The coronavirus pandemic hit Kerr County the hardest yet over the Fourth of July weekend. On Monday, about 40 new cases were reported by local officials and Peterson Health. 

But the worst may be yet to come.

Kerr County has at least 100 active cases and has seen 159 people test positive for the virus, but a majority of those have come since June 1. The increase also means that the county could face state-imposed restrictions on restaurants and retail, but Kerrville City Manager Mark McDaniel said that he didn’t expect that to happen. 

“To get to that three positives per 1,000 people we would have to have a 50% increase in active cases,” McDaniel said Monday afternoon. “Even then it’s at the discretion of (Gov. Greg Abbott).”

During Monday morning’s Kerr County Commissioners Court meeting, Dub Thomas, the county’s emergency management coordinator, told the commissioners that he feared that the results from last week’s testing by the Texas Military Department at the Doyle Center could reveal a new outcropping of cases.  At that event, 548 people were tested, but just how many of those were from Kerr County is to be determined. 

Thomas told the commissioners that Peterson Health had tested 112 people over the weekend and 30 came back positive — a positivity rate of 26%, or double the state’s rate of 13%. An additional 10 people from the county tested positive. 

At least two people are hospitalized at Peterson Regional Medical Center, but there could be others taken to hospitals in San Antonio. One such case was revealed by Carolyn Northcutt, a Kerrville real estate agent, who said her husband was taken to Audie Murphy Veterans Administration Medical Center in San Antonio after contracting the virus at Kerrville’s Veteran’s Home. 

The Veteran’s Affairs Administration in San Antonio did not return calls or emails for comment. 

The virus has also worked its way into some of Kerrville’s 18 sober living homes. Those homes are often filled with those recovering from alcohol and drug abuse, and depend on the group setting to work through their treatment. The downside is, unlike a nursing home, as many as 16 residents can come and go as they please — often to work.

Thomas said the county is working to get another screening event scheduled for the Doyle Center — possibly by July 14. 

Kerr County’s surge is similar to what’s happening around the state of Texas. The state saw its most confirmed cases for a Monday this week with more than 5,300. Mondays have often been one of the most lightly reported days for the state, but Tuesday numbers have almost always been double compared to Monday.

The state also saw another big increase in the number of people hospitalized and there are currently more than 8,600 people hospitalized. Texas has added more than 250 new coronavirus-related hospitalizations for eight consecutive days and on Monday that number rose by another 517 people. 

Other Kerrville city leaders expressed their concern about the pandemic, and urged the public to take precautions seriously. 

“The best protection that can be provided is from the citizens themselves and that is to just wear a mask — all the time, when in public,” Councilwoman Judy Eychner said. “This is what the Governor has asked and this is what the city asks of each and every citizen — please — just wear the mask. Think of others instead of yourself. Demonstrate Kerrville Kindness and just do it!”

McDaniel said his biggest concern is not having any more deaths, or serious hospitalizations, but he’s also worried about the impact on the economy. 

“Kerrville has been very fortunate,” McDaniel said of economic losses. “Our sales tax numbers haven’t been as bad as we thought, they haven’t been great but they are better than we expected.” 

If the virus continues its surge, the impact on jobs and businesses could take it toll, especially if local businesses are faced with scaling back again — that’s a scenario that McDaniel thinks is unlikely. 

“I’ve talked to several restaurants and they never came off the 50% capacity anyway,” McDaniel said. “We never want to be going backward in terms of being reopened.”   

DEVELOPMENT COUNTDOWN

10 new discoveries about the pandemic

Everyday, we learn something new about the coronavirus pandemic from its impact on politics to that of health care. Here are some of the things we’ve learned about coronavirus over the last few days from a wide range of sources.

A DECLINE IN OPTIMISM

On Monday, The Texas Tribune reported that a poll conducted by the University of Texas found that Texans’ assessments of pandemic responses have soured. In the latest survey, 46% of voters say efforts to deal with the coronavirus in the U.S. are going well — down from 56% in April. Asked about the efforts in Texas, 47% say things are going well — down from 66% in April.

They’re also less optimistic about getting activities like social gatherings and sporting events back to normal. While 21% think that we’re already at the point where things can return to normal or will be in the next few weeks, 30% thought that was the case in April. Then, 41% thought things would be back to normal within the next few months; that’s fallen to 22%. Now, most think it will be back to normal in the next year (29%) or in a year or more (26%). The poll was conducted by the Texas Politics Project at the University of Texas.

DON’T BELIEVE THE ANTI SOCIAL DISTANCING RHETORIC

A video that was sent to The Kerrville Daily Times by readers featured what seemed to be an informative debunking of the coronavirus by Dr. Kelly Victory, but her claims start to fall apart real fast when you peel back the truth. 

How do we know? Consider her claim: “Let’s start with the idea of social distancing isn’t even an established health care concept, and certainly not one in the public health. The whole idea of social distancing was based on a theoretical model that was explored by a high school student at a science fair some years ago looking at how an infectious disease might hypothetically spread as the result of potential exposure amongst kids at school. In other words, it was never scientifically based.”

The reality of Victory’s story is actually far more complex than she lets on in the video, including the fact that the “science fair” was actually a fair organized by the intelligence community, and the model was immediately picked up by the Department of Homeland Security under the administration of George W. Bush and vetted by scientists and adopted by the Centers for Disease Control. Also, the student who came up with the model did so with the help of her father, who was a top scientist at the Sandia National Laboratory in New Mexico. There is a fair amount of debate about the effectiveness of social distancing, but to say it’s not accepted in public health is a stretch of facts. 

IT MAY BE AIRBORNE

More than 200 scientists have called for the World Health Organization and others to acknowledge that the coronavirus can spread in the air — a change that could alter some of the current measures being taken to stop the pandemic. 

In a letter published this week in the journal Clinical Infectious Diseases, two scientists from Australia and the U.S. wrote that studies have shown “beyond any reasonable doubt that viruses are released during exhalation, talking and coughing in microdroplets small enough to remain aloft in the air.” That means people in certain indoor conditions could be at greater risk of being infected than was previously thought. 

The WHO has long maintained that COVID-19 is spread via larger respiratory droplets, most often when people cough or sneeze, that fall to the ground. It has dismissed the possibility of airborne transmission, except for certain high-risk medical procedures, like when patients are first put on breathing machines.

The letter was endorsed by 239 scientists from a variety of fields. It stated that the issue of whether or not COVID-19 was airborne was of “heightened significance” as many countries stop restrictive lockdown measures. 

The authors cited previous studies suggesting that germs closely related to the new virus were spread via airborne transmission. They said “there is every reason to expect” that the coronavirus behaves similarly. They also cited a Washington state choir practice and research about a poorly ventilated restaurant in Guangzhou, China, each of which raised the possibility of infections from airborne droplets.

“We are concerned that the lack of recognition of the risk of airborne transmission of COVID-19 and the lack of clear recommendations on the control measures against the airborne virus will have significant consequences,” the scientists wrote. “People may think they are fully protected by adhering to the current recommendations but in fact, additional airborne interventions are needed.”

Scientists around the world have been working furiously to understand the new virus. The U.S. Centers for Disease Control and Prevention says it is thought to mainly jump from person to person through close contact, but adds: “We are still learning about how the virus spreads.”

Martin McKee, a professor of European Public Health at the London School of Hygiene and Tropical Medicine who was not linked to the letter, said the scientists' arguments sounded “entirely reasonable.”

WHAT’S THE RISKIEST THING YOU CAN DO WHEN IT COMES TO COVID?

The Texas Medical Association sent out a graphic that ranked the riskiest behavior when it comes to getting infected with COVID-19 — on a scale of 1-10, 10 being the most risky. 

Those landing at 8s were: going to a buffet, working out at a gym, going to an amusement park and going to a movie. When it came to the riskiest behaviors, falling in the 9 category, going to a concert, going to a sports stadium, attending a religious service with 500 or more people and going to a bar were considered the most likely places to contract the virus. 

WHY ARE DEATHS DECLINING?

One of the big questions people are asking is why aren’t more people dying from coronavirus, and it turns out that it’s a complicated answer. News website Vox reported that public health officials fear that those who are infected with coronavirus often spend weeks or months battling the virus before they die — as was the case with Tony-nominated actor Nick Cordero Jr., who died on Sunday after a three-month battle against the virus. 

“Why aren’t today’s deaths trending in the same way today’s cases are trending? That’s completely not the way to think about it,” Eleanor Murray, an epidemiologist at Boston University, told Vox reporter Dylan Thomas. “Today’s cases represent infections that probably happened a week or two ago. Today’s deaths represent cases that were diagnosed possibly up to a month ago, so infections that were up to six weeks ago or more.”

“Some people do get infected and die quickly, but the majority of people who die, it takes a while,” Murray continued. “It’s not a matter of a one-week lag between cases and deaths. We expect something more on the order of a four-, five-, six-week lag.”

CORDERO’S DEATH

At 41, Nick Cordero Jr. was at the height of his prowess on Broadway before coming down with coronavirus. The Tony-nominated actor spent 91 days in intensive care, had his leg amputated, suffered strokes, had to have a pacemaker to help his heart  and was in need of a double lung transplant at the time of his death on Sunday. 

Cordero starred in the musical adaptation of the Woody Allen film "Bullets Over Broadway" in 2014, for which he earned a Tony nomination. He had also appeared previously on Broadway in "Rock of Ages," "Waitress" and "A Bronx Tale: The Musical."

THE CHANGING DEMOGRAPHICS OF THOSE TESTING POSITIVE

As the virus takes hold across the state, those being infected continue to be those 54% are under the age of 50, but that age group is increasingly landing in the hospital. UT Southwestern Hospitals looked at the increase in Dallas and Fort Worth and found that 46% of those requiring hospitalization were under 50, and that same demographic represented 34% of the intensive care in the region. 

THE SMELL TEST IS PROBABLY BETTER

In an article in the only health care publication, STAT, the notion that temperature checks were going to catch those infected with COVID-19 was challenged, because so many people who have the virus don’t present symptoms and those who are feverish may not actually be infected. The solution? How about a smell test? 

STAT reported of all the nose-to-toes symptoms of Covid-19, the loss of the sense of smell — also known as anosmia — could work particularly well as an add-on to temperature checks, significantly increasing the proportion of infected people identified by screening in airports, workplaces, and other public places.

“My impression is that anosmia is an earlier symptom of Covid-19 relative to fever, and some infected people can have anosmia and nothing else,” physician Andrew Badley, who heads a virus lab at the Mayo Clinic, told the online news site. “So it’s potentially a more sensitive screen for asymptomatic patients.”

STAT reported that a recent study, Badley and colleagues found that Covid-19 patients were 27 times more likely than others to have lost their sense of smell. But they were only 2.6 times more likely to have fever or chills, suggesting that anosmia produces a clearer signal and may therefore be a better Covid-catching net than fever.

THERE IS A LOT OF WORK BEING DONE IN THE FIGHT AGAINST THIS VIRUS

An article in Bloomberg pointed out that there is a blizzard of research being developed on the virus — much of it awaiting peer review. Bloomberg reported as many as 1,000 Covid-related research papers are being released daily ahead of peer review and publication, according to Soumya Swaminathan, the World Health Organization’s chief scientist. “Our goal is to see that the learnings from science are as quickly as possible channeled into impacts for patients and communities,” she told reporters in Geneva last week.

AND THE BIGGEST THING IS WHAT WE DON’T KNOW

If there’s one key element about the coronavirus pandemic is how little we still don’t know about the virus. The journal Nature highlighted how scientists are still unsure why the virus affects some people differently. 

Here is how Nature described the challenge: “An international team analysing the genomes of roughly 4,000 people from Italy and Spain turned up the first strong genetic links to severe COVID-191. People who developed respiratory failure were more likely to carry one of two particular gene variants than were people without the disease.

“One variant lies in the region of the genome that determines ABO blood type. The other is near several genes, including one that encodes a protein that interacts with the receptor the virus uses to enter human cells, and two others that encode molecules linked to immune response against pathogens. The researchers are part of the COVID-19 Host Genetics Initiative, a global consortium of groups that are pooling data to validate findings and uncover further genetic links.” 

However, at the end they admitted there is still much they don’t know. 

Bloomberg profiled some of those challenges in an article about the myriad of symptoms and conditions related to the virus, but it also highlighted that many doctors are relying on trial and error. 

“I look at all of those things and tinker with the ventilator for a good while everyday to try to find that balance,” said Dr. Jarrod Mosier, who is also an associate professor of emergency medicine and medicine at the University of Arizona. “To me, that is the thing that will save the most lives in this disease -- just excellent critical care management of ARDS.”

Mosier said he’s hoping it results in better patient survival. “I think that’s the case, but it’s very hard to answer that question when you’re in the thick of it,” he said. “Some days I think we’re actually getting pretty good at this. And other days I think, ‘This is demoralizing.’”

(1) comment

Charlie McRae

Excellent reporting, sir.

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