SAN ANTONIO – Dr. Steven Argumedo is saddened by how hard the COVID-19 pandemic has hit the West Side where he grew up and the South Side where he now works. But he’s not surprised.
“It was a ticking time bomb waiting to happen, unfortunately,” the lifelong San Antonian told KSAT at the WellMed Primary Care Clinic where he works.
The three city council districts that represent the south and west sides of San Antonio - 3, 4, and 5 - have the three highest COVID-19 case rates and, combined, make up almost half of the city’s deaths - 568 out of 1,188 through November. The number of deaths jumps to more than half when not counting deaths in congregate settings, like nursing homes or the jail - 466 out of 903..
The “time bomb” to which Argumedo referred is the large amount of underlying health conditions that people in these parts of the city have, coupled with problems accessing health care. Those health problems put residents at higher risk if they contract COVID-19.
“So out of the patients that we have lost, we have seen that they are obese, that they have uncontrolled diabetes, they’re older, they’re frail. That’s another subset that we have seen. So its impact is huge,” Argumedo said.
Interim San Antonio Metropolitan Health District Director Colleen Bridger echoed the link to underlying health issues.
“Before the pandemic, whenever we would do maps showing prevalence of chronic disease - so like obesity, diabetes, smoking, etc, - the same parts of town would also show up as having some of the worst health statistics,” Bridger said. “And so, what I think we are seeing here is this unfortunate collision between the COVID pandemic and this decades-long chronic health crisis in those parts of the city.”
There’s a higher proportion of uninsured people in these areas, too, Bridger said.
“So when you don’t have health insurance, you’re going to put off going to the hospital as long as you possibly can because you’re not sure how you’re going to be able to pay for that bill,” Bridger said.
As for the overall prevalence of the disease, Argumedo thinks it relates to how the community is set up.
“Houses tend to be smaller, tighter spaces. And then you have multigenerational families living in those small homes,” he said.
“You’ll have a younger adult who may have to go to work. They may spread it - obtain it through there, come home. Grandma gets infected, and then the rest of the household gets infected.”
Additionally, Argumedo said “the maintenance of your health, knowledge about the well being, it is a major, major deficit in this area. And so we’re seeing that magnified right now.”
Another issue is how many residents are employed in jobs they can’t do remotely.
“They have to be at the grocery store every day stocking shelves, you know,” Bridger said. “Or they work in a place that doesn’t allow them to stay home when they’re not feeling well.”
District 3 Councilwoman Rebecca Viagran made the same point during a presentation of the data on Thursday to City Council.
“A lot in those multigenerational households are also are essential workers ... Who have to put their kids in school, or who have to show up because there’s not the luxury of being able to work from home on a digital - on an Internet platform,” Viagran said, while urging that these communities get prioritization for the COVID-19 vaccine.
The case numbers from November alone show that the three districts are still among the hardest hit in the city, but they don’t look quite as disproportionate. While Bridger credits community health care workers with helping to get out information about the virus, resulting in a “stabilization” in the South and West Side, the numbers aren’t actually very encouraging.
“I mean, we’re not seeing plummeting rates of anything, she said. “What we’re seeing is a leveling out across the city - of, you know, the north half of the city is catching up with the south half, rather than the south half slowing down.”
So whatever side of the city you live on, you still need to take precautions.