For the fourth day in a row, Bexar County had no additional coronavirus deaths to report, Mayor Ron Nirenberg said Wednesday.

There are now 1,126 confirmed cases of the new coronavirus recorded in the county, 46 more than reported Tuesday. Of those, 79 are in the hospital, 38 in intensive care, and 22 on ventilators.

Nirenberg urged residents to continue adhering to the mask order that he and Bexar County Judge Nelson Wolff issued last week.

“When you are not within 6 feet of someone, it’s OK to not wear a mask,” Nirenberg said. “But when you get closer, we need you to wear your mask.”

“Our social distancing has been working, we have been flattening the curve, but we need to stay the course.”

The number of COVID-19 cases in the county jail continues to rise. Five more inmates tested positive at the Bexar County Adult Detention Center, bringing the total number of inmates with COVID-19 to 34, the Bexar County Sheriff’s Office said Wednesday. Two more deputies have tested positive as well, bringing the total to 29, though 10 have fully recovered and returned to work.

Dawn Emerick, the director of San Antonio Metropolitan Health District, said Metro Health continues to investigate each positive COVID-19 case and the individual’s close contacts.

“[Contact tracing] is the backbone of epidemiology and that will never end,” she said.

In the United States, the average COVID-19 positive person had been in close contact with three people, Emerick said. But in San Antonio, health officials have seen a range from three to 44.

Metro Health does not do contact tracing for cases in the county jail, as the University Health System provides health care in the facility, Emerick said.

Bexar County is testing between 1,250 and 1,300 people a day, Emerick said, which she said is not enough. As the County aims to ramp up its testing, contact tracing efforts will need to be enhanced as well, Emerick said. Metro Health is currently working with a health IT company that specializes in COVID-19 contact tracing to see if implementing that technology could help with case investigation efforts, she said.

Cautioning Bexar County residents about the efficacy of antibody testing, Emerick explained the difference between viral testing and antibody testing. Viral testing – where samples are collected by inserting a swab into the nose and then sent to a lab to have the ribonucleic acid (RNA) extracted – is the only way to get a COVID-19 diagnosis, Emerick said. Antibody testing can only identify the presence of coronavirus antibodies. And of the 90 antibody tests currently on the market, only four have been approved by the U.S. Food and Drug Administration. 

“None of those tests, even the ones that are regulated, are reportable to Metro Health,” she said. “So we have no idea what is happening, what test results are. We can’t do any surveillance on them. … This is not a statement or position to say they’re not of value. I think it’s too early. The science just isn’t there.

“I love football, I love sports, so I’d say the antibody testing is not ready for prime time yet. Can they be? Yes. But the public should be cautious.”

Emerick urged residents who have symptoms consistent with COVID-19 to call the Metro Health hotline, 210-207-5779, and ask to be tested at the Freeman Coliseum drive-thru site, which performs viral testing.

Of the cases in Bexar County, 71 percent had a fever only, while 67 percent had only a cough. A little more than half of positive COVID-19 cases presented with both fever and cough, Emerick said. But literature is starting to show that even a low fever of 99.6 could indicate a coronavirus infection.

“If someone is curious of whether they should go [get tested] and they have just a slight fever of 99.6, I would call and try to get an appointment,” Emerick said.

Jackie Wang covered local government for the San Antonio Report.