In just the last 24 hours, Dallas County has reported more than 400 new COVID-19 cases and nine more deaths.
The county has now eclipsed 15,000 cases since testing began in March.
Dr. Nick Karr has served as an ER doctor at several DFW hospitals and founded Sinai Urgent Care Clinic with locations around the metroplex. At the start of the pandemic, he launched SafeWork, one of the first non-governmental test sites in Dallas.
“One of the things we noticed pretty early on was that people wanted to get tested. And we were still at that point in time coming out of flu season. There was a lot of confusion and I think that’s going to be an issue going into this next season, because of the overlap between the COVID symptoms and influenza,” he said.
County officials said there are increasing outbreaks of cases being reported from multiple large social gatherings since the beginning of June and that the recent death of a 12-year-old is under investigation by the Medical Examiner’s office as a COVID-19 associated death.
What's Causing the Uptick?
Karr believes a number of things overall are causing the uptick in numbers across North Texas.
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“I really think a lot of what we’re seeing now is a result of things opening back up. And I think that some of this was from what was going on during Memorial Day. The holidays are a good opportunity for these viruses to spread,” he said.
He also believes people coming out of quarantine fatigue and not wearing facial coverings or practicing safe hygiene is another culprit.
“They’re burning out, people are tired. I think a lot of people have pent-up energy from spending a lot of time indoors and are ready to get out and get on with their lives,” he said. “But as we are in the midst of all this, as we are seeing the rates go up -- people are going out more and relaxing those precautions that they were taking previously.”
He added, “It’s hard to maintain that level of vigilance. The virus does not get fatigued, the virus does not get tired and go away, it’s still there.”
Dr. Karr said he fears the spread is being driven, in part, by large gatherings of people, including the recent protests. Dallas County leaders had urged participants of recent protests to get tested.
And with a major holiday around the corner, there may result in another uptick in cases following Fourth of July.
Much of it boils down to the duration and intensity of exposure to a person with COVID-19.
“So either you’re in a very enclosed space with someone and they’re not necessarily shedding a whole lot of virus -- but you’re there for a prolonged period of time,” Dr. Karr explained. “Or, you’re around someone who has a high viral load and you might be in a wide-open space. But that proximity to them, that seems to be what drives the spread of the virus.”
Is It Just More Testing?
Dr. Karr said the factors in our environment (reopening, mass gatherings, not wearing masks) are an indicator that the increased numbers of positive cases are most likely due to the virus spreading, not so much an increase in testing.
For example, the Safework testing operation partners with local businesses and companies to test essential workers like those in the grocery, restaurant, manufacturing, and healthcare industry.
Karr said the fact that they’re seeing a huge increase in positive cases among their testing pool says something.
“The rates of positives that we were getting with the same business, even two weeks or month later – it has increased significantly. So that tells me, we were testing the same 500 or 1,000 people a month ago and now we’re retesting them and seeing the rates go up? That would indicate to me that the virus is becoming more widespread,” he said. “And if you just look at the hospital data, you’re seeing an increased number in hospitalizations. So I think it’s another indicator.”
Asymptomatic Spread
New estimates of the number of asymptomatic people with the coronavirus suggest that "silent" COVID-19 is much more prevalent than once thought, according to two studies published in May.
Dr. Karr agrees that people who are asymptomatic or pre-symptomatic are driving the spread of this disease.
In fact, he knew of one man who spent a weekend traveling to Austin and had no idea he had it until after that he was tested at work. Some people are even mixing up symptoms with seasonal allergies.
“The patients that tested positive they’ll tell me, 'I was kind of having some mild runny nose or a little bit of a headache but I figured it was just my allergies, I get them this time of year.' So that’s one of the biggest challenges we are facing, is the idea that this overlaps not just flu but with other more mild symptoms," said Dr. Karr.
That is why experts recommend that if you think you may have been exposed or are having questionable symptoms, it’s important to get tested and take the proper measures to stop the spread.
“If you have suspicion that you could have it, obviously self-quarantine. Taking that level of personal responsibility is really important,” said Dr. Karr.
Looking ahead, he also believes any potential for another wave later in the year will depend on how many students head back to school in large groups this fall semester.
“You look at a typical flu season, where a lot of that correlates with kids going back to school. Especially in this case, with children being asymptomatic for the majority children,” he explained. “I think as we look to kids going back to school, there’s going to be another big concern. I think that is going to be a large percentage of why there will be an uptick this fall and winter. Independent of the speculation of cold versus warm weather -- maybe that has some impact -- but I think the kids are unfortunately going to be a large part of how this gets spread.”
Dallas County Health Director's Take
The Dr. Philip Huang, the director for Dallas County Health and Human Services, said during the early reopening phase they were encouraged by the number of hospitalizations because it plateaued and didn't increase significantly, but that's changed.
He said they've seen record number of new COVID-19 cases and hospitalizations.
“I think since Memorial Day with additional opening up, now we’re starting to see effects of that and I think people, are sort of forgetting about it you know the the weather’s nice out there, things are opening up, people just thinking, ‘Hey we’re over it’ let’s just go back to normal,' and that's what we can't do. We still have to take this very seriously," said Dr. Huang.
He said more research has shown that cloth facial coverings help play a role in the ability to open the economy safely.
“If everybody did that and wore the cloth facial coverings, diligently, then that can really help slow down and prevent further spread," Dr. Huang said.
He said the county remains in the 'Red Zone' which is the highest level on their risk level chart. It indicates for people to 'Stay Home, Stay Safe.'
"We want to get to orange, yellow and green as much as anyone, but it seems like for us to do that the safe way, the cloth facial coverings, if people did that, that would help us to be able to open up and open the economy more," he said.
With the highest number of new cases recorded on Wednesday at 413, he said he wouldn't be surprised to see numbers around 400 become the new normal.
"We cant let up on this, people need to do their cloth facial coverings, wash their hands, stay 6 feet distance, those things work and they make a big difference," Dr. Huang said.
