To be Young, Wild and Free… In The Time of COVID

It’s been quite the week in San Antonio, y’all. I usually wait a bit longer to throw more data at you, but San Antonio went from choppy waters to tropical storm waves in a few days.

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CNN photo of Hurricane Harvey

In the month of May, San Antonio averaged 44 (median 54) new COVID-19 cases per day. Reporting of test results can be erratic with some back logs, so the range was 0–189. Between June 1–16, we have averaged 113 new cases per day (Median 222!), with most of those since June 9 and a high of 436 on Tuesday, June 16, totaling 4873 cases.

You know when you were in your 20s, and you felt like nothing could harm you? Well, something can. COVID-19. We’ve spent a long time saying it was mostly elderly people and those with other health complications who had to worry.

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Since May 19, most of our new cases are in people under 40, with the biggest increase in the 20–29 year old group. And it’s not because that’s where we have the most people (blue bar shows the percent of each group in the population).

With 91% of cases symptomatic, the increase corresponds to more hospitalizations (241, 4.7%), more ICU admissions (91, 1.8%) and more people on ventilators (43, 0.84% of all cases). And yes we’re testing more, but our positivity rate (the % of tests positive) which had hovered around 4–4.5% for a few weeks, has pushed back up above 5%. We were there before, but that was when we were testing only extremely ill patients and not very many. We’d expect with more testing, we’d get more cases, but the positivity rate would go down.

It’s not the location.

We want to be able to say “I caught COVID-19 at *name the bar you went to yesterday.*” Or, as I’ve been asked 10 times this week “it’s those protests.”

In the absence of molecular epidemiological data (i.e. analyzing the viral RNA in each person), we won’t know. It could have been that bar you went to 5 days ago (less likely) or HEB (also less likely), or maybe the drinks with friends in your house (more likely)…

With respiratory diseases, tracing the source of infection is incredibly difficult. I work in probabilities rather than absolutes. Is something more likely, less likely, maybe likely? Without that molecular data, you can’t say a certain place was the source of COVID-19.

But what you CAN do is minimize contact. Going to a bar following strict protocols or having 10 friends in your house in a small room? Which one has higher risk? Understand your risks, and take precautions.

Texas began “Re-opening” on May 1. Many restaurants stayed closed. And when the bars could re-open, many took their time, making sure they had strict protocols in place. My neighborhood ice house, The Friendly Spot has the “BestiePact.” They even offer you a mask if you don’t have one, an expense no food and beverage business can afford right now.

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I was at Weathered Souls Brewing yesterday, and they were above and beyond in following safe practices. And they have great beer and are Black owned. We go to Tito’s for take out so much my daughter wondered if we were the ones keeping them in business. 100% mask wearing, hand sanitizer, strict protocols.

South Alamode has been following Best Practices from the start. And they mean it.

Certainly not all businesses have been extra cautious. But we forget that people socialize outside of bars and restaurants. A month ago, every one was still wearing masks and sticking to small groups. Now, it’s more common to see large groups at backyard parties, in the parks, on the river and more. No masks in sight.

We’re all tired of quarantine and we want to socialize. Can we do that safely? Dr. Julia Marcus from the Harvard School of Public Health has written excellent articles about focusing on risk reduction rather than complete abstinence.

You don’t need to hide away. Humans are social creatures and need each other. We can take steps to reduce risk, like not hosting 20 of your dearest pals over, but keeping it to just a few and maintaining distance. And if you choose to go to your neighborhood pub, #MaskUp.

(edit: we had another 236 cases today, same pattern)

Dr. Rohr-Allegrini is an epidemiologist and tropical disease scientist currently working to prevent diseases through immunizations.

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