The mayor of San Antonio declared a public health emergency Monday over the presence of coronavirus in the Alamo City. He also announced that the city will no longer permit people quarantined at Lackland Air Force Base to travel into and through San Antonio. He emphasized that the public did not face any greater risk.
The announcement came only hours after federal health officials admitted that a patient released from federal quarantine tested positive for the virus and spent two hours at one of the city's busiest shopping centers before being recalled into quarantine. On Monday afternoon, mall officials announced it was closing its doors for 24 hours for decontamination.
Ron Nirenberg's declaration explained that he has "determined that extraordinary and immediate measures must be taken to respond quickly, prevent and alleviate the suffering of people exposed to and those infected with the virus, as well as those that could potentially be infected or impacted by COVID-19."
Nirenberg's three-page "Declaration of Public Health Emergency" reviewed the events since December 2019 and up to March 2, when the Centers for Disease Control reported a COVID-19 patient released and re-quarantined over the weekend went to San Antonio's North Star Mall before returning to isolation.
Nirenberg's declaration explained that the Texas Disaster Act of 1975 appointed him the "emergency management director of the City of San Antonio" with the authority to "declare all rules and regulations that may inhibit or prevent prompt response to this threat suspend for the duration of the incident."
The declaration activated San Antonio's emergency management plan. It will remain in effect for at least seven days, beginning on Monday. It may not continue beyond that seven-day limit "unless continued or renewed by the City Council," according to the declaration document.
Nirenberg also declared "that ingress into and travel through the City of San Antonio from Lackland by those persons that have been quarantined in the facility is not permitted. No previously quarantined person shall be permitted to enter the City of San Antonio until further notice."
He tweeted later on Monday to emphasize that "this declaration is explicitly designed to ensure evacuees from the Diamond Princess cruise ship cohort remain at Lackland AFB until further testing is completed. This is NOT to signify that the public is at any increased risk."
BREAKING: San Antonio Mayor @Ron_Nirenberg declares public health emergency regarding COVID-19. Part of the hope of this is getting the CDC to respond to and address the city’s concerns about moving evacuees from Lackland. @TPRNews pic.twitter.com/4HStB6xI2k
— Joey Palacios (@Joeycules) March 2, 2020
North Star Mall closes
San Antonio Metro Health Assistant Director Anita Kurian explained on Monday that the patient had twice tested negative for COVID-19 and was released on Saturday. She said the patient visited North Star Mall for about two hours. She added that the patient was not showing any symptoms.
“Based on the history we’ve gotten from her and based on our risk assessment the exposure at the mall is deemed to be low.” However, she said, people who may have been at the mall should monitor themselves for symptoms.
City health officials say they contacted the mall and encouraged them to do a deep cleaning. Mall officials said on Monday that the mall was closing for 24 hours.
A note posted on the mall’s Facebook page said while there was a low risk to the public, they were taking extra precautions for the well-being of the shopping center community.
The patient also stayed at a Holiday Inn hotel near the airport and was in contact with about 18 people at the Texas Center for Infection Diseases.
BREAKING: City of San Antonio officials say the released and re-quarantined COVID-19 patient went to North Star Mall before returning to isolation. She was at the mall from 5:30 to 7:30 PM Saturday, according to Metro Health. The patient was asymptomatic on release. @TPRNews pic.twitter.com/AFndlwQZ4S
— Joey Palacios (@Joeycules) March 2, 2020
'An abundance of caution'
The developments came a day after the CDC announced that it would retest the patient.
The patient had twice tested negative for the virus that causes COVID-19 and was released. The patient, who interacted with members of the San Antonio community, was then recalled to isolation after results from a third test — which came up positive — were reviewed.
The CDC explained on Sunday that the individual was among a group of people brought back to the U.S. from Wuhan, China, and quarantined at Lackland Air Force Base. The patient was the only evacuee from that group to test positive for the disease. The evacuee was taken to Methodist Texsan Hospital, then transferred to the Texas Center for Infectious Diseases. The patient remained there for several weeks.
"At the time of discharge from the facility," the CDC said on Sunday, "the patient was asymptomatic and met all of CDC’s criteria for release – resolution of any symptoms and two consecutive sets of negative test results, collected more than 24 hours apart." The results of a third sample, the CDC said, were "determined to be weakly positive."
"Out of an abundance of caution," the statement said, the CDC recalled the person back to the medical facility. It did not identify the facility or the patient.
The statement added that local health officials were working to determine how many other people may have been exposed to the patient and to notify them about the exposure.
In a joint statement Sunday night, San Antonio and Bexar County officials reported that "Metro Health has been tracking where the person went, who they interacted with, timeframes outside the federally ordered quarantine and who may have been exposed. This information will be shared with the public when completed."
Nirenberg was critical over the weekend development. “The fact that the CDC allowed the public to be exposed to a patient with a positive COVID-19 reading is unacceptable,” he said in Sunday's joint statement. “We will hold the CDC accountable to providing complete transparency for the public. This situation is exactly why we have been asking for federal officials to accept the guidance of our medical community.”
Today we learned that the CDC mistakenly released a patient from the Texas Center for Infectious Disease who later returned a positive COVID-19 reading.
The fact that the CDC allowed the public to be exposed to a patient with a positive COVID-19 reading is unacceptable.
— Mayor Ron Nirenberg (@Ron_Nirenberg) March 2, 2020
Bexar County Judge Nelson Wolff shared Nirenberg’s critical reaction: “This has been our biggest concern and now we will experience the consequences of no action. Time and time again, I have raised issues concerning evacuees, inappropriate accommodations, the risk of exposure during transporting and the need for additional monitoring and extended quarantine periods.”
"Our federal representatives, the CDC, and the US Department of Defense cannot and should not ignore us now,” Wolff added. “We are in dire need of additional resources and protocols immediately to include longer quarantine periods and the opening of appropriate facilities such as the Alabama facility or the San Antonio Military Medical Center. Please do not delay any longer and risk local transmission.”
Wolff told TPR on Sunday night that he was concerned about Monday’s planned release of more than 130 evacuees from the Diamond Princess cruise ship, who also have been quarantined at Lackland Air Force Base. He wasn't sure if they should be released. But if they were, he said, "they don't live here. They should go straight home."
The latest developments in San Antonio came after New York City and Rhode Island reported their first infection cases, joining more than 70 other cases in the U.S. Washington State has also reported at least six deaths from COVID-19. The World Health Organization has confirmed more than 87,000 cases of COVID-19 in at least 60 nations, and it estimated almost 3,000 people have died throughout the world.
The primary elections
They also came on the eve of the 2020 primary elections on Tuesday, March 3.
Bexar County elections official Jacque Callanen said at a Monday press conference that she strongly recommended that election judges concerned about the coronavirus use hand sanitizer at polling places.
She said she could not guarantee election judges at all 280 polling sites across the county will provide hand sanitizer but she praised those who made plans to do so.
“I applaud them if they do precautions as far as ... keep wiping down the equipment," she said. "Hand sanitizers will be there.”
Callanen added that voters could bring their own hand sanitizer too. The polls are open from seven a.m. to 7 p.m. on Tuesday.
Bonnie Petrie can be reached at Bonnie@TPR.org and on Twitter at @kbonniepetrie.
Joey Palacios can be reached at Joey@TPR.org and on Twitter at @Joeycules.
Brian Kirkpatrick, Kathleen Creedon and Fernando Ortiz Jr. contributed to this report.