When the first cases of coronavirus were detected in the United States, Samantha Tillman didn’t take it too seriously.
In late May, after Gov. Greg Abbott rolled back lockdown rules and allowed bars in Texas to partly reopen, Tillman, 29, went out to lift a few cold ones, just because it had been so long. She patronized a few restaurants, went to the grocery store, the gas station. She had a birthday party for her son and took a family trip to Port Aransas.
Her 67-year-old father didn’t hesitate to head downtown and stand with others defending the Alamo during a crowded Black Lives Matter protest in June. Then they both started feeling sick. Tests confirmed it: COVID-19.
“I thought this is just a big joke,” Tillman said. “Until a friend of mine who lives down the street lost his father to the virus.”
Tillman, a hairstylist who lives in St. Hedwig, is one of a growing number of young people who have contracted COVID-19 since Texas reopened, fueling a surge of infections that is overwhelming hospitals, testing centers and public health departments in San Antonio and statewide.
On May 1, the same day retail stores, restaurants, movie theaters and malls resumed operations, people under age 40 accounted for 42 percent of all COVID-19 cases in Bexar County. By last week, it had climbed to 57 percent, Metropolitan Health District figures show.
“This is an extraordinarily dangerous time,” Bexar County Judge Nelson Wolff said recently. “Our hospital capacity could run out in the next week or two if we keep growing like this.”
Doctors, public health workers and infectious disease experts point to several reasons for the rising rates of COVID-19 among young people in Bexar County — a trend found in places where new infections are breaking daily records, such as Oklahoma, Florida, Ohio and Arizona.
“There are so many things that contribute to that increase,” said Angela Clendenin, an assistant professor of epidemiology and biostatistics at Texas A&M University. “There’s no way to credit it to a single event.”
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One major factor was Abbott’s decision to reopen restaurants, businesses and bars. It was widely perceived as permission to resume normal activities, and to do so without face masks.
Many people — particularly young adults who are more likely to go out and socialize with friends in groups — let their guard down. The virus, which can be readily transmitted by people who show no symptoms, spread like wildfire.
The increase in COVID-19 cases among young adults has local officials worried. Metro Health is developing a targeted approach to raise public awareness and cut the spread of COVID-19.
Among the initiatives the agency hopes to unveil soon: A public health campaign — partly directed at young adults — and a handful of ads or stories on Snapchat and Tik Tok, social media platforms popular with teenagers and young adults. Another is partnering with social media influencers who can share COVID messaging with their hundreds or thousands of followers.
“Many young people don’t consume media the same way their parents and grandparents did,” said Michelle Vigil, a spokeswoman for Metro Health. “They don’t watch TV. They don’t listen to the radio. They don’t like Facebook. We have to try a variety of different techniques to get the message out.”
That message is more urgent than ever. Young adults, unaware they’re infected, are not only spreading the virus to each other, but also to their parents, grandparents and other older relatives, who are more vulnerable and likely to die.
And while young people, by virtue of their age and health status, tend to not get as sick from the virus, they still can suffer fatal complications.
As of Tuesday, 225 people in Bexar County under the age of 40 were being treated in hospitals, one-quarter of the total hospitalizations. Of those, 55 were in intensive care units and 18 were on ventilators to help them breathe.
Of the 175 people who have died from COVID-19 in Bexar County, eight were under the age of 40, including two teenagers, one of whom was a recent graduate of Southwest Legacy High School.
“It’s terrifying,” said Marilyn Galindo, an internal medicine physician at University Hospital. “I’m in my mid-30s. I’m having to send home people younger than me with a tank of oxygen. These are completely healthy 30-year-olds who may have lung damage for the rest of their life.”
Where did it start?
For some young adults, it’s hard to pin down how they contracted the virus.
Ryley Stewart, 23, thinks she picked it up at the gym, where she worked out about 10 times in June. In the weeks before she tested positive, she had visited several restaurants — including Chicken N Pickle and Hops and Hounds — but both times, she sat outside with only one other person.
Clarissa Rodriguez, 23, surmises that her boyfriend, an H-E-B employee, brought the virus home. Other than work and trips to the store, the couple rarely went out.
Nina Contreras, 38, suspects she contracted the virus from a colleague at work, who later tested positive. The same with Ernestine Diaz, 35.
Valerie Casanova, 35, isn’t sure yet if she has the virus, but it seems likely. Her 13-year-old daughter had body aches and night sweats shortly after attending church with her father and grandfather, both of whom later tested positive.
At the start of the pandemic in the U.S., young people were not the target of warnings about virus. They may have even thought they were exempt.
“The public health messaging focused on certain people that tended to get sicker, including people who are older and those with underlying health conditions,” said Julie St. John, an associate professor of public health at Texas Tech University Health Science Center.
“Part of that was because we didn’t know a lot about the virus at that point,” St. John said. “We learned more as time went on.”
Directions from health experts were confusing, even contradictory, at least initially.
One example: Early in the pandemic, U.S. Surgeon General Jerome Adams discouraged the public from buying or wearing masks. “Seriously people — STOP BUYING MASKS!” he wrote on Twitter in February. “They are NOT effective in preventing general public from catching #coronavirus.”
In April, following new guidance from global health organizations, Adams clarified his statements in favor of people wearing masks.
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“Once the initial message gets out, it takes a lot of effort and exposure to change that,” St. John said. “It takes a lot of work to change a person’s mind.”
The reopening of states in late May also confused the public. It was never supposed to be at the expense of wearing a mask and maintaining social distancing, she said.
Unfortunately, that message got lost.
Since then, Abbott has ordered bars closed again and masks be worn.
Many public health experts emphasized they aren’t blaming young adults for the recent surge in infections. They said going out and socializing are a normal part of development for young adults.
Sara Oswalt, a public health professor at the University of Texas at San Antonio, said many young people she works with understand the danger of the virus, “and they changed their behaviors at first, but that is hard to maintain long term. There is a desire to return to life pre-COVID.
“Alternatively, because the numbers weren’t really bad at first here, it’s possible many people didn’t see it as a risk. So they resumed their normal behaviors.”
‘This was a big shock’
Vanessa Hernandez, 35, was treated at a local hospital, soon after testing positive for COVID-19 on June 10.
She had visited the R&J Saloon off South Flores Street on the South Side. Within 24 hours, Hernandez began getting headaches and body aches. It felt like she was coming down with the flu. Her temperature spiked to 100.3 degrees.
Over time, she began to feel tightness in her chest and could barely breathe. She went to a hospital, where doctors determined she had fluid in her chest. She stayed for three days.
“It was pretty awful,” said Hernandez, who has no underlying health conditions. “I had no idea how my body was going to react. There are stories of young people who are perfectly fine — they just get a few symptoms — and there are stories of young people dying. The fear of all that, of all those possibilities, was awful.”
With time, Hernandez began to feel like herself, but the symptoms continued off and on for several weeks, and it took a month before she tested negative.
“I figured I would only have to quarantine for two weeks,” she said. “But the virus affects everyone differently. Just because it’s been two weeks, doesn’t mean the virus is gone. People need to be retested.”
Throughout the ordeal, she took extra precautions to keep her two children healthy. Still, they too developed symptoms. Her daughter, who is 17, was briefly treated at the hospital after throwing up for two days straight.
“When any child is sick, being the mom, it’s just hard,” Hernandez said. “Thankfully, I was starting to feel better. I wasn’t at my worst. But watching her not being able to eat, watching her take out the trash because she was constantly throwing up, that’s what scared me the most.”
Kim Garza, 34, also was briefly treated at an area hospital after she contracted the virus at a family gathering in mid-June, maybe from her nephew’s girlfriend, though it’s hard to say for sure.
“They spent the night, and I saw his girlfriend drinking Theraflu that night in my kitchen,” Garza said. “When I think back, I think she knew she was sick. But she didn’t say anything.”
Garza had many of the common symptoms — headache, sinus pressure, loss of taste and smell, nausea. She never had a fever. Neither did her father or her three children, all of whom became ill.
But at one point, after experiencing shortness of breath, Garza went to an emergency room. She was given a breathing treatment and steroids and sent home.
“This was a big shock for me, getting sick,” she said. “Even though I saw everything going on, on the news, I didn’t think it would happen to me.”
Infecting others
Christine Leyva considers herself reasonably healthy. At 35, she gets sick once or twice a year — if that.
In late May, one week after Abbott announced that bars could reopen, she didn’t think much about going out with her friend, Cathy, to visit several bars on the St. Mary’s strip.
“Early on, everyone was saying that the coronavirus was only affecting older people and those with underlying health conditions,” said Leyva, a local real estate agent. “I didn’t think I could get sick or pass it along to others.”
Within three days, Cathy fell ill and tested positive for COVID-19. Leyva, who felt fine for the most part, decided to self-isolate.
But by that point, it was too late — Leyva had already spent time with her parents, who are in their 60s, and her sister, who has an 8-month-old baby.
Within a month, Leyva tested positive for COVID-19. So did her father and sister.
It’s possible her mother, nephew and niece also had the virus. They had minor symptoms and never got tested.
Leyva felt awful about infecting her family. At one point, her sister took her daughter — Leyva’s 8-month-old niece — to the hospital after the baby became fussy and appeared to be sick.
There, doctors said it was likely just teething. Still, her sister didn’t talk to Leyva for a week.
Now, Leyva takes a lot more precautions. She wears her mask frequently, even when it’s not required, and she doesn’t go to restaurants as much.
“It’s scary,” Leyva said. “I understand why the numbers are rising. I think a lot of people like me don’t get bad symptoms. They’re passing it on without even knowing it.”
