A report released Tuesday by a team of San Antonio health experts calls for a slow reopening of businesses with sustained social distancing, along with a swift increase in coronavirus testing and contact tracing.

But after a statewide order by Gov. Greg Abbott loosening lockdown restrictions starting Friday, businesses are set to begin reopening even before one of the key benchmarks in the San Antonio report is met.

That metric is a decline in the number of new coronavirus cases over a 14-day period. So far, San Antonio has not seen such a decline, Dr. Barbara Taylor confirmed Monday during a joint meeting of the San Antonio City Council and Bexar County Commissioners Court.

During the meeting, Taylor, who chaired the Health Transition Team, said the reopening plan released by Abbott’s office Monday “aligns with ours in a lot of ways.” However, unlike Abbott, her team lays out a set of specific criteria for reopening the local economy in stages.

Dr. Barbara Taylor, an infectious disease expert with UT Health San Antonio, speaks to elected officials via video chat.
Dr. Barbara Taylor, an infectious disease expert with UT Health San Antonio, speaks to elected officials via video chat. Credit: Brendan Gibbons / San Antonio Report

“As a data-driven team, we all thought that those were really important,” Taylor said. “We wanted be very transparent to the public about what would make us change our current status, either forward or back, so that everybody can get on board and everybody knows.”

Those criteria are:

  • A sustained decline in the number of new coronavirus cases during a period of at least 14 days
  • The ability to test all people who show symptoms of the virus, their close contacts, and people who work closely with the public
  • Effective contact tracing to help ensure infected people stay isolated and to offer testing for those who might have gotten the virus from a person known to be infected
  • A prepared health care system that can safely care for all patients, including sufficient hospital capacity, workforce, and personal protective equipment for health care workers

With the exception of a two-week decline in new cases, San Antonio is “actually in a pretty good place” with these criteria, Taylor said.

“I say that cautiously,” she continued.

On Monday, Abbott announced the reopening of restaurants, retail stores, museums, and movie theaters on Friday at 25 percent capacity. Abbott said that Texans could learn as soon as May 18 whether businesses will be able to expand to 50 percent capacity, if two weeks pass with no “flareup” in cases.

Abbott then defined “flareup” as an increase in hospitalizations, deaths, and infection hotspots. He said an increase in overall cases of COVID-19 alone could be attributed to an increase in statewide testing and would not be enough for the state to reconsider its reopening plan.

“There’s no one single factor we look at,” Abbott said. “We look at all of the data and consider what the data means.”

Since Abbott’s announcement, some San Antonio officials have expressed caution about moving too fast. They have little recourse, though, as the governor’s order supersedes any local stay-at-home orders.

“The risk that the governor took with these new orders is that the gating criteria has not been met in the major metros,” Mayor Ron Nirenberg said.

Other Texas cities also have not seen a decline. On Tuesday, Dallas County recorded its highest day of new reported cases at 135 and tied its deadliest day of the pandemic with 10 deaths, according to Dallas County Judge Clay Jenkins.

Nirenberg went on to say that San Antonio does not yet have the “level of testing capacity necessary to identify and isolate new infections that arise.”

“I hope that we continue to trend in the right direction and contain this virus, but without those criteria being met, it is a risk for which we won’t know the effect for several weeks,” Nirenberg said.

One of the steps the Health Transition Team report calls for is a near doubling in daily coronavirus testing. San Antonio’s current capacity is 1,600 tests per day, Taylor said, including private and public labs. That should increase to more than 3,000 per day, the report states.

“Because testing has been limited, and because only individuals with symptoms have been tested, no one knows how many people in Bexar County/City of San Antonio actually have the virus,” the report states.

In addition to people with symptoms, the report recommends testing asymptomatic people who work close to those most vulnerable to the disease. These include nursing homes, skilled nursing facilities, assisted living facilities, shelters, and unsheltered homeless populations.

The team also called for more contact tracing of people close to those who are known to be infected so they can be encouraged to isolate themselves. The San Antonio Metropolitan Health District has been using contact tracing to pursue infections since the early days of the local epidemic, with 17 case investigators and 70 trained volunteers, according to Taylor.

The number of contact tracers working with Metro Health should increase to 175, the report states.

Taylor and Metro Health Director Dawn Emerick were more assured about the ability of San Antonio’s medical system to cope with with an increase in coronavirus cases.

Emerick said the Bexar County Office of Emergency Management and the South Texas Regional Advisory Council are closely tracking the number of available ventilators, beds, and emergency transports, among other health system data.

Brendan Gibbons

Brendan Gibbons is the San Antonio Report's environment and energy reporter.