In an effort to better understand the extent of the coronavirus outbreak in Bexar County, Metro Health on Monday, announced it was expanding capacity at its testing sites for people with no symptoms and pre-symptomatic people.

The impetus for the decision began last week when Metro Health tested 270 people at pop-up clinics in two different areas of the city in an effort to expand COVID-19 testing. Of those tests, several came back positive for people who were exhibiting no symptoms, contributing to a total of 50 positive but symptomless Bexar County residents, Metro Health Director Dawn Emerick said during the City and County evening briefing.

Private labs also can test people without symptoms.

“We felt like after we did the pop-up sites last week in neighborhoods, and we saw a lot of people coming in who were both showing symptoms and were asymptomatic, it sent us a signal that we needed to change our strategy” to reflect what’s happening locally, Emerick said. 

Concerns about people without symptoms unknowingly infecting others has been a worldwide concern for months, but only recently did the CDC encourage the testing of people without symptoms if there were enough test kits to cover high-priority cases first. The Bexar County Adult Detention Center also raised red flags about people without symptoms being infected when, after testing inmates and staff, it found 246 of the 358 tested showed no symptoms, according to Metro Health statistics.

Emerick said Monday that Metro Health was collecting 1,600 tests per day, but has the capacity to test 3,000. She noted the updated local testing guidelines ask clinicians to “use their judgment” when determining whether to test a person without symptoms, and to continue to prioritize high-risk people first as there are limited tests available at a given site. Those include hospitalized patients with symptoms, health care workers, and residents and workers in congregate living settings. Emerick also suggested calling testing sites ahead of time to make sure they could accommodate a person without symptoms.

Bexar County continues to see modest upticks in daily cases. Monday, 19 residents tested positive for COVID-19, bringing the total number of cases to 1,920, Mayor Ron Nirenberg said. The County also recorded its first death since May 8, that of a staff member at the Southeast Nursing Home and Rehabilitation Center who battlied the virus at a local hospital for more than a month. The total number of deaths in Bexar County is now 57. 

Nirenberg acknowledged that the County is seeing an increase of hospitalizations, which is currently 63, with 45 people on ventilators in intensive care units. 

“Our capacity in local hospitals remains strong, but there has been an increase in the number of people in hospitals,” including 25 people who are currently under investigation for COVID-19, Nirenberg said. 

Bexar County Judge Nelson Wolff said with more testing available, people need to be prepared for an uptick in cases so they “aren’t shocked by it.” He stressed that San Antonio has been “ahead of the curve” when it comes to prioritizing testing vulnerable populations, including workers in nursing homes and hospice care facilities. It also showed when Metro Health brought testing to people it didn’t think were getting tested.

“The fact that we had that many people show up made it obvious” that there needed to be more outreach to the community in general, Emerick said. 

Emerick stressed continued mask usage, both to protect the wearer from people without symptoms people and for those who are pre-symptomatic to guard against unknowingly spreading the disease to others.

Nirenberg said he hoped loosening the restrictions to testing will help keep the community as a whole safer.

“It shows progress [in communication about the disease] that people are showing up to get tested,” Nirenberg said. “We have to keep encouraging that.”

Roseanna Garza

Roseanna Garza reports on health and bioscience for the San Antonio Report.