Tracking the source of virus no easy task

As COVID-19 cases surge in San Antonio, pushing hospitals closer to the breaking point, public health investigators are scrambling to interview those who contracted the virus to pinpoint the sources of infection.

But they’re running into an obstacle: About 40 percent of people who test positive are not returning calls, said Assistant City Manager Colleen Bridger, who oversees the San Antonio Metropolitan Health District.

“We still struggle with the fact that most people aren’t answering the phone when we call,” she said. “Right now, we really need the public’s help in answering calls.”

Even when investigators have gotten through to people with confirmed infections, it can be difficult to narrow down where they were exposed to the virus, Bexar County Judge Nelson Wolff said.

“What’s really exasperating is that they’re doing this contact tracing, and a lot of people are saying, ‘I’ve been here, I’ve been here, I’ve been there,’ and they haven’t been able to tie it down like they had hoped to do,” Wolff said.

He added, “People are picking it up all over, not one place. And they blamed it on Memorial Day, but Memorial Day was 30 days ago, so that’s not what caused this.”

Wolff thinks there’s a simple explanation for the surge in infections: “People just quit being cautious. I saw it all over.”

Based on interviews with people who test positive, case investigators for Metro Health have found most were infected during visits with close friends or family; at workplaces; at retail and grocery stores; at bars, restaurants and entertainment venues; and at mass gatherings, city spokeswoman Laura Mayes said.

But the information largely is anecdotal and frequently vague, making it difficult for officials to identify the sources of infections with any precision.

For instance, the CEOs of San Antonio’s four major hospital systems told officials last week that auto dealerships were among the top three places for transmission — along with bars and gyms.

“I have no idea why car lots are a hotbed for COVID,” Bridger said. “They all were in agreement that that’s what they were seeing.”

The information was collected by nurses across the city who asked COVID-19 patients where they thought they had contracted the virus. Hospital leaders shared the news with city officials during a conference call Friday.

Despite the lack of hard data, Bridger and Mayor Ron Nirenberg warned the public about auto dealerships, bars and gyms during a televised news briefing Friday — immediately stoking anger among auto dealers, who accused the mayor of spreading hearsay.

This week, S.A. Auto Dealers released a statement pushing back against the city’s assertion.

“We have not received nor seen any scientific evidence to support recent suggestions that area auto dealerships have been the source of high rates of corona-virus infection,” said Pam Crail, president of the association. “We want to assure the community that we will continue working with our membership and city leaders to ensure that the local auto industry does everything necessary to help mitigate the spread of COVID-19.”

Bill Day, president of North Star Dodge, wants the mayor to retract his comment — although Nirenberg qualified his statement about auto dealerships at the briefing, saying it was “anecdotal.”

“Half of Texas probably doesn’t even know what that word means,” Day said. “In layman’s words, it means he didn’t have any information to back that statement up. It’s kind of rumor, gossip.”

Elected leaders have shown a reluctance to single out specific businesses as sources of high transmission. At the Friday news briefing, a reporter asked for such a list.

“I wouldn’t recommend it,” Bridger said. “I think in a big city, there’s too many different locations that you would have to name.”

“You’re exactly right on that,” Wolff told Bridger. “I would hate to think of the liability of tagging somebody and being wrong about it and ruin their whole business. I think you’re right.”

Nirenberg echoed that reticence after taking flak from the auto dealers.

“We don’t need to single out industries or businesses in particular to know that what transmits this virus is close contact over a prolonged period of time, and that everyone, regardless of the business they work in or visit, needs to wear masks and practice physical distancing,” he said.

“What I have heard from other public health officials that won’t show up in the data is that we may be seeing a lot of transmission in people’s homes, having others who don’t live in the house over and spending a lot of time in close quarters with them,” Nirenberg added. “This is anecdotal information, too, but until we have better data, we’re using the information we have to make good decisions.”

With the virus now widespread in the community, Bridger said questions about whether transmission has occurred at auto dealerships largely are a distraction.

“The point there is not to avoid car dealerships,” she said. “The point is you never know where you might be exposed or might be exposing people to COVID-19. So take these universal precautions” — wearing masks, washing hands frequently and staying 6 feet away from others — “wherever you go.”

She added that health officials are “looking into” reports of infections at car lots to better understand why that might be happening.

“I’m assuming that they’re not doing test drives, but I don’t know that for a fact,” Bridger said. “If they’re doing test drives with two or more people in the car, that seems like a bad idea.”

Test drives are taking place at North Star Dodge’s four locations, Day said. The dealer allows customers to shop online, but only about 5 percent of sales are closed that way, he said.

“Our brand is blue-collar,” Day said, explaining that financing and credit issues can make contact-free deliveries more difficult.

He added, “A lot of people love to come in and touch, smell the car, drive the car.”

Day said he would not force customers to wear a mask while shopping or even while test-driving a vehicle, despite a new city-county order mandating that businesses require employees and customers to wear masks in situations where maintaining a 6-foot distance is difficult.

“We would ask them (customers) to put on a mask (during a test drive), but we would definitely make sure our guy, our gal, puts on a mask,” he said. “If a customer comes into my store without a mask and they’re social distancing, am I going to ask them to leave? No, I’m not.”

Day said just one of his employees has tested positive for COVID-19. And he was indignant that the mayor or anyone else would single out his industry without hard numbers to back it up.

“If you’re going to say that to the media, you go and put your measurement to the test,” he said. “It’s hard for me to buy that if they don’t measure it.”