It was great to see San Antonians dancing in the streets and honking their horns in celebration Saturday, but our long national nightmare is most emphatically not over.
I’m not talking about the four years of the Trump presidency. I’m talking about the eight months of the coronavirus – it seems like more than four years – that has devastated much of our economy, put tens of thousands out of jobs, and kept the city from being its normal, exuberantly partying self.
The last few weeks have increased my nervousness as I check on the daily figures released by Mayor Ron Nirenberg and Bexar County Judge Nelson Wolff.
Without going into the mind-numbing numbers, since mid-October we have seen slow but steady gains in the number of cases, the hospitalizations, and the positivity rates of those being tested.
On Sunday, 88 new cases were announced, the lowest since the spike began in mid-June. But the number turned out to be an outlier. On Monday the count was 417, intensifying a sense that we could, at any moment, explode into the kinds of numbers we saw here in July. Then we were getting about 1,200 new cases a day with skyrocketing hospitalizations and deaths. This compares with about 200 daily in recent weeks and lower rates of hospitalization and deaths.
The sense of foreboding is amplified by the more rapidly rising rates across Texas, and the even more threatening national numbers. At more than 100,000 new cases a day the United States passed 10 million cases Monday, just 10 days after it reached 9 million. We are approaching a quarter of a million deaths.
Still, while it is clear we cannot let down our guards, there are reasons to be optimistic, even if some come with caveats. Let me count a few.
We are San Antonio. I don’t mean to sound chauvinistic, but our leaders have taken the crisis seriously and for the most part our citizens have followed suit. Most importantly, the leaders took advantage of our extraordinary medical resources by appointing a remarkable panel of epidemiologists and public health experts and then followed their advice, even when it meant not relaxing unpopular restrictions. They have not paid a political price as the overwhelming majority of citizens have complied with mask mandates, especially when indoors while shopping, keeping appointments, and voting.
The city, with the help of the scientists, has quietly shown creativity in the battle. For example, the positivity rate of people tested for the virus – currently at around 8 percent, up from a low of 4.8 percent not long ago – is skewed by the fact that a high percentage of the people getting tested have experienced symptoms. To get a more accurate measurement of how widespread the frequently silent disease is, some special populations are being tested.
Dr. Ruth Berggren, the Harvard-trained specialist in communicable diseases at UT Health San Antonio, said every person booked into the Bexar County Jail is tested for COVID-19. That’s about 140 to 150 people a day.
“These are not people who are real good at following rules,” she said. Yet the numbers are very good. Out of eight recent consecutive days, Berggren said, six days had zero positive results and the other two days one positive each.
“These are the canaries in the coal mine,” she said. Other groups tested include every one getting elective surgery in Bexar County and everyone getting dental procedures at the UT Health San Antonio School of Dentistry. The former are testing at about 2 percent positive and the latter at about 1 percent.
On the national front, last week’s election means that the White House will pivot sharply from denial to battle stations. President Donald Trump’s lax approach has made the White House a superspreader location, with more than a dozen including himself and most recently his chief of staff and secretary of Housing and Urban Development contracting the virus. Trump’s inaction while promising a cure is “just around the corner” while accusing doctors of profiteering off the disease has been disastrous for the nation.
President-elect Biden has listed conquering the pandemic as his top priority, marshaling the vast resources of the federal government. Wasting no time, Monday he appointed a panel of medical experts to help lead his attack on the virus.
Most importantly, his approach will be based on science. Expect an early effort to restore the Centers for Disease Control and Prevention, politicized and virtually shut out of the effort by the Trump administration, to its former status as one of the world’s most effective public health institutions.
Trump has said we need to “open up the economy,” but Biden understands, as Jerome Powell, chair of the Federal Reserve has said, that the economy can’t fully recover until the pandemic is brought under control. Most people will not resume their previous lives as long as they are worried about exposing themselves and their loved ones to a lethal disease.
Crucial to solving the disease are providing care not only for its medical victims, but also for economic victims. Biden will join Powell in seeking a second major stimulus package to help the millions of workers and small businesses that have been devastated by necessary shutdowns. The question is whether Senate Majority Leader Mitch McConnell will allow such a package to become law.
There are more reasons for optimism. One is that we have learned a great deal about the coronavirus, both how to avoid contracting it and how to treat it.
We have learned, for example, that it is much more effectively spread through droplets in the air than through touching infected surfaces, as was thought in the pandemic’s early days. That’s why masks and social distancing have proved so effective, and why being indoors where tiny infected droplets can hang in the air for hours is more dangerous than being outdoors. We in San Antonio are fortunate not to be forced indoors by harsh winter weather.
We also are learning that previously shuttered businesses and schools can be at least partially opened up if done with care.
Meanwhile, drugs such as remdesivir, which was tested in important federally funded trials at UT Health San Antonio, and dexamethasone, a steroid, provide effective treatment if not a cure. The former has been found to shorten the recovery time for hospitalized patients. The latter has saved lives in cases where the immune systems of seriously ill patients overreact.
Another cause for optimism is promising early findings from Pfizer about its COVID-19 vaccine, still undergoing trials.But Berggren cautions that patience will be necessary. The first batch of doses, once one or more vaccines are approved, will go to front-line healthcare providers to stop their attrition. Second will come doses for people in nursing homes and other especially vulnerable populations.
It could be late spring or early summer before vaccines are available for the general population. What’s more, warned Berggren, the effectiveness of the vaccine will depend on overcoming the skepticism and resistance of a substantial part of the population. So it will be some time more before we are fully free of the threat.
Informed optimism is indeed in order, but so is patience, determination, and sacrifice. Any letdown will push back the day that San Antonians can be fully themselves and party like few other cities.