For third time in a week, San Antonio records 1,000-plus new coronavirus cases, as transmission enters ‘worsening phase’

Lauren Caruba

For the third time in a week, San Antonio has reported more than 1,000 new coronavirus infections on a single day, as health officials issued new recommendations Monday urging residents to avoid spending time indoors with anyone not part of their household.

Anita Kurian, who heads the communicable disease division at the Metropolitan Health District, said the department is strongly suggesting against gathering or dining indoors with other people, including in restaurants. She added that restaurants can help reduce transmission by converting to outdoor-only dining and prioritizing takeout service.

The directive also discourages residents from singing, yelling or exercising indoors around nonhousehold contacts.

“The more people you’re around indoors, the greater the risk of COVID-19,” Kurian said during the daily coronavirus briefing. She noted that respiratory droplets can occasionally travel farther than 9 feet, beyond the 6 feet generally recommended for safe physical distancing.

“While wearing a mask mitigates the risk, it is not possible to wear a mask while eating or drinking,” she said.

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The new guidelines come as local transmission of the virus has significantly accelerated, particularly in the past week.

With 1,117 new cases reported Monday, the cumulative case count for Bexar County rose to 81,174. The rolling seven-day average for new cases now tops 830, more than four times what it was at the start of November.

In the past seven days, San Antonio has recorded nearly 6,000 new cases, compared with about 8,000 added during the entire month of October. Officials now categorize the number of new cases per 100,000 people as severe.

“Transmission is now in the worsening phase,” Mayor Ron Nirenberg said during the briefing.

The increase in cases came before Thanksgiving, and any transmission from holiday gatherings and travel won’t become apparent in health data for 10 days, officials noted. The city and the county had imposed a temporary overnight curfew during the four-day holiday period in an effort to curb the spread of the virus.

Kurian said health officials are asking residents to “be more selective about who you are around indoors until we are on the other side of this surge.”

“As the cold weather approaches and in the wake of Thanksgiving gatherings, we are expecting our case counts to increase through the end of the year,” she said. “This is certainly the most critical of all months for us.”

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Hospitalizations related to COVID have also increased in the past week, continuing a steady upward trend that began in late October.

On Monday, 587 people with COVID were being treated in area hospitals, up from 509 a week ago and 235 a month ago. Fifty-eight of those patients were admitted in the past day, and 76 are transfers from El Paso, where the hospital system has been overwhelmed with COVID patients. Of those being treated, 182 patients were critically ill and 99 were breathing with the support of a ventilator.

County Judge Nelson Wolff noted that COVID hospitalizations are not spiking the way they did over the summer, at the height of the area’s first major coronavirus surge. San Antonio-area hospitals are treating about half the number of patients they were when hospitalizations peaked at more than 1,200 patients in mid-July.

COVID patients account for a little more than 15 percent of all hospitalized patients in the area, a figure that was over 30 percent at the peak of the surge. Officials characterize the strain the pandemic is placing on hospital resources as moderate. Fourteen percent of staffed hospital beds, about 650, were available Monday.

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The weekly positivity rate, or the portion of people testing positive for the virus, decreased for the first time since early October, when it began to rise again. The rate is now 9.2 percent, down 0.8 percentage points from the previous week, which Nirenberg called the “one thing that’s going well out of a sea of things that are going wrong.”

He said the reduction in the positivity rate could be connected to the large number of people without symptoms who sought testing before gathering with others for Thanksgiving. The rate, which helps measure the level of transmission being captured by testing, tends to decrease as more people are tested.

At just under 35,000, the number of people who were tested for the coronavirus last week in Bexar County was less than the week prior, when it reached an all-time high of 45,000. Nirenberg noted that many labs were closed during the holiday, limiting access to testing even as demand for it remained high.

Officials said testing was expected to increase in the wake of Thanksgiving, when people will want to know whether they became infected after gathering.

“Increasing testing is something that we’ve been trying to do for a while now, and it’s really started to pick up here the past few weeks,” Nirenberg said. “Part of that is probably there was more illness, more virus in the community. But I think people have also seen how easy it is to get tested and how important it can be to find an infection early.”

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Nirenberg and Wolff stressed that a one-week change in the positivity rate was not indicative of a trend, nor what the next few weeks may hold.

The San Antonio area won’t be “on the other side of the pandemic” until an effective vaccine is administered to 70 to 80 percent of the population, Kurian said.

“Until then, we need to continue masking and practicing physical distancing,” she said.

There were no COVID-related deaths reported Monday, leaving the local death toll from the pandemic at 1,357.

Lauren Caruba covers health care and medicine in the San Antonio and Bexar County area. To read more from Lauren, become a subscriber. | Twitter: @LaurenCaruba

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