AUSTIN -- School districts, local officials and hospitals are pushing back on Gov. Greg Abbott’s executive order barring mask and vaccine mandates, setting the stage for legal showdowns over coronavirus safety measures just as cases are surging in Texas and hospitals are filling up.

Houston ISD signaled its intention to require face coverings when students return this month. The University of Texas Medical Branch in Galveston requested an exemption to mandate COVID-19 vaccinations for staff, but was denied. Dallas County Judge Clay Jenkins required face masks at a meeting this week; he’s now being sued.

Abbott, a Republican facing reelection in 2022, shows no sign he will change course. At a conference in Dallas this week, he declared that going forward “there will not be any government imposed shutdowns or mask mandates.”

While GOP activists cheer the move, public health experts warn cases could continue to climb and potentially overwhelm hospitals without immediate action. The highly contagious delta variant is driving the spread in Texas and cutting a path largely through unvaccinated communities. Hospitalizations are rising at their steepest rate since the pandemic began.

Abbott continues to urge coronavirus vaccinations for those who want one. But Texas lags many other states: about 53% of residents here 12 and older are inoculated against COVID-19, compared with more than 58% percent nationwide.

Dr. Mark McClellan, who advised Abbott earlier in the pandemic, said local officials need flexibility based on conditions in their area.

“There is evidence that wearing a mask, especially at times of high community transmission which Texas has right now, does help significantly,” said McClellan, former commissioner of the U.S. Food and Drug Administration and director of the Duke-Margolis Center for Health Policy at Duke University.

“I appreciate that wearing a mask is inconvenient, I would rather not do it,” he said. “But if there are high rates of transmission in the community I think it’s important for local authorities to have the ability to make a decision that works best for their students and their population.”

Early last year, Abbott said he would rely on data and doctors in making decisions to promote public health. McClellan was one of Abbott’s four original medical advisors, but is no longer playing that role.

Abbott has remained in regular contact with one of the original advisors, Department of State Health Services head Dr. John Hellerstedt, since the beginning of the pandemic, according to spokeswoman Renae Eze. Hellerstedt did not answer questions about whether he agreed with Abbott’s executive order.

“Governor Abbott has been clear that we must rely on personal responsibility, not government mandates,” Eze said in a statement. “Every Texan has a right to choose for themselves and their children whether they will wear masks, open their businesses, or get vaccinated.”

Abbott, whose two primary challengers decry mask mandates and criticized him over restrictions imposed early in the pandemic, is winning praise in his approach from conservatives. Texas Republican Party Chairman Matt Rinaldi asked supporters Wednesday to sign a thank you card for Abbott’s rebuke of coronavirus mandates.

“I thank Governor Abbott for this critical, common-sense action,” he wrote in an email.

But calls are growing for Abbott to loosen the rules, which are at odds with the latest federal guidelines. The U.S. Centers for Disease Control and Prevention recommends universal masking at school and suggests that even vaccinated people wear face coverings indoors where cases are surging, a step that would protect themselves and others who are immunocompromised or unvaccinated.

Children under age 12 are not yet eligible for a shot, making them particularly vulnerable when they return to school this month.

Houston ISD first

On Wednesday, Houston ISD became the first school district to announce plans to require masking when classes start for its nearly 200,000 students. The proposal will come up for a vote at the district’s board meeting next week.

“The health and safety of our students and staff continues to be the guiding compass in all of our decisions,” Superintendent Millard House II said in a video posted to Twitter.

It remains to be seen whether other school districts follow suit in defying Abbott’s order. El Paso officials wrote to Abbott this week urging him to give school districts a choice in whether to require masks or not. Dallas ISD did not respond to a request for comment.

Violations of Abbott’s order can result in a fine of up to $1,000. Georgina Pérez, a State Board of Education member from El Paso, volunteered to raise money to help pay fines for school districts that defy the governor’s order by mandating masks.

“Knowingly not protecting children from harm goes against everything that teachers stand for,” she said.

Abbott’s office did not immediately respond to questions about whether any fines have been levied to date. Houston Mayor Sylvester Turner has faced no pushback since he told the city’s roughly 20,000 workers on Monday to resume wearing masks at work, according to a spokesperson.

Attorney General Ken Paxton told Jenkins on Friday to stop requiring masks at county commissioners court meetings.

“Please revoke your recent mask mandate by August 9, 2021, or I will consider all available options to stop your unlawful mandate,” Paxton wrote without elaborating.

Exemptions sought

Some institutions that sought exemptions from Abbott’s order have been rejected. The latest version blocks a wide swath of government entities, including cities, counties, universities and publicly funded hospitals, from requiring staff get the vaccine while full FDA approval is pending.

The University of Texas Medical Branch would want to require vaccination of its frontline clinical staff and requested an exemption, but was told to abide by the governor’s order, according to Dr. Janak A. Patel, director of the Department of Infection Control & Healthcare Epidemiology.

Dr. John Zerwas, the UT system’s vice chancellor for health affairs, raised the exemption request with Abbott recently, who was not willing to change his position, he said.

Parkland Hospital, a publicly funded organization that falls under Abbott’s order, plans to require its employees get vaccinated as soon as the FDA fully approves the shot. In anticipation, Parkland alerted staff this week that the first dose will be required by Sept. 24 and the second — or single Johnson & Johnson dose — by Oct. 15. Approximately 71% of staff are already vaccinated against COVID-19.

“These steps are necessary to protect Parkland’s complex patient population who, due to their socio-economic status, often have no choice in where they receive care,” said Michael Malaise, senior vice president of communications and external relations for Parkland, in an email.