And predictions for the near future are growing increasingly dire.
As San Antonio sinks deeper into a crisis that has gripped Texas urban areas in recent days — the county reported 638 new cases on Thursday, its highest daily count yet, and 628 COVID-19 patients being treated in hospitals — one model by the Southwest Texas Regional Advisory Council expects 1,900 hospitalizations by mid-August, a figure that would overwhelm hospital staffing.
“We’re actually currently on the worst-case scenario curve” of that model, said Dr. Junda Woo, medical director at the Metropolitan Health District.
The health district relies on the modeling by STRAC, which coordinates trauma services and emergency care for Bexar and 21 surrounding counties.
Another expert is projecting a catastrophic 8,000 new hospitalizations here in the next three weeks unless more people change their behavior by wearing masks and practicing physical distancing.
“We will see our hospitals at full capacity in less than two weeks,” said Dr. Juan Gutierrez, chairman of UTSA’s math department who was selected by the city this spring to help project the course of the epidemic. “This is not a speculation. We know that this happened in Italy. When hospitals became overwhelmed, people were sent home and we just hope for the best.”
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Gutierrez has published projections of the epidemic from its onset, accurately predicting an initial peak in May. After that relatively small spike, cases were in decline until infections and hospitalizations began surging exponentially this month.
Social gatherings — particularly with friends and family at home — are partly to blame, said Dr. Barbara Taylor, an infectious disease specialist who leads a health team advising city and county officials.
“Your risk is raised if people who are not in your bubble of close contacts come over to your house,” Taylor said. “We’re seeing a lot of that (in COVID-19 patients), people who stayed home but then had people over. Well, if the people aren’t in your bubble, then they’re a risk to you and a risk to others.”
That includes even family members, she said.
“It’s hard because it’s your family, right? They feel like they should be in your bubble,” Taylor said. “But the reality is, if they’re not in your immediate bubble, they are high-risk to you and you are high-risk to them because they’re new.”
Taylor offered more advice as the disease surges.
Some who fear exposure to the virus are rushing out to get tested, she said. But the results of any test will be negative up to two days after exposure regardless of whether someone is infected.
COVID-19 Tracker: Interactive maps track coronavirus cases in San Antonio, Texas counties and the U.S.
“If you’re asymptomatic and you’ve been exposed, you should wait for eight days” to get tested, she said.
With the virus now so widespread, Taylor urged residents with any potential symptoms of COVID-19 — even a runny nose or diarrhea — to self-isolate.
“People with mild cold symptoms might not think, ‘I have this new coronavirus, which sounds so scary,’” she said. “Really, we should not be dismissing any symptoms that come with COVID at this point.”
Taylor added, “There is no safe space in our community right now. There is no risk-free space. But there are things that you can do to make those spaces less risky” — wear a mask, wash your hands frequently and practice physical distancing.
Too many Texans took the state’s gradual reopening as a cue to stop doing exactly those things, said Jimmy Perkins, former dean of the UT School of Public Health.
“People’s perception was that something changed, but nothing had changed,” Perkins said. “The fact of the matter is, maybe 5 to 7 percent of the population has had COVID. So we’ve got at least 90 percent of the population that’s a reservoir. All you’ve got to do is let those people loose and it’s going to increase exponentially.”
The massive surge in cases in the past three weeks has increased the percentage of people who test positive for COVID-19 from around 4 percent to 18 percent. San Antonio had one of the lowest big-city infection rates in the country in May. Now it has one of the fastest-growing infection rates.
“It’s frustrating,” Mayor Ron Nirenberg said. “We have seen a geometric rise in our case rates, and it’s happened literally within a matter of three weeks. That acceleration, unless we work together to get a grip on this virus, this car is going full speed headed toward a brick wall.”
A close-knit culture in San Antonio has likely contributed to the sudden rise in cases, said Cherise Rohr-Allegrini, an epidemiologist and a member of the health team led by Taylor.
“Our culture is one that’s very community focused, very family focused,” she said. “People get together, people hug, and not just San Antonio, but I think our Hispanic culture, and this is similar to Italian culture — people are very close. This is how we show our love and affection. And also our family size. It’s a wonderful thing about our culture. It also makes it hard for us to physically distance.”
Rohr-Allegrini added, “We have to change our messaging so people understand the risks associated with that.”
A critical message, Taylor said, is that family gatherings of any kind are high-risk.
“This is a community disease and this is a family disease,” she said. “We see this go through families where everyone gets infected. It’s really contagious. And it’s mostly people breathing on one another.”
Gutierrez’s “theoretical maximum” of total infections in Bexar County is a staggering 920,000 residents — about 40 percent of the population. Like Taylor and Perkins, he hopes a recent city-county order that compels businesses to force employees and customers to wear masks will reverse the upward trend.
“There is ample evidence, scientific evidence, that (wearing masks) works,” he said. “So that is what people should be doing. Exactly that. It’s the most important thing.”
“I think there just has to be more messaging about wearing masks,” he said. “If we get good compliance on wearing masks and people decide to quit going into places where they congregate, like bars, then we can turn it around.”
Doing so will take a collective effort, Gutierrez said.
“This virus is new, but new in a way that we absolutely did not expect,” he said. “That is, we have never seen before in history, we don’t have record of this, a respiratory virus driven by asymptomatics. We have not seen a respiratory virus whose numbers are growing in summer. COVID does not behave like other diseases.
“This curve is growing,” he added. “Trying to stop this little curve from growing is going to be like trying to stop a 2-mile train. It might not happen quickly.”
Staff Writer Marina Starleaf Riker contributed to this story.