took place, does not conduct its own contact tracing, a county spokesman said, relying instead on the state health department, which did not respond to a list of questions about its efforts to locate close contacts of Mr. Abbott.
An image posted on Monday to Mr. Abbott’s personal Twitter account showed him posing with Jimmie Vaughan, a well-known blues rock guitarist based in Texas whose brother died in 1990. Shortly after Mr. Abbott announced his positive test, Mr. Vaughan said in a statement that he had tested negative.
On Friday, the governor met in his office with at least 18 people — “friends from the Indian American community here in the state of Texas” — to commemorate the anniversary of India’s independence. Only one mask could be seen.
But it was images of the event in Collin County on Monday night that drew the most attention.
That the governor had been at a large and almost entirely mask-less event a day before his positive test dramatized the largely two-track experience of the virus in Texas — and underscored the politically charged nature of any response.
Collin County, once reliably conservative, has become hotly contested by Democrats and is seen by many political analysts in Texas as a bellwether for the state. Democratic candidates and activists believed they could flip the county in 2020 but came up short. Mr. Trump won the county by more than four percentage points.
Energizing Republican voters in the county is important for the party, and staying in touch with his base is important for Mr. Abbott, who is facing challenges in the Republican primary next year from several candidates who see him as vulnerable on the right.
Understand the State of Vaccine and Mask Mandates in the U.S.
- Mask rules. The Centers for Disease Control and Prevention in July recommended that all Americans, regardless of vaccination status, wear masks in indoor public places within areas experiencing outbreaks, a reversal of the guidance it offered in May. See where the C.D.C. guidance would apply, and where states have instituted their own mask policies. The battle over masks has become contentious in some states, with some local leaders defying state bans.
- Vaccine rules . . . and businesses. Private companies are increasingly mandating coronavirus vaccines for employees, with varying approaches. Such mandates are legally allowed and have been upheld in court challenges.
- College and universities. More than 400 colleges and universities are requiring students to be vaccinated against Covid-19. Almost all are in states that voted for President Biden.
- Schools. On Aug. 11, California announced that it would require teachers and staff of both public and private schools to be vaccinated or face regular testing, the first state in the nation to do so. A survey released in August found that many American parents of school-age children are opposed to mandated vaccines for students, but were more supportive of mask mandates for students, teachers and staff members who do not have their shots.
- Hospitals and medical centers. Many hospitals and major health systems are requiring employees to get a Covid-19 vaccine, citing rising caseloads fueled by the Delta variant and stubbornly low vaccination rates in their communities, even within their work force.
- New York. On Aug. 3, Mayor Bill de Blasio of New York announced that proof of vaccination would be required of workers and customers for indoor dining, gyms, performances and other indoor situations, becoming the first U.S. city to require vaccines for a broad range of activities. City hospital workers must also get a vaccine or be subjected to weekly testing. Similar rules are in place for New York State employees.
- At the federal level. The Pentagon announced that it would seek to make coronavirus vaccinations mandatory for the country’s 1.3 million active-duty troops “no later” than the middle of September. President Biden announced that all civilian federal employees would have to be vaccinated against the coronavirus or submit to regular testing, social distancing, mask requirements and restrictions on most travel.
Mr. Abbott’s response last year to the coronavirus, measures that included business restrictions and a mask mandate, angered some Republicans and helped spark a revolt within the state party. Allen West, the former Florida congressman, was elevated to the party’s top post last summer and has since quit the position to challenge Mr. Abbott.
But as coronavirus hospitalizations have again surged in the state, nearing last year’s peaks, Mr. Abbott has resisted calls for new mandates. He also has banned local elected officials from imposing mask or vaccine requirements. After leaders in several large cities, including Dallas, San Antonio and Houston, bucked the order and went ahead with mask mandates, the governor took them to court. The Texas Supreme Court is currently weighing the issue.
In place of mandates, the governor has instead urged Texans — whose rate of vaccination lags the national average — to get vaccinated voluntarily. As intensive care units become increasingly filled, he has asked hospitals to voluntarily postpone elective procedures and has expanded the use of the monoclonal antibody treatment he is now receiving. The state health department also has requested five mortuary trailers from the federal government to be deployed as needed, though none had been requested by cities or counties as of Tuesday.
In a short video message about his positive test, Mr. Abbott pointed to his own vaccination to explain why he did not feel sick. “I have received the Covid-19 vaccine and that may be one reason why I’m really not feeling any symptoms right now,” he said from a balcony in the Governor’s Mansion overlooking the State Capitol.
But his treatment, and the lack of information about it, raised questions even among some doctors. “It’s hard to piece it together from the public information,” said Dr. Peter J. Hotez, a professor at Baylor College of Medicine in Houston and a vaccine expert.
The use of monoclonal antibodies before any symptoms develop is not unusual, though, said Dr. Aruna Subramanian, an infectious-disease doctor at Stanford Medicine. “It is really meant for people who are not yet in the hospital to prevent hospitalization,” she said. “The earlier you get it, the better.”
But, she added, the level of testing and treatment received by Mr. Abbott is not typical. “This should be all the more reason for people to get vaccinated, and wear masks and take precautions,” she said. “Because they’re not going to get the treatment he’s getting.”