Advice for at-risk readers: The COVID-19 undercount is real – San Antonio Report

San Antonio Report
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My worse fear after testing positive for COVID-19 a second time two weeks ago is that I had inadvertently infected family members, friends and even some community leaders.
It’s a concern more in our city should share as infections spike here and as local medical and health experts tell me the growing undercount in COVID-19 transmission is creating a false sense of security in the public.
“As a physician working in this area, I am sure you will understand why I don’t want to be quoted,” one local COVID-19 expert wrote after reading my Thursday column. “The public has been downright vindictive to public health officials and doctors trying to help them. I value my privacy and safety.”
Afterward, we spoke at length for this column. This public health expert, who has been deeply engaged in COVID-19 treatment and prevention for two years, echoed others who have told me in recent days: The undercount and current infection spike are serious and the virus is spreading because people are no longer taking precautions. Several readers who contacted me after they or family members or friends recently contracted COVID-19 said the infections caught them by surprise.
Only two days before my positive test — and as of Saturday I have tested positive for 11 consecutive days — I arrived at the Twig Book Shop at the Pearl to moderate a conversation with Bexar County Judge Nelson Wolff about his new pandemic memoir, The Mayor and the Judge. I had tested negative one day earlier as a precaution.
One of our son’s close friends and a few of her friends had tested positive after attending a local club concert. Our son did not attend the concert, and he and other family members, including Hilde Maeckle, my 89-year-old mother-in-law who lives with us, had tested negative, too.
Wolff and I shared a restaurant table after leaving the Twig, where we both connected with friends and book shop staff we both know — most in the at-risk age group of 65 or older.
The next day I dropped by the San Antonio Report’s newsroom, conferred for a few minutes with editors, greeted a few reporters and then met Angie Mock, the Report’s CEO and publisher, and an octogenarian donor for lunch at an indoor restaurant.
I was back to living my life pre-pandemic. No mask, so social distancing, no fears. I felt safe being in indoor public settings with others. I thought I was conducting myself responsibly — much like I imagine you are living your life today.
If there is one thing we have learned about this persistent coronavirus in its ever-mutating variations, it’s that vaccines and boosters are largely effective in preventing serious disease and hospitalization, but they do not entirely block transmission of the virus.
For many Americans, that might mean an infection equivalent to a common cold, the flu or an asymptomatic experience. For aging Americans and other at-risk people, it can be a matter of life or death. Even seniors who lead active, healthy lives without serious preexisting conditions should reassess the risks.
The morning after being with Wolff and others at the Pearl, I awoke with a sore throat and congestion, which I attributed to allergies and San Antonio’s worsening air quality. Then our son called to say he had tested positive.
I tested negative again, but my symptoms worsened, and my test two days after the event at the Twig was positive. Then I did what medical experts tell me far too people are failing to do out of a misguided sense of guilt, fear or shame: I started calling everyone.
People responded with appreciation rather than anger or blame. None of them, as it turned out, would test positive. My wife, Monika, moved upstairs to a guest bedroom and since then I have isolated at home, kept my distance from family and contented myself with a daily outdoor walk, masked, with our dog.
I also reported my positive test result to my family physician who, in turn, registers the positive case with public health officials.
The local physician and longtime medical school professor who contacted me pointed to what she identified as telltale data that showed an early March increase in the presence of the virus in wastewater. Click here to see the Centers for Disease Control and Prevention wastewater surveillance data and guidance.
“I saw this spike in infection coming at the beginning of March, and I started to change my behavior then, but I have smart friends who are surprised to learn they have got COVID,” the physician said. “If you look at the city’s website it appears things are normal, that risks are low, but because of the undercount problem, that’s not accurate.”
One day after my column was published, a full 10 days after I first tested positive, and two days after delivering a major speech at a North San Antonio Chamber of Commerce event attended by about 450 people, Wolff, 81, and his wife, Tracy, tested positive for COVID-19. You can read our coverage here. The article by Reporter Andrea Drusch also noted that San Antonio Police Chief William McManus also is isolating at home after testing positive for COVID-19.
Even though the Wolffs are fully vaccinated and boosted, their resumption of public life had caught up with them as it did with me.
“I was embarrassed to test positive for COVID-19 at the same time, anecdotally, that I was hearing about lots of friends also testing positive,” one business leader who asked not to be identified told me. “I thought I was paying careful attention to the available data, and there was nothing out there suggesting a spike. I feel sympathy for local public officials because they are unable to urge the public to use masks and practice social distancing now. It’s just not possible politically.”
The physician agreed: “It’s hard to get complex truths out to people, and public officials can’t use the M word.”
Vaccination is still the best weapon society has to control the spread.
The flu season is normally 26 weeks long each year and results in 30,000 deaths spread over that time nationally, or 150 deaths a day. COVID-19 is present at varying levels for 52 weeks a year, and the current rate national death rate is double that daily. COVID-19 is not the flu.
San Antonio cannot shut down again. Neither can the country or the world. Individuals, however, can reduce their risk. I am going back to outdoor dining with friends. I am wearing masks inside public places like the grocery store. I am availing myself of the easily obtained free at-home tests provided by the government.
As I approach my 70th birthday I am coming to terms with making life changes that might be around as long as I am. I don’t necessarily like it, but the alternative, living a high-risk life bound to be shortened, is not an option.
To Nelson and Tracy Wolf and Chief McManus and all the others laid low with COVID-19, get well soon.

Robert Rivard is co-founder and columnist at the San Antonio Report. More by Robert Rivard

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