Sunday, July 05, 2020

San Angelo's Tale of Two Holidays

The City of San Angelo announced 84 new COVID-19 cases today.  There are 39 people currently hospitalized with the coronavirus.  From the Friday of Memorial Day weekend to the Sunday after July 4th cases rose by 528 or 555%.

As of July 3rd 63 patients have been hospitalized with the coronavirus.  That number is at least 75 as of today's report.

City Council will entertain a budget amendment for nearly $1.1 million in CARES funding and coronavirus related expenses.  What is not on the agenda is a report on the massive increase in cases and the city health department's strategies to address the rise.

Mayor Gunter has been out front on the pandemic and encouraged citizens to act in ways that minimize COVID-19 spread.  She recently wrote:

Leadership is thinking about others, not just about yourself. Leadership is not standing in the middle, it is making the tough choices even when you know you will be criticized and ridiculed. We, as a City and as elected officials have been challenged to make all the right decisions to protect the health and safety of all our citizens

I know that our local health authority and our city attorney, in conjunction with myself as Mayor and our City Council, have worked every day to try to make the right decisions with the information we have.
I believe the Mayor.  As the situation deteriorates in our community I want to hear from our elected and paid officials about plans to address the rise in cases and hospitalizations.  City Council is an appropriate forum for such a presentation.  I hope it happens soon.  

Update 7-6-20:  The City released two press releases today on COVID-19.  The first stated that coronavirus testing is only done to confirm a positive case.  Officials referred to the item as a clarification.  I would characterize it as the first time leaders have informed the community of its testing strategy.  The second informed the community that the public will not be allowed at the upcoming boat races on Lake Nasworthy.  A gold standard pandemic response includes halting inbound infections, as well as aggressive testing and quick/thorough contact tracing.  How many boaters are coming from areas with a high incidence of COVID-19?     

Update 7-7-20:   City Council approved the nearly $1.1 million budget amendment for CARES Act funds from the state.  There was no public presentation on our deteriorating COVID-19 situation and the city's comprehensive response, however officials indicated they would soon pay for housing coronavirus patients so they can recover in isolation.  Officials said the city is not testing patients therefore CARES Act funds cannot be used for testing at the present time.

Tuesday, June 30, 2020

Clearing Up Released vs Recovered COVID-19 Patients

Health Department Director Sandra Villareal tried to explain to San Angelo Live the difference between recovered and released COVID-19 patients. Finding her explanation confusing I researched the difference.

Most communities are not classifying cases as recovered. Arizona will report recovered patients but the method for calculating the measure is unclear.  AZ Central reported:

Jessica Rigler, the Arizona Department of Health Services assistant director, elaborated on the complexity of defining “recovered,” saying there is no standard definition. The state initially took repeated tests of infected individuals to find out exactly when they tested negative, she said, but as case numbers increased and testing supplies fell short, that was no longer viable. 

The state considered an algorithm for identifying recovered cases by going back 30 days and comparing total cases with death certificates. By knowing the number of people who died in the past month, the state can estimate the number of people who have recovered, Rigler said.  

Minnick, the spokesman, did not answer a question about the final process the state used to determine who counts as recovered.  Only a handful of other states report on recovered cases.

Recovered patients should meet clinical criteria that is consistently applied.  COVID-19 is a tricky virus that can harm the body in multiple ways.  Clinicians do not know the long term implications of the disease so using the word recovered could be premature.

The City's website states the following on released patients:

The removal of positive cases from quarantine/isolation is based on guidance from the Texas Department of State Health Services (DSHS) and Center for Disease Control (CDC); therefore, the health department will report the number of positive cases that have been removed from isolation in adherence to these guidelines. Because removal from isolation is on a case-by-case basis, a cumulative count will be reported on a weekly basis every Friday. 

As a local health department, we are under the umbrella of DSHS. When it comes to case management, DSHS does not report on the medical management, recovery or follow-up of patients on any infectious disease. We follow suit.

DSHS and the local health department are focused on identification of infectious disease (in this case COVID-19) and the notification of contacts of said case(s), as well as providing and adhering to guidance issued by DSHS or CDC. The health department would also report any deaths associated with the disease. Medical management, follow-up and recovery information of patients are between the individual and their medical provider or physician. 
The CDC utilizes three different strategies to release patients from isolation.  They are:

1.  Symptoms based strategy
2.  Time based strategy
3.  Test based strategy -- A test-based strategy is contingent on the availability of ample testing supplies and laboratory capacity as well as convenient access to testing.
Sandra mentioned the first two strategies.  When asked Villareal said "they can retest" but framed it as a means to become a plasma donor.  I thought the test for antibodies after having the disease was different from the test indicating the presence of active COVID-19 virus.

San Angelo's Local Health Authority recently ordered citizens to wear masks in stores.  His order revealed the "length of time it takes to get a COVID-19 test result back has increased to seven days."  That may explain why the City is not using a test based strategy to release patients from isolation.   It simply takes too long.

Update 7-7-20:  The City of San Angelo informed the public of its testing strategy and its non-testing method for releasing positive patients.  Public information officials called it a clarification but it is the first communication the city had for citizens on its testing practices.  Today's City Council meeting revealed the city is not performing any tests.  Those are being done by area hospitals.

Monday, June 29, 2020

City and Goodfellow AFB Restrict Lake Nasworthy Access to July 4th Fireworks

Goodfellow Airforce Base was the first to restrict access to its Recreation Camp at Lake Nasworthy for the July 4th fireworks show.  The base website stated on June 26th "The Goodfellow Recreation Camp will not be a viewing area for the fireworks display at Lake Nasworthy."

Today the City of San Angelo announced all Lake Nasworthy parks will close Friday July 3rd at midnight and remain closed until July 13th.  It's not clear at this time if the fireworks show will go on.

Update 6-30-20:  The fireworks show is a go. The Lake Nasworthy Homeowner's Association encourages residents to come out, legally park and treat the fireworks show like a drive in theater.  As normal viewing will be closed this sounds a recipe for a traffic nightmare.  The trash debacle is normally seen the next morning.  Hopefully viewers will do as requested and take their refuse with them when they leave.

Twin Buttes Reservoir will be open over the July 4th weekend.  For decades the July 4th weekend was an annual trashing event.  The property remains without restroom facilities despite promises from the City, the Bureau of Reclamation and Parks and Wildlife to make improvements.

Update 7-1-20:  The Lake Nasworthy Homeowners Association announced Tuesday, June 30, that it would be moving forward with the annual fireworks show July 4. In light of this announcement, the City of San Angelo will open certain parks to allow citizens to view the fireworks. These parks will be open from 3 p.m. to 11 p.m.  Lake Nasworthy parks that will be open from 3 p.m. to 11 p.m. July 4:
  • Mary E Lee Beach, 2160 Mary E. Lee Road
  • South Concho Park, 1608 South Concho Drive
  • Pecan Creek Park, 8400 Country Club Road
  • Knickerbocker Park, 6402 Knickerbocker Road
  • Hillside Drive, 6600 block of Knickerbocker Road
  • Fish Hatchery Road Park, 3500 block of Country Club Road.
Update 7-3-20:  The Homeowner's Association postponed the fireworks show.  Lake Nasworthy parks are once again closed until July 13th.

Saturday, June 27, 2020

Texas Reopening Pauses: Current Case Explosion

Pandemic diseases spread at a rate determined by actions of their hosts, actual and potential.  Texans mixing more resulted in an increase in positive cases in June.  I noticed the change in late May when shopping.  Few people wore a face mask as stores became increasingly crowded.

The City of San Angelo reported 31 new cases today, bringing the total to 342.  It was 95 before Memorial Day weekend.  Lots of events loom.  How many will be super spreader events?

Update 6-29-20:  Texas Gov. Greg Abbott says the coronavirus "has taken a very swift and very dangerous turn in Texas over just the past few weeks."

Update 6-30-20:  Texas had 6,975 positive cases today, a new record high. The exponential growth theory remains in play.

Thursday, June 25, 2020

City Acts to Reign in Coronavirus

San Angelo officials undertook a flurry of activity to address weeks of growth in coronavirus cases.  Yesterday afternoon the city published:

The City of San Angelo has issued an order that prohibits any outdoor public events over 100 people and all public events with more than 100 people in any City facility. This is effective immediately. This also applies to outdoor events in the county unless approved by the county judge.
In addition, it requires masks to be worn in all auditoriums/theaters and performance halls by employees, volunteers and audience members.
The City gave an exception to events approved by City Council's Special Events process.

It's not clear which upcoming events fit that exception.

Wake the Desert canceled this year's event due to the coronavirus.

The flurry came after cases rose from 95 before Memorial Day weekend to 282 this afternoon. Mayor Brenda Gunter shared her concerns with citizens on March 16th.  City Council as a whole and Tom Green County Commissioners Court failed to address the growth in cases in their recent meetings.  Public health officials made no presentation and elected leaders asked no questions of those officials.

Commissioner's Court did approve spending over $1 million in coronavirus aid.

County Judge Steven Floyd did not think citizens were up for everyone wearing a mask, a component of a gold standard pandemic approach.

Another element is rigorous contact tracing.  Two days ago the city said it would classify all cases as community spread from this point forward.  The City Attorney informed Council several meetings ago that she was doing contract tracing, but that was before our local numbers soared.

This afternoon Local Health Authority Dr. Vretis ordered shoppers to wear masks to prevent further disease spread.

Effective 12:00 a.m. on June 27, 2020 all retail stores that have a posted occupancy load of 100 persons or more within Tom Green County, Texas shall require all customers 10 years or older and all employees to wear a mask or cloth that covers the mouth and nose while they are within the store or within 6 feet of a person from another household when they are outside the store and on store property.
His order revealed the "length of time it takes to get a COVID-19 test result back has increased to seven days."  A week's delay in diagnosis makes contact tracing very difficult.

That means San Angelo is behind the curve on three elements of a gold standard pandemic response, everyone wear a mask, rigorous contact tracing and aggressive testing.

Texas had a record 5,996 new cases today.  The U.S. hit a record 36,975 cases yesterday.  A gold standard pandemic response is sorely needed but elected officials don't have an appetite for it.

Update 6-26-20:  San Angelo reported 29 positive cases today (311 total), while Texas had 5,707.  The United States reached another record with more than 44,000 new cases.  Dr. Anthony Fauci said contract tracing was not going well.

Update 6-27-20:  San Angelo had 31 new cases today bringing the total to 342.   Texas passed Illinois today to become the state with the 4th largest number of cases.  Not long ago Texas was over 20,000 cases behind Illinois. 

Tuesday, June 23, 2020

City Council Special Meeting is Not on Coronavirus

The City of San Angelo experienced a sharp rise in COVID-19 cases since Memorial Day weekend.  Positive cases are up 170%, from 95 on May 31st  to 256 today.

City Council will hold a special meeting June 24th at 5:00 pm but the topic is not our deteriorating public health situation.  Instead, city leaders will consider spending up to $6.5 million for improvements for Goodfellow Airforce Base.

I hope base leaders inform City Council of their efforts to contain COVID-19.  Everyone on base must wear a mask.  Goodfellow has had two positive cases to date.

Mayor Gunter and Dr. James Vretis attribute the rise to people ignoring steps needed to contain the disease. 

"Each time an individual is in close contact with another, they increase their chance of exposure to coronavirus," Vretis said. "Over Memorial Day, we saw many gatherings of greater than 10 people who obviously were not from the same household."

Vretis said they have seen the percentage of shoppers wearing masks continuously decrease.
Oddly, Vretis and Mayor Gunter approved a gathering of up to 1,000 people at Lake Nasworthy in the midst of the recent rise of cases.   The Beers, Bands and BBQ Bazaar event will be held July 24-25, 2020.  In between is July 4th holiday, when families gather to celebrate the founding of our nation.

The way to get our community to a vaccine is through following public health measures.  Texas hit 5,489 new cases today.  Before Memorial Day weekend new cases ranged from 500 to 1,500 per day.   Exponential spread of the disease would be disastrous for Texas citizens.

A second person died of the disease in San Angelo and eleven people are currently hospitalized.  To survive in West Texas required fortitude and the help of neighbors.  Citizens can show both characteristics by wearing masks and social distancing.  That's mighty neighborly.

Update 6-24-20:  Texas Governor Greg Abbott said yesterday: “I did authorize local officials to have the authority to establish regulations in gatherings of 100 or more people,” he said. “This was intended to allow local authorities in particular to regulate gatherings for Fourth of July celebrations. We did not specify what restrictions or regulations they could impose. It’s possible they could require masks in such an environment. It’s going to be up to local officials in that regard.”

The City announced 16 new COVID-19 cases today bringing the total to 272.  Texas daily case count reached a record 5,551.  Council approved the $6.5 million funding for Goodfellow improvements needed for the grant application.  A Goodfellow leader spoke but on the project was silent as to coaching Council on coronavirus control.

Update 6-25-20:  Mayor Gunter and County Judge Steve Floyd issued an order that prohibits any outdoor public events over 100 people and all public events with more than 100 people in any City facility.  It also equires masks to be worn in all auditoriums/theaters and performance halls by employees, volunteers and audience members. The order does not apply to events approved through City Council's Special Events process.

Thursday, June 18, 2020

Coronavirus Accelerating in San Angelo

New COVID-19 cases the last four days were 15, 10, 20 and 20.  The highest daily count prior to Memorial Day weekend was seven.  Cases more than doubled since the last Friday in May.  Case, case, case, cluster, cluster, boom.  We appear to be entering the boom phase.  Everyone wear a mask.

Update 6-20-20:  The city announced nine new cases for each of the last two days.  Total is now 232 positive cases.  The state of Texas reported 4,430 new cases today, a record number.

Update 6-22-20:  Cases total 250 today.  That's a 163% increase from 5-29-20. City Council will hold a special meeting on 6-24 but it is not on the coronavirus explosion.  Council will entertain spending up to $6.5 million in improvements for Goodfellow Airforce Base.

Sunday, June 14, 2020

Coronavirus Spreading in San Angelo

The number of positive COVID-19 cases soared over the last two weeks for San Angelo and Tom Green County.  City statistics revealed 53 new cases since the start of Memorial Day weekend.

City Council will deal with a possible super spreader event in their upcoming meeting.

It's not Mardi Gras but is a sizeable gathering where people are highly unlikely to wear masks and social distance.

This is the only one of two COVID-19 related agenda item Council will consider, according to the posted agenda.  The other item involves the issuance of health permits.

Should COVID-19 cases continue to rise it may be wise to postpone the Beer, Bands and BBQ event.

Update 6-15-20:  The City announced 15 new positive cases today with total positive cases reaching 164.  City officials revealed an error from April 26 when a positive case was not added to the count. That is why the total went up 16 today, 15 new plus the April error.

Update 6-16-20:  Ten new coronavirus cases today brings the total to 174.  Several council members asked about a plan to reduce the risk of attendees getting COVID-19.  Event sponsors submitted a risk minimization plan to the city prior to our recent increase of cases.  That plan was not included in council's background packet. Participants are to wear a mask and social distance.  I'm not sure why that would happen at Beer, Bands and BBQ Bazaar when it isn't happening in the grocery store.  Anyway, Council approved the event by a vote of 6 for and 0 against.  This came after Mayor Brenda Gunter encouraged citizens to self isolate to reduce disease spread at the beginning of the meeting.

Update 6-17-20:  The City announced 20 new COVID-19 cases today.  That's 45 new cases in three days.   Add the missed case from April and the total testing positive is now 194.

Update 6-18-20:  NYT highlighted our community as a COVID-19 hotspot due to our soaring number of new cases. Cases have more than doubled since Memorial Day weekend began going from 95 to 194.  Case, case, case, cluster, cluster, boom!  Add another 20 postive cases today.  Total 214.

Wednesday, April 29, 2020

City Animal Shelter Seeks Bids for Adoption Services

The City of San Angelo issued a request for proposal (RFP) for animal adoption services.  Proposals are due May 12th.  Shelter Director Morgan Chegwidden previewed the new arrangement with the Animal Shelter Advisory Committee in October 2019.

The scope of services includes:

In October staff indicated by memo changes from the prior relationship with PAWS.  They include:
  1.  Assigning the spay/neuter and rabies vaccine expense of adopted pets to the selected vendor; 
  2.  Allowing the selected vendor to set and collect their own adoption fees; and 
  3.  Opening the hours of operation to be set by the selected vendor no longer requiring them to match city shelter hours.
Those changes were not in the draft RFP shared with the Animal Shelter Advisory Committee or the current version on the city's website.

The City contracted with Concho Valley PAWS for shelter veterinary services in 2018 but received little service in 2018 or 2019.  PAWS performance under the vet contract has hardly been "exceptional."

PAWS contract with the city expired the end of February but is renewable in one year terms.  I believe the city and PAWS are timing the new arrangement with the opening of PAWS new facility.

Concho Valley Homepage reported:

In 2020, Concho Valley PAWS’ adoptable animals will be getting a new home — the “David and Judith Hirschfeld Adoption Center.”

“We have leased land directly next door to the San Angelo Animal Shelter so the accessibility to the animals is functional,” explained Wilson.

The center will be built in two phases. Phase one has been underwritten by David and Judith Hirschfeld. 

“The front building will offer office space for our adoption staff, a spay/neuter clinic, a training room, a party room and an education room,” added Wilson.
 Phase two is the physical space for adoptable animals, with plans for over 50 kennels.  

The COVID-19 pandemic has impacted shelter operations yet there is no mention of this in the RFP.
The medical community recently learned the coronavirus can be passed on to pets.  

While San Angelo has avoided widespread, serious COVID-19 cases over 58,500 people have died in the U.S. from the disease.  Serious illness or death is not a valid reason for the shelter to accept an animal under its surrender policies.  

Also, there is also no language regarding who performs spay/neuter surgeries prior to adoption or the mandatory microchipping. Why is this notable?  Local ordinances require:

All animals adopted from the animal shelter shall be spayed or neutered and microchipped prior to release.  No animal shall be eligible for adoption unless spayed or neutered and microchipped.
The City has hidden behind Concho Valley PAWS in the past when asked for compliance information.

Animal Services has provided an update that this (rabies certificate) is not a document of the city – an external vendor provides these services.
The City's standard contract language addresses ownership of documents and public information obligations.  A new arrangement looms, one that gives more responsibility to the contractor. 

Update 5-15-20:  The city's website indicated:

It's interesting City officials could send an RFP to area rescues after ignoring repeated offers from one listed rescue to buy the city's excess veterinary surgical equipment.  The City donated said equipment to Concho Valley PAWS which was under contract to conduct spay/neuter surgeries for the shelter but not performing.

Thursday, April 23, 2020

Coronavirus Testing Demand Drops in San Angelo

San Angelo Health Department statistics indicate COVID-19 testing fell in half since April 11th.  Local Health Authority Dr. James Vretis lamented the drop on KLST yesterday.  Dr. Vretis hopes to test employer and other groups to better understand the prevalence of COVID-19 in our community. He indicated tests are available for the public at Shannon's remaining drive up testing location at the corner of Beauregard and Oakes Street in downtown San Angelo. It is open every day from 9 am to 5 pm.

With fewer tests being conducted the number of positive cases remained at 41 for the last six days.  However, six of the last nine positive cases were the result of community spread. 

Update 4-24-20:  The City reported a 42nd case of COVID-19, a woman in her 40's who was diagnosed in another state.  She lists her residence as San Angelo and that is why her case is added to the total for Tom Green County.

Friday, April 17, 2020

ASU President Brian May Disappeared Overnight

Texas Tech regents accepted Dr. Brian May's resignation last Friday evening. Angelo State University staff and supporters learned of this shocking change via e-mail on Saturday.  Texas Tech's announcement expressed no appreciation for Dr. May's hard work and numerous accomplishments since 2012.

How could this happen?  I imagine Texas Tech blamed Dr. May for the racist incident between two ASU students.  Tech had a student shoot and kill a university police officer in October 2017.  That incident occurred under Chancellor Robert Duncan's tenure.  Current Chancellor Ted Mitchell assumed the role in October 2018.  The Texas Tech student was charged with capital murder in November 2019 and could face the death penalty.

I don't believe one episode of student violence, however disturbing, cost Dr. May his position.  But it likely damaged his relationship with Dr. Mitchell.  That relationship broke completely on April 10, 2020.

Had Dr. May done something so terrible to cause an immediate resignation?  Many who knew Brian May loved him.  He was kind to and interested in ASU employees.  Could Dr. May have a private face that differed from the one seen by the public?  Sure.  But what happened a week ago was so in-congruent with Angelo State's Ram Family had known and experienced with their leader.

While his resignation could have been the result of a poor personal choice it is more likely the result of Dr. May standing up for ASU and the people he served.  The novel coronavirus instantly wrecked the U.S. economy and devastated energy prices.

Today's management practices emphasize dollars and data over everything else.  Dr. May stood for people, a minuscule priority in a world where human resources is "strategic."  HR exists to implement executive priorities, not take care of workers.  Saying "No" is not acceptable in a top down hierarchy.

I believe Texas Tech asked Dr. May to do something he would not do, as a man of conscience.  Did they ask May to reduce ASU employees by X percent?  Did they want him to use technology in an invasive manner or add busy work to a soon to be depleted workforce?  We can't truly know as no one is talking.  

We do know what is in our hearts, which broke in the sudden resignation of Dr. May.  I am sure ASU's Interim President is competent and deserves a chance to lead.  But not acknowledging the tremendous loss of Brian May and faculty, staff and student's heartbreak could turn the Ram Family into a dysfunctional one.  Texas Tech robbed the ASU family of the chance to say thank you and goodbye to the leader they loved.

Enough pain looms on the horizon in our COVID-19 world.  Taking away the opportunity to honor a beloved leader is a strategic management decision.  And for many it hurts like hell.

Update 4-19-20:  University of Arizona announced furloughs and pay cuts for employees.  Closer to home Baylor University made $80 million in budget cuts for the coming year.

Thursday, April 16, 2020

Tom Green County Reaches 40 Cases

Johns Hopkins University tracks global coronavirus cases on it website.  The data can be viewed at a county level and Tom Green County's information can be seen above.  Yesterday the City announced its 40th positive test result for COVID-19.  The patient is a woman in her 20's and she had no known contact with a positive case.  This is our 10th case of community spread. 

Update 4-17-20:  Case #41 is a female teen and the result of community spread.  Six of the last nine cases have been community spread.

Wednesday, April 15, 2020

Frontier Communications Declares Chapter 11 Bankruptcy

A company press release stated:

Frontier Communications Corporation (NASDAQ: FTR) (“Frontier” or the “Company”) today announced that, together with its subsidiaries, it has entered into a Restructuring Support Agreement (“RSA”) with bondholders representing more than 75% of Frontier’s approximately $11 billion in outstanding unsecured bonds (the “Bondholders”). The RSA contemplates agreed-upon terms for a pre-arranged financial restructuring plan (the “Plan”) that leaves unimpaired all general unsecured creditors and holders of secured and subsidiary debt. Under the RSA, the Bondholders have, subject to certain terms and conditions, agreed to support implementation of a Plan that is expected to reduce the Company’s debt by more than $10 billion and provide significant financial flexibility to support continued investment in its long-term growth. To implement the Plan, the Company and its direct and indirect subsidiaries voluntarily filed petitions under Chapter 11 of the United States Bankruptcy Code in the Southern District of New York. 

Frontier expects to continue providing quality service to its customers without interruption and work with its business partners as usual throughout the court-supervised process. The Company has sufficient liquidity to meet its ongoing obligations. Under the RSA, trade vendors will be unimpaired for both pre- and post-petition obligations.
The word bankruptcy was only used to describe the court and legal code, not the process Frontier had declared.  Flashback to better times..

On July 1, 2010, Verizon Communications distributed Frontier Communications stock to its shareholders..
Frontier's stock price reached $124.50 on February 20, 2015.  Sadly, it's now 26 cents.

Sunday, April 12, 2020

Dr. Brian May Resigns with Little Thanks

Angelo State University President Dr. Brian May submitted his resignation on Friday. This news is heartbreaking for many in the Angelo State family.  A press release stated:

The chairman of the Texas Tech University System Board of Regents and I have accepted Brian’s resignation as president of Angelo State University,” said Dr. Tedd L. Mitchell, chancellor of the Texas Tech University System, in a prepared statement. "We wish Brian and his family well.”
The news stunned ASU employees and supporters.  Also shocking was the lack of appreciation for years of hard work Dr. May invested in the university, which had numerous achievements under his tenure as President.

Leading a university became more challenging with the coronavirus outbreak spanning the globe.  Dr. May has been concerned about student safety as many youth believe "it won't happen to me."

Unfortunately, a ASU student played a racist prank on an international student which escalated into violence.  The story spread beyond San Angelo.

Angelo State University has a strategic relationship with Sejong University in Seoul, South Korea.  I don't know their level of concern about the incident. but I would expect them to take it seriously.  Dr. May wanted all ASU students to treat one another with respect and dignity.

There is another reason to keep ties between ASU and Sejong University strong.  The United States has much to learn from South Korea's response to the COVID-19 outbreak. The racist student prank turned violent may simply be a disturbing backdrop for Dr. May's resignation. 

Texas Tech's press release had far more information on the interim replacement than Dr. May.  Knowing what he's done for the university there is a significant lack of appreciation for his leadership and numerous contributions.  It's sad to see in these difficult times.

Thursday, April 09, 2020

COVID-19 Cases Reach 32

The City of San Angelo reported seven new coronavirus cases.  The Standard Times reported:

The new cases include: 
- Male in his 60s, exposure to known case
- Male in his 40s, exposure to known case
- Teenage male, exposure to known case
- Young boy, community spread
- Female in her 30s, exposure to known case
- Preteen female, exposure to known case
- Teenage male, exposure to known case
Cases in our community are much younger.  78% of cases are patients in their 40's or younger.  The one death to date was a man in his 70's.  Five cases have no known origin and are considered the result of community spread.

Update 8:30 pm on 4-9-20:  A positive case was reported at a local daycare.  It's not clear if this is the young boy listed above as community spread or another case.   Local health officials have significant contact tracing to do as the city enters a Good Friday holiday.

Update 4-10-20:  The City reported its 33rd positive COVID-19 case, a woman in her sixties with community spread.  This is our sixth case in our community where the patient had no known contact with another positive case.

Update 4-11-20:  The daycare case is being handled by the Department of Healthcare Services as the child is a resident of another county.  City Health Director said children cannot go to daycare if they have a 104 degree temperature or higher.  She did not say anything about contact tracing and testing for those who may have been exposed via diaycare.  The city reported two news cases, bringing the total to 35.  Both are women, one in her 20's and the other in her 40's.  Both are cases of community spread

Monday, April 06, 2020

San Angelo's Second COVID-19 Cluster

San Angelo's tenth COVID-19 case spread the disease to three people when they visited a local business.  The man in his 30's had an unknown source of his disease.  Three women in their 40's contracted the disease as a result of this person visiting their place of work.  This is the second publicly known cluster.  A local family had the coronavirus spread through their household.

City officials stopped sharing information on new individual cases on their COVID-19 webpage.  They are sharing basic information about the patient's sex and age with the media for new positive tests.

Contrast this approach with South Korea, a country which used data and information to arm authorities and citizens to intelligently combat the COVID-19 threat.

The result of the tracking is not only used by health authorities but also made public via national and local government websites, free smartphone apps that show the locations of infections, and text message updates about new local cases. This help citizens avoid hotspots of infections.
South Korea mobilized massive resources right away to stop the coronavirus from overwhelming their country.  They have mostly contained their first wave.  The United States' COVID-19 tsunami may crest soon in hard hit parts of the country, but the water level is rising in non-hotspots.

Pray that those stricken with the disease make a full recovery and for the safety of family, friends and our community.

Update 4-6-20:  The City reported 3 new COVID-19 cases, two preteen females and a male 50-59.  The total is 24 cases.  All had contact with known cases in our community.

Update 4-8-20:  There are 25 cases of COVID-19, three of which have recovered to the point they are no longer being tracked.  The newest case is a male teenager with no known contact with a COVID-19 patient, making it another case of community spread.

Update 4-9-20:  A man in his 70's died from COVID-19   Case #1 and Case #9 were men in their 70's.  It's not clear which case died from city reports. 

Saturday, April 04, 2020

City Hits 20 COVID-19 Cases

The City of San Angelo reported three new cases of COVID-19, bringing the total to 20 confirmed cases.  The three new cases are all are women in their 40s.  The Standard Times stated that none involved community spread.  The city's website provided no information on cases 18, 19 and 20.  The younger patient profile continued with sixteen of the first 20 cases in our community are under the age of 50.

San Angelo could see in a matter of weeks what other areas are experiencing.  Cases in the United States are going up an order of magnitude every 8-9 days.  Today the U.S. hit 300,000 cases.  It hit 100,000 cases on March 26th, 

This exponential growth should be concerning to area citizens.  20 could become 200 around Easter.  200 could be 2,000 by May Day.

Practice physical distancing, wear a mask out in public and pray for the safety of family, friends and neighbors. 
Update 4-5-20:  The City reported its 21st case today, a male in his 60's who got the disease from a known COVID-19 patient.  

Friday, April 03, 2020

Seven New COVID-19 Cases in San Angelo

The City of San Angelo reported seven new confirmed coronavirus cases in our community.  They are:

Case #11: teenage female, family member of case #7 (preteen female)\
Case #12: newborn male, family member of case #7
Case #13: male in his 40s, family member of case #7
Case #14: female in her 40s, family contact with another positive case
Case #15: female in her 20s, family member of case #6 (female in her 20s)
Case #16: female in her 20s with no known contact with a positive case, categorized as a case of community spread
Case #17: female in her 60s, travel-related case.
Our area has younger people testing positive.  Only four of our seventeen cases are people over the age of 50.  Thirteen are in their 40's or lower.  This may not hold but it seems unusual given what has been shared about this disease.

The newest confirmed cases show disease clustering in families.  Pandemics spread in the following pattern:  case, case, case, cluster, cluster, boom.  San Angelo may be near the boom phase. Everyone should wear a mask. 

Tuesday, March 31, 2020

Tom Green County has Nine COVID-19 Cases

The City of San Angelo Health Department reported three new COVID-19 cases, bringing the total to nine in our area:

Case #1: male in his 70s who traveled 
Case #2: male in his 20s who came into contact with a positive case within the state 
Case #3: female in her 30s who had no known contact with a positive case, categorized as a case of community spread 
Case #4: male in his 30s, close family member of case #3 
Case #5: young boy, close family member of case #3
Case #6: female in her 20s who came into contact with a confirmed positive travel-related case
Case #7preteen female, she and her household have been self-isolating since March 24
Case #8: man in his 50s from out of town who was here for work purposes - currently hospitalized in San Angelo
Case #9: man in his 70s - currently hospitalized in San Angelo
Testing continues to rise, reaching 451, but turnaround remains a concern as 209 of those results are pending as of 2:00 pm today (3-31-20).
While testing is growing the number of patients with the virus can double in less than a week.  Roughly ten days ago an influential community leader estimated San Angelo had 600 COVID-19 cases.  If that were true it could have doubled twice, from 600 to 1,200 to 2,400 during that time. 

State Governors continue to share concerns about the limited number of tests available.  A nurse in Midland, Texas has symptoms but cannot get a test to see if they have the coronavirus.  This is concerning to co-workers and a potential risk for patients.  Shannon's Dr. Shultz explained the CDC testing criteria in a short video

Chris Martensen researched and posted videos over the last two months on his Peak Prosperity website.  Early on Chris illuminated a gold standard panedemic approach. 

Super spreader stories and MIT researchers lend credence to COVID-19 being airborne.  Those who need to go out in public to run critical errands should wear a mask and gloves, especially if someone in their home is medically fragile.  This novel coronavirus is easily spread and not a disease to be taken lightly.  The pattern in other communities has been case, case, case, cluster, cluster, boom.

I pray that our community be spared the sudden devastation this coronavirus has wrought elsewhere.  May it be manageable for our local health resources.

Update 4-2-20:  The City reported a tenth case.  Case #10: male in his 30s who had no known contact with a positive case, categorized as a case of community spread.  Seven of the first ten cases are under 40 years of age.

Saturday, March 28, 2020

City Ramps Up Testing

The City of San Angelo reported 287 COVID-19 tests have been performed and that 3 positive cases have been identified to date.  The number rose from 108 and no positives on 3-21-20.

A high profile community leader estimated San Angelo had 600 coronavirus cases This was prior to the city announcing the first positive case on 3-24-20.  Without testing it is difficult to know the rate of spread.  Other communities have seen cases double in 3-4 days and go up an order of magnitude every two weeks (examples:10 to 100, 100 to 1,000, 1,000 to 10,000, 10,000 to 100,000). 

Yahoo Finance reported:

Philanthropist and billionaire Bill Gates believes that the best way to stop the spread of the coronavirus, or COVID-19, is to “quite dramatically” ramp up testing while keeping social distancing measures in place for six to ten weeks.

“We have to raise the level of testing and the prioritization of that testing quite dramatically ... so that we take the medical problem and really stop it before there's a large number of deaths.
Healthcare workers, especially those working with patients in the home, are flying blind at the moment.  Testing has increased in our community in the last week but it needs to increase dramatically for leaders and clinicians to understand the scope of the problem.  It will also help citizens make better decisions going forward.

God's peace, joy and strength be with us during this difficult time.

Update 3-29-20:  San Angelo has five total cases as two new cases of COVID-19, a young boy and man in his 30's, tested positive.  They are family of third case in Tom Green County, which resulted from community spread.

Pandemic spread goes case, case, case, cluster, cluster, boom.  

Update 3-30-20:  A small town in Northern Italy distributed masks to residents and is yet to experience their first case of coronavirus   A Washington choir experienced a cluster outbreak when no member was sneezing or coughing.  This led experts to conclude the virus is airborne.  Everyone wear a mask.

Tuesday, March 24, 2020

Tom Green County has First COVID-19 Case

The City of San Angelo reported this morning:

The City of San Angelo Health Department has confirmed one positive case of coronavirus disease 2019 (COVID-19) in Tom Green County. This is the first case to be confirmed in the area. 

The affected person is a male in his seventies who had traveled, officials stated. 
As of now citizens don't know where in Tom Green County he lives.  A press conference is scheduled for 3:30 pm today.  It's officially here, five days after City Council held an emergency meeting.

One high profile community leader said last week that San Angelo likely had 600 cases.  Testing will begin to reveal the extent of the coronavirus in our community.  God bless us all, especially the elderly and medically fragile.

Update 3-25-20:  The City reported a second positive case, a young man in his 20's who'd contacted someone else in the state with the disease.  He received a test at Shannon and it was positive.

Update 3-28-20:  The City reported a third possible case, a woman in her 30's with no identifiable contact with a known coronavirus patient.  San Angelo has community spread. San Angelo is at case, case, case.  Next up cluster, cluster, boom.

Update 3-29-20:  There are two new cases bringing the total to five.  The new cases are family members of case #3, a young boy and a man in his 30's.

Update 3-30-20:  A sixth case has been identified, a young woman who had contact with a traveler who contracted COVID-19

Saturday, March 21, 2020

Conservative Senator, This Citizen and San Angelo Mayor Concerned about Coronavirus

The Republican Chairman of the Senate Intelligence Committee said the following on February 27th in a meeting with supporters:

"There's one thing that I can tell you about this: It is much more aggressive in its transmission than anything that we have seen in recent history.  It is probably more akin to the 1918 pandemic."
The United States is about ten days behind Italy where coronavirus cases have overwhelmed hospitals and taken out healthcare professionals.  I had elective cancer surgery Monday at Shannon Medical Center.  Had I been in Washington state or New York City my procedure would've been cancelled.

The evening of my surgery Shannon reduced visitation to one family member.  They set up visitor screening at the front door, asking visitors to complete a COVID-19 screening.

While there I kept the door to hall closed.  Outside my room I could hear people coughing and wondered if that was a yet to be diagnosed person, patient or staff.  I needed to walk as part of my recovery and decided loops at my end of the hall would provide the best protection.

My goal was to get home as soon as possible and needed to complete a checklist to do so.  One of those was coughing.

During my two day hospital stay the world changed dramatically. Mayor Gunther and City Council went from addressing the potential outbreak in public comment on 3-17-20 to a full blown press conference on 3-19-20.   The City has links to substantial resources on its website.

The City is following CDC guidelines and recommendations.  Yes, that's the same CDC that botched testing, one of many key strategies required to control a pandemic.

San Angelo Live reported:

At the end of Friday, March 20, the City of San Angelo Heath Department reported:
  • 108 total tests taken
  • 16 negative tests
  • 92 tests are pending, awaiting the results from the lab
Today, a Shannon Medical Center spokeswoman said the labs are turning around the tests in about seven days.
On February 23rd, (nearly a month ago)

South Korea has raised its coronavirus alert to the "highest level" as confirmed case numbers keep rising.

President Moon Jae-in said the country faced "a grave turning point", and the next few days would be crucial in the battle to contain the outbreak. 
South Korea chose mass testing.  Our current seven day turnaround with 85% of test results not back falls well short of what is needed/required.

That means everyone has to do their part to protect themselves and their loved ones until the threat abates.  Listening to the call to help others during this time is encouraged.  Just do it safely.

May God's peace and love be upon you and remain with you.  In Christ's name we pray.  Amen

Monday, March 02, 2020

City Public Health Addresses Coronavirus Topic

KSAN interviewed Health Department Director Sandra Villareal.  In addition the city added information on the Coronavirus to the Health Services webpage.  This information was not available over the weekend.

A number of states experienced community spread of the Covid-19 coronavirus.  Physicians estimate the virus has been in the United States for six weeks as travelers returned from areas that had coronavirus outbreaks.

San Angelo has Goodfellow Airforce Base which serves all branches of the military in its training mission.  Angelo State University has a large contingent of international students.

The Health Department did not mention testing or what to do if one has the symptoms listed.  It also did not mention what people without health resources should do if they get a respiratory illness.

The U.S. strategy has been light on testing, without which tried and true public health measures like contact tracing and isolation cannot be implemented.

The City of San Angelo finally said something about the pandemic coronavirus.  However, it did not rise to the level of a news story or press release.

Update 3-3-20:  One month ago a CDC representative said "The goal is to catch the majority of cases and slow the entry of the virus into the country. She added the public health system remains on high alert." As of this morning the CDC website states "CDC is remanufacturing the reagents with more robust quality control measures. New tests will be distributed once this issue has been addressed."  An ER physician offered advice for the public and stressed the role of local health departments.

Update 3-4-20:  The City published a news story about the coronavirus.  The piece stated "there are no cases of COVID-19 in the general population in San Angelo or Texas at this time."  It did not say if any testing of patients had been conducted.

Update 3-5-20:  The Trump coronavirus team refused to answer a question on uninsured people paying for the diagnostic test.  The Hill reported on the potential cost of the test. 

The Trump team will miss its promise to make 1 million tests available by the end of this week.  Bloomberg reported "The lack of testing kits for hospitals and health departments has created a gaping vulnerability in the U.S. effort to contain the virus."

San Angelo Live ran a story on Health Department preparations for the coronavirus coming to town.  Their piece did not address testing or what to do if one has the symptoms listed.  It also failed to advise people without health resources what they should do if they get a respiratory illness.  Three new cases of coronavirus arose in the Houston area from people who traveled overseas, at least one to Egypt.

Update 3-6-20:  Mayor Brenda Gunter put out an official communication on the city's preparedness for a possible coronavirus outbreak.  "Any positive case of coronavirus will be confirmed through the City Public Health Department and distributed to the public via the City Public Information office."  Health Department Director Sandra Villareal gave a coronavirus update to City Council during public comment on 3-3-20.  Council later approved a Hazard Mitigation Plan for the City and Tom Green County.  Council asked if it included pandemic.  A search of the document showed it lacked the words "pandemic" and "epidemic."

Update 3-11-20:  The World Health Organization declared the coronavirus a pandemic.  Dr. Anthony Faucci told Congress "If we don’t do very serious mitigation now, what’s going to happen is that we’re going to be weeks behind, and the horse is going to be out of the barn, and that’s the reason why we’ve been saying, even in areas of the country, where there are no or few cases, we’ve got to change our behaviour. We have to essentially assume that we are going to get hit. And that’s why we talk about making mitigation and containment in a much more vigorous way."  In some parts of the U.S. we are already weeks behind.

How many contagious individuals traveled to San Angelo during this time?   The City's Health Services webpage added two CDC videos, one for elderly patients and another on how the disease is spread.

Update 3-13-20:   City Council's agenda for 3-17-20 has only one item on the regular agenda.  It is not the coronavirus, but a resolution for Republic Services to access tax exempt bonds through the State of Texas.  Of the nearly $500 million San Angelo's landfill would get $6.2 million for improvements.  There is no agenda item for the novel coronavirus.  One columnist wrote "So, to our elected officials: You have critical responsibilities to the country. It is essential that you trust the experts from CDC, the National Institutes of Health and local health departments. Make sure they have the funding they need to manage this crisis. Tell us the truth … this is a dangerous virus, not a hoax, and there is no magic bullet."

Update 3-14-20:  San Angelo Independent School District canceled classes through March 20th after the district became "aware of the self-reporting and self-quarantining of people in the community who traveled to areas of high exposure." Bell County confirms their first case of coronaavirus.  The person recently returned from a trip to Europe.  Austin has three cases of coronavirus, one a "transfer from a rural hospital in a different region" of the state.  Another recently traveled from Houston, which is believed to have community spread.  Yesterday Dallas County reported its ninth coronavirus case.  Fort Bend County also has nine cases.  Tyler has three cases while Gregg County has one.  As of yesterday Texas Tribune reported 50 cases in Texas and broke that number down by county.

Update 3-15-20:  Texas eliminated access to primary care as part of its public health responsibility in the early 2000's.   That was part of a U.S. wide dismantling of public health resources and capabilities.  "America has no real public health system – coronavirus has a clear run.  Local and state health departments are already bare bones, having lost nearly a quarter of their workforce since 2008, according to the National Association of County and City Health Officials."