A mother’s death from COVID-19 leaves Hispanic Chamber leader ‘powerless’ but determined to help others

This story was originally published by San Antonio Report and can be found here

Dr. Erika Gonzalez is a mother and a military veteran, a community leader on the rise, a practitioner in and owner of an allergy practice with three locations in San Antonio.

But the coronavirus outbreak has proved unsparing and, on Wednesday, Gonzalez will join her two sisters in reciting the rosary before laying to rest their mother, Laura Gonzalez, who died Aug. 13 from complications of COVID-19. She was 69.

Her death came despite the precautions she took to keep from contracting the virus and efforts by her physician daughter, her family, and the doctors to save her. Having connections to the medical community and knowledge of the health care system were not enough.

“You can bet that we did everything we could, no stone left unturned, no connection that I didn’t try to use,” Gonzalez said. “We were powerless.”

Now Gonzalez is keeping a watchful eye on her 80-year-old father, Heriberto, who is still hospitalized with the virus but appears to be recovering.

The couple fell ill within days of one another in mid-July. Unlike many victims of the virus, Laura’s symptoms did not include fever, a cough, body aches, or shortness of breath – the most common signs of coronavirus.

Only when she couldn’t eat due to persistent nausea and vomiting – and Laura’s daughters worried their mother could become dehydrated – was she diagnosed and hospitalized. By then, her blood oxygen levels were dangerously low even though she was not complaining of shortness of breath. Heriberto’s hospitalization followed a day later.

Within the week, the Centers for Disease Control and Prevention added nausea and vomiting to the list of coronavirus symptoms, Gonzalez said.

Remembering a mother

Gonzalez describes Laura as the strongest woman she knows. As a young wife and mother who learned English watching daytime TV, Laura returned briefly to her home in Mexico to attend dental school, then rejoined her husband in the U.S. and started her own practice in a border town.

“I have great memories of going to work with my mom,” Gonzalez said of those years in which the seeds of her own medical career were planted.

But Laura was also devoted to her son with special needs and other medical conditions who required extra care and attention. “Not until I became a mom did I fully realize how hard that must have been to take care of a child with special needs and three other young girls and own a small business,” Gonzalez said. “It’s unbelievable to me, honestly.”

In Laura’s later years, following retirement and the death of their son, she took advantage of every day, especially to travel, Gonzalez said. “She lived it to the fullest and never let anything slow her down.”

But when the coronavirus outbreak began in March, Laura and Heriberto sheltered at home, only venturing out to the grocery store. Gonzalez doesn’t know how her parents contracted the virus.

Family advocates

Laura’s first coronavirus test came back negative but it soon became obvious she needed to be hospitalized.

“Like any other family, my two sisters and I were doing our best to advocate for my parents,” Gonzalez said. “We were in touch with all their physicians either because we knew them personally or knew someone who knew them.”

After her mother was intubated and put on a ventilator, the sisters decided to transfer the couple from a private hospital to Brooke Army Medical Center (BAMC). They hoped Laura could receive extracorporeal membrane oxygenation (ECMO) treatment at BAMC, one of only two local hospitals equipped for such care.

The hospital was also a familiar place for them. Gonzalez had done her fellowship training at BAMC and her sister would soon be working there as a specialty surgeon. It felt like home, she said, and Heriberto, as a veteran and one of the first physician assistants to be trained in the Air Force, and his wife were eligible to receive treatment at BAMC.

“It turned out to be one of the best things we did for them,” she said, though Laura’s condition deteriorated before she was able to receive ECMO treatment.

But as her mother faded, the hospital allowed Gonzalez the chance to be with her mom in her final hours – an opportunity she doesn’t take for granted, since many family members have not been permitted to be present as their loved ones died.

Using her voice

A former military physician and now community leader as chairwoman of the San Antonio Hispanic Chamber of Commerce, Gonzalez hopes she can help military medical facilities pioneer a solution that allows families like hers to be with their loved ones dying of the virus. “Because we all know that if we’re taking proper precautions that the risk is a lot lower, and I think in situations like that it will just prevent a lot of mental anguish that some of these families go through,” she said.

The pandemic also accelerated her plans for a nonprofit she founded in April. Months before her own parents fell ill, she established Con Corazón San Antonio, an organization that will work to address health inequity and emergency preparedness in underprivileged communities.

Due to the pandemic, the first initiative of Con Corazón is raising awareness about the importance of donating convalescent plasma to help others recover from illnesses such as COVID-19. While her mother was able to receive plasma therapy, Gonzalez believes it could have improved her chances if she’d had it sooner.

“We’re hoping to turn a very tragic moment in my personal life into hopefully seeing some good come out of it and maybe helping somebody else or another family down the road,” she said.

Gonzalez said she chose to serve as the Hispanic chamber’s chairwoman this year to use her voice to support the small business community, especially in health care.

“Never in my mind did I ever imagine that it would take on a whole different meaning with this pandemic,” she said.

But her platform is now more personal than ever. Despite her grief, she is speaking out now in the hopes she can influence how the community responds to the public health crisis.

“People might think that somebody in my position, whether it’s because I’m a doctor, or whether it’s because I’m the chair of the chamber … I can make it better by my knowledge or connections or whatever,” she said. But in this case, she was powerless to change the outcome for her own mother.

When Gonzalez saw her mother’s perplexing symptoms worsen, she said she felt as bewildered and fearful of the virus as the rest of the medical community.

“How does a virus do what I’m seeing?” she said she thought to herself. “It was a very sobering realization.”

‘Death is all around us’ – novel coronavirus deaths concentrated on San Antonio’s South Side, new data shows

This story was originally published by San Antonio Express News and can be found here

‘When we’re full, we’re full’: COVID-19 pushes San Antonio hospitals to the limit

This story was originally published by San Antonio Express News and can be found here

The alarming surge of COVID-19 hospitalizations in San Antonio — where at least one in four new patients has the disease — is growing at a faster rate than in other major Texas cities.

For the last week, the number of hospitalized COVID-19 patients in the trauma-care region that includes San Antonio rose by 55 percent, state health department figures show.

If the surge continues, it could overload the local health care system in the next week or two.

The increase in hospitalizations over the past seven days was 44 percent in the Houston region, 34 percent in the Austin region and 21 percent in the Dallas-Fort Worth area. In Houston, the largest medical center in the world exceeded its normal intensive care capacity Wednesday.

Texas has emerged as a hotbed for the coronavirus pandemic, adding more than 43,000 cases in the past week alone. It was one of the states most aggressive about reopening its economy, but Gov. Greg Abbott has been forced to pause further business reopenings, shutter bars and suspend nonemergency surgeries in hard-hit areas to save resources for COVID-19 patients.

Abbott signed an executive order Thursday requiring nearly all Texans to wear masks in public, a reversal of his order earlier in the pandemic that barred local officials from enforcing their own mask mandates.

The state’s major metropolitan areas aren’t the only communities swamped by COVID-19 patients. Cities across South Texas, which rely on San Antonio as a medical hub, are experiencing some of the highest spikes, painting a dire picture of the stress on hospitals.

In the Corpus Christi area, the state reported last week that just nine intensive care beds were available for a dozen counties with a combined population of more than 600,000 people. Hospitalizations there increased by 100 percent over the past week.

In Laredo, the health department director announced Thursday that hospitals had reached maximum capacity. The next day, government leaders said hospitals in the Rio Grande Valley were full, too.

“If we get to that point, where we truly run out of capacity in our hospitals, it means that we won’t be able to care not just for COVID patients, but we won’t be able to care for patients that we care for all the time — that means patients with heart attacks, or strokes or cancer or trauma,” said Dr. Bryan Alsip, vice president of University Hospital in San Antonio. “When we’re full, we’re full.”

For more than two weeks, San Antonio has experienced some of the fastest COVID-19 case growth in the country, ranking fifth in the U.S. and first among large Texas cities.

One in 10 people who tested positive for the disease since the start of the pandemic in Bexar County has been hospitalized, the Metropolitan Health District reported.

In less than three weeks, the number of patients being treated for COVID-19 in area hospitals has increased more than five-fold — from 176 on June 15 to 1,120 as of Saturday.

There are more COVID-19 patients in San Antonio hospitals now than there are in hospitals in New York, the original epicenter of the pandemic in the United States.

To keep pace with the surge, San Antonio leaders have tapped the state health department and the military to send more than 800 nurses to help staff hospitals. Nearly 180 arrived last week. Seventy more are expected Monday.

Area hospitals are scrambling to add new beds. Recovery rooms normally reserved for surgical patients are being converted into intensive care units. Pediatric intensive care units are being reconfigured to accommodate dozens of adult patients.

Without enough hospital beds or staff, patients could wait hours in emergency rooms before overnight rooms become free.

But hospital leaders say the efforts to rapidly add beds and staff will hit a limit. A disease model developed by Sg2, a health care consulting group, and UT Health San Antonio forecasts 1,800 COVID-19 hospitalizations by mid-July under the best-case scenario.

Initially, that model predicted a worst-case peak of 1,900 hospitalizations in mid-August.

If San Antonians don’t wear masks and continue to spread the disease, the worst-case trajectory now envisions 2,400 hospitalizations around July 21 — more than twice the current patient volume.

“The die is cast probably for the next 11 days. Those folks are infected. They will be coming in,” said Dr. Ian Thompson, CEO of Christus Santa Rosa Hospital-Medical Center. “What you do today will determine what happens two weeks from now — whether you’re in the emergency room with no beds in the inn.”

San Antonio area hospitals had just 647 available staffed beds as of Saturday. The disease model health officials rely on projects that 600 more COVID-19 patients will need hospitalization by next weekend.

Eric Epley, executive director of the Southwest Texas Regional Advisory Council, said hospitals need to create staffed beds “out of thin air” to see San Antonio through the peak. The advisory council, known as STRAC, oversees trauma and emergency care in a 22-county area.

Shiela Sandoval, left, a nurse in one of the four COVID-19 units at Methodist Hospital, talks with Dr. Timothy Osonma about a patient. San Antonio has had a massive influx of coronavirus patients into its hospitals.
Shiela Sandoval, left, a nurse in one of the four COVID-19 units at Methodist Hospital, talks with Dr. Timothy Osonma about a patient. San Antonio has had a massive influx of coronavirus patients into its hospitals.

Bob Owen /San Antonio Express-News

But if the worst-case scenario unfolds and hospitalizations continue to double almost every week, officials will be forced to exercise last-resort options, such as sending patients to specialty hospitals and the 250-bed field hospital at Freeman Coliseum. Eply said San Antonio wasn’t near that point yet.

“The reality is, if you’re in the hospital in the cafeteria in a bed, you still have radiology. You still have respiratory therapy. You still have imaging, lab capability,” Epley said. “You have lots of things that are in the hospital that become much more difficult once you leave the property.”

Catastrophe foretold

Public health experts saw a catastrophe in hospitalizations looming weeks before Metro Health did.

A few days after Memorial Day — and nearly two weeks before then-Metro Health Director Dawn Emerick acknowledged the arrival of a “second wave” of the virus — the Bexar County Medical Society sent a warning to Mayor Ron Nirenberg and Bexar County Judge Nelson Wolff.

“Upon review of local data presented regarding current hospitalizations in the STRAC region due to COVID-19 positive cases, we see a concerning trend developing with an uptick of cases,” said the May 29 letter. “This may be in response to the recent ‘reopening’ of the economy.”

The letter recommended officials keep a close watch on COVID-19 hospitalizations and post a warning indicator on the city website whenever the numbers increase five days in a row.

“They thanked us for the input and passed it along to the appropriate committee,” said Dr. Vince Fonseca, a member of the organization’s board who signed the letter along with two others. “At that time, they were still touting, ‘We flattened the curve, we’re on the downside of the peak,’ and we thought that was incredibly unlikely just by the nature of respiratory pandemics that appear in the spring.”

Fonseca said the society’s concerns largely were dismissed. He believes Metro Health officials were lulled into a false sense of security at a time when they should have been fortifying the city’s defenses, upgrading outdated technology and hiring more case investigators to track the spread of the disease, as recommended by a city-county health transition team.

“We wasted our time,” Fonseca said. “We wasted those weeks. And now we’re scrambling.”

In the weeks that followed, the doctors’ worst fears were realized. Early on in the pandemic, experts had warned that San Antonio, which in 2018 had the highest poverty rate among the nation’s 25 largest metro areas, could be devastated by an uncontrollable outbreak of the virus.

San Antonio for years has been one of the most economically segregated cities in America, where many families live in crowded conditions, with grandparents, parents and young children under one roof.

The poorest residents are more likely to have pre-existing conditions — such as asthma and diabetes — that put them at higher risk if infected with COVID-19. The situation is similar in other South Texas communities, including Corpus Christi, Laredo and cities in the lower Rio Grande Valley, where hospitals are inundated with patients.

Dr. Erika Gonzalez, an allergy and immunology specialist and a board member at CentroMed, a nonprofit health network with clinics throughout Bexar County, said soaring COVID-19 hospitalizations in San Antonio are likely related to the prevalence of underlying medical conditions.

“Asthma rates here in San Antonio, we’re about 400 percent higher than the rest of the state as far as asthma exacerbations and asthma hospitalizations. It’s dramatic,” she said. “It’s not an environmental thing because we all have similar air quality. It’s something more internal, and a lot of it has to do with access to health care, and we’re seeing it mostly in the Latino and African American community.”

Latinos make up about 60 percent of Bexar County’s population but account for about 74 percent of COVID-19 infections. Black residents no longer account for a disproportionate number of cases, but they still account for 15 percent of COVID-19 deaths — even though they are 9 percent of the population, according to Metro Health data.

Dr. Javed Jeffrey, left, ECMO Specialist Shelby Wingfield, right, and Clayton Lundgren, center, observe a patient before visiting with him in the ECMO unit at Methodist Hospital.
Dr. Javed Jeffrey, left, ECMO Specialist Shelby Wingfield, right, and Clayton Lundgren, center, observe a patient before visiting with him in the ECMO unit at Methodist Hospital.

Bob Owen /San Antonio Express-News

People of color also are more likely to be infected in part because they are less likely to be able to work from home, Gonzalez said.

“The majority of the essential workers, almost 80 percent of front-line workers at grocery stores, are either African American or Latino,” Gonzalez said. “They are exposing themselves more. That really is a socioeconomic thing. They don’t have the luxury of staying home and sheltering.”

Young infecting old

Over the past few weeks, the average age of patients who require hospitalization has changed. Hospitals have seen a surge of patients under 40. A significant portion have no underlying health conditions that would put them at greater risk from the disease.

Dr. Jan Patterson, a professor of medicine and infectious diseases at UT Health San Antonio, said it appears younger people let their guard down when Texas reopened.

After Memorial Day’s large gatherings, the disease began to spread rapidly. And across the state, mixed messaging on masks from state and federal leaders meant many people didn’t wear face coverings in public or when gathering with relatives and friends.

“These younger people are getting infected, but the thing of it is, San Antonio is really big on family and we have a lot of multigenerational households,” Patterson said. “So even though that parent or grandparent may have not necessarily been out, it’s brought to their household by people who have been out.”

Patterson said more young people are being hospitalized — and when they arrive at the hospital, they often bring with them parents or grandparents who also contracted the disease.

The trend has spurred San Antonio’s health executives and government officials to beg residents to heed warnings — such as avoiding large gatherings, staying 6 feet apart and wearing masks.

Allen Harrison, president and CEO of Methodist Healthcare System, put the danger in starkly personal terms.

“My dad died when I was in college. He never saw me graduate. He never saw me get married. He didn’t meet any of my kids,” Harrison said. “San Antonio is a family-centered city. There are a lot of people who regard their members of their family as precious to them— irreplaceable.

“Why would you gamble those relationships with your family in the midst of a pandemic right now?”

Local leader to advocate for small businesses in DC

This story was originally published by the San Antonio Business Journal and can be found here

Dr. Erika Gonzalez, chairwoman of the San Antonio Hispanic Chamber of Commerce, was chosen as one of four national co-chairs for the Small Business for America’s Future coalition.

The organization, based in Washington, D.C., consists of small business owners and leaders who advocate for policies that facilitate small business growth, while leveling the playing field with big business. The organization asks policymakers to prioritize Main Street businesses by advancing an economic framework and Covid-19 recovery plan for small businesses and their employees.

Small Business for America’s Future surveyed more than 1,200 small business owners nationally. Of those surveyed, 84% said they felt leaders favor big business over small business, and 81% of respondents said leaders do not understand the needs of small business.

The survey also found that 53% of respondents have incurred new debt related to Covid-19, with nearly 25% of them having new debt of more than $20,000, and 18% with debt over $100,000.

The organization is an evolution of the former organization called Businesses for Responsible Tax Reform, which launched in 2017 as an advocate for small businesses during tax reform. It will now focus on three areas of policy reform: health insurance, taxes and economic security.

“We’re committed to ensuring policymakers at every level of government prioritize Main Street by advancing an economic framework that benefits both small businesses and our employees,” Gonzalez said. “Reducing the crushing cost of providing health insurance will be important to ensuring small businesses are strong enough financially while maintaining coverage for employees.”

The other three co-chairs of the organization include Frank Knapp, president and CEO of the South Carolina Small Business Chamber of Commerce; Anne Zimmerman, owner of Zimmerman and Co. CPAs in Ohio; and Shaundell Newsome, owner of Sumnu Marketing and board chairman for the Urban Chamber of Commerce Las Vegas.

The group had been co-chairs for Businesses for Responsible Tax Reform, but wanted to be more geographically and racially diverse, specifically looking to add a Latina as a co-chair, said Gonzalez, who is CEO of the South Texas Allergy and Asthma Medical Professionals PLLC.

The organization reached out to the U.S. Hispanic Chamber of Commerce, which recommended Gonzalez.

“It lets me represent the Latino businesses nationally,” Gonzalez said.

Her Spanish speaking abilities has already enabled her to communicate the organization’s message to bilingual audiences across the nation.

Mental Health Experts’ Advice for Entrepreneurs Affected by COVID-19

Mental Health Experts’ Advice for Entrepreneurs Affected by COVID-19

This story was originally published by San Antonio Report and can be found here

Mental health experts encourage small-business owners wrestling with coronavirus-related stress and anxiety to talk openly and honestly about their struggles to cultivate a flexible work environment that can adapt to the needs of the business and its employees.

In a webinar hosted by the San Antonio Hispanic Chamber of Commerce (SAHCC) on Thursday, the local experts said a “silver lining” to the coronavirus pandemic is that it highlights the need for people to pay attention to their mental health when they are struggling with heightened or overwhelming emotions.

“What we know is that there is a lot of power in acknowledging the struggle,” said Clarissa Aguilar, behavioral health consultant with the Center for Health Care Services, Bexar County’s mental health authority. “Checking in with people if they seem like they need help or resources, and helping people remember the mission and vision, will help keep people connected to the passion that” made the entrepreneurial venture possible.

Joining Aguilar in the conversation focused on “normalizing” conversations about mental health and the workplace were Adriana Dyurich, a licensed counselor with UT Health San Antonio, and Dr. Ted Williams, founder of Genesis Psychiatric Center and UT Health San Antonio psychiatry professor. Rivard Report Editor and Publisher Robert Rivard moderated the panel conversation, sponsored by UT Health San Antonio, on the videoconferencing platform Zoom.

SAHCC Chairwoman and webinar organizer Dr. Erika Gonzalez said that SAHCC’s health and bioscience committee had planned to spend this year creating a health and wellness program for employees of small businesses that included a strong mental health component, but “when the pandemic occurred, there were more and different mental health issues that arose as small business owners struggled to keep their doors open and people employed,” so the focus shifted to employers.

“We were in an existing mental health crisis in our country before the pandemic hit,” Aguilar said, noting “the mental health effects for this pandemic will be longer lasting than the physical health ones.”

“The first thing I have done is tried to help my employees understand at least my perspective of the facts,” Williams said. “Fear-driven behavior won’t help us very much.”

Mental health support

Center for Health Care Services
Adults: (210) 261-1250; Children: (210) 261-3350

Texas Health and Human Services Commission
COVID-19 Mental Health Support Line, (833) 986-1919

Ecumenical Center of San Antonio
15-20 minute wellness visits by phone, (210) 616-0885

Guardian House
Free daily support group, noon Monday-Friday, (210) 733-3349

Cross Bridge Church
Pastor Shawn Sullivan, (210) 849-5905

Reflection International Ministries
Ramon Chapa, (210) 365-5250

CJC Life Church
Text (210) 724-3353 to begin the process

Mind Your Self Counseling
Support for ages 5 and up, (210) 564-9116

Stephen A. Cohen Clinic at Endeavors
Virtual appointments for veterans and immediate family, (833) 286-8387

Providence Place
Marriage and family therapy, (210) 643-7464

Williams, a small-business owner, said that because SAHCC members and business owners are “leaders of the community,” people will be looking to them to know what to do as the economy continues to reopen and the virus continues to be diagnosed throughout Bexar County.

Williams said COVID-19-related policy changes likely will take up the vast majority of staff meeting time because circumstances and guidance are continually evolving, but also essential are ongoing conversations about “all employee and employer needs.”

Dyurich said being more open to communication about emotions will help even when “talking about the practical issues [like] how to schedule shifts and the workflow.”

“I don’t think that anybody expects business leaders to know how to respond as mental health professionals, but to be able to validate what people are saying, to listen to the one another with openness and honesty, will help organizations to be flexible and adapt to people’s needs,” Dyurich said, adding that no solution fits everyone. “We are experiencing a lot of fear, trauma, and grief that doesn’t have to stay much longer than needed” if we address instead of internalize them.

Aguilar said that by thinking “about what you value,” personally and professionally, and “the things that drive those values,” business owners can create a plan of action.

“Small-business owners are having to think about the challenges and ethics involved, because economically there is a need, but from a social or population health perspective” they may wonder if they are doing the right thing for the community, Aguilar said. “If you can focus on one thing that is related to what you value the most, it can help you feel better about making decisions and also help with mental health.”

For small-business owners to stay grounded, Aguilar used the metaphor “dropping the anchor,” which involves “acknowledging thoughts and feelings and engaging in the present moment to guide decision-making.”

“We are all facing a big storm but we may not all be in the same boat, and dropping the anchor won’t make the storm go away but it will keep the boat in place,” Aguilar said.

Williams recommended “giving each other quite a bit of grace to have differing opinions.”

“When people are afraid, they can’t help in that moment that they are afraid, and we need to not be judgmental about their behavior so they won’t be judgmental about our behavior,” Williams said. “Remember that ultimately we want a good outcome not just for ourselves, but for each other, because that will win the day.”

But for those moments when people are too overwhelmed with their emotions to process them reasonably on their own or through conversations with trusted peers, the panelists said it’s important for people to know what resources are available to people who need help from trained professionals.

“There is a difference between being down and upset and being depressed,” Williams said, explaining that depression stays with a person; it’s not a feeling one simply moves on from.

In addition to talking openly about feelings both at and outside of work, panelists encouraged people experiencing overwhelming emotions to spend 30 minutes a day doing something active or meditative, including spending time outside or going for a walk, and “giving yourself grace and prioritizing what is important in a given moment.”

For those with children at home, it might be that math is not the thing needing to be prioritized at the moment. Remind yourself that teachers were trained to know how to teach their students, Dyurich said.

Noting that most entrepreneurs are high achievers, Aguilar said it can be important to “dial back down the expectations you set for what can be accomplished.”

“During this time people need to learn how to better embrace and respond to change,” Aguilar said. “We might not have the most optimal circumstance in our home or at work, but we can remember we are trying to do our best.”

Roseanna Garza

ROSEANNA GARZA

Roseanna Garza reports on health and bioscience for the San Antonio Report. 

Panel to Discuss Entrepreneur Anxieties Fueled by Coronavirus Pandemic

Panel to Discuss Entrepreneur Anxieties Fueled by Coronavirus Pandemic

This story was originally published by San Antonio Report and can be found here

In an effort to address the unique challenges small business owners and entrepreneurs have faced during the coronavirus pandemic, the San Antonio Hispanic Chamber of Commerce (SAHCC) is hosting a mental health webinar on Thursday to discuss stress and anxiety in the business community. The goal is to help “normalize the conversation” and empower those in need to reach out for help.

“The mental health concerns experienced by [small business owners] and entrepreneurs is something that we have seen” increase over the years, with more people dying by suicide and experiencing crises, SAHCC Chairwoman Dr. Erika Gonzalez said. “When the pandemic occurred, there were more and different mental health issues that arose as small business owners struggled to keep their doors open and people employed.”

The COVID-19 Mental Health Webinar, moderated by Rivard Report Editor and Publisher Robert Rivard, will discuss mental health challenges for small business owners, including entrepreneurs with children juggling work and home life demands, stresses and risks involved in owning a small business, and information about available resources for those needing support.

Panelists include Clarissa Aguilar, behavioral health consultant with the Center for Health Care Services, Bexar County’s mental health authority, Adriana Dyurich, a licensed counselor with UT Health San Antonio, and Dr. Ted Williams, founder of Genesis Psychiatric Center and UT Health San Antonio psychiatry professor.

Dr. Lyssa Ochoa, chair of SAHCC’s healthcare and bioscience committee, said the panelists were selected because of their mental health expertise but also their entrepreneurial experiences that “help give insight and reflection into the stresses of small business ownership.”

“How small business leaders have been handling the stress of COVID-19 is something important to talk about because mental health has quite a stigma attached to it, and at the same time, we have the least resources in San Antonio [to address it],” Ochoa said. “If a person had a previous mental health concern, it might be even worse for them now, and we need people to keep checking in on how they are being impacted.”

Ochoa said SAHCC’s health and bioscience committee had planned to spend this year creating a health and wellness program for employees of small businesses that included a strong mental health component, but “this pandemic turned everything upside down” and the focus shifted to the employers.

The committee is now dedicating that time to discussing how the anxiety and uncertainty already attached to the entrepreneurial experience is exacerbated due to coronavirus, and that it is more important than ever to reach out for help.

“As small business owners, we are used to handling stressful situations, but we are trying to make sure we put out there that despite the ability to handle stress, it’s OK if a person needs help,” Ochoa said.

The webinar will air on Zoom from 10 a.m. to 11:30 a.m. on Thursday, May 28, and is open to the public free of charge. To register in advance, click here.

Roseanna Garza

ROSEANNA GARZA

Roseanna Garza reports on health and bioscience for the San Antonio Report. 

City officials collect more than 16,000 cloth face coverings to donate to senior centers

This story was originally published by NEWS4SA and can be found here

On The Record | COVID-19 impact on telemedicine

This story was originally published by PBS and can be found here

 

Host T.J. Mayes talks with Dr. Erika Gonzalez, CEO of STAAMP Allergy, about how the COVID-19 pandemic might have changed the future for telemedicine. San Antonio Chamber of Commerce President and CEO Richard Perez discusses the return of customers to business, and why the next step for success is to make customers feel safe.

Aired: 05/14/20

Rating: NR

How to distinguish allergies and COVID-19 symptoms, according to a San Antonio expert

This story was originally published by MYSA and can be found here

The coronavirus pandemic has added a layer of uncertainty and anxiety to allergy season.

San Antonio residents are turning to professionals to make sure their symptoms are allergies and not something else.

Dr. Erika Gonzalez of South Texas Allergy and Asthma pointed to a couple of symptoms that can help people tell the difference.

“If they’re having a dry cough and fevers, then that definitely should clue them in that this is not allergies,” Gonzalez said. “It’s not necessarily COVID — it could be another flu or another virus — but it’s not allergies.”

Itching, on the other hand, is associated with allergies.

“If people are having itchy eyes, itchy nose, itchy throat, or even itchy ears — you know when your ears are itchy inside — that’s a very reassuring symptom that this is an allergy,” Gonzalez said.

The allergist noted that people should feel reassured if their symptoms improve after taking an antihistamine like Zyrtec or Allegra. If you have something other than allergies, you’re not going to feel better by taking those medications.

Gonzalez screens patients for COVID-19 and can test for the virus at her practice if they meet the criteria. So far, there have not been any positive cases.

The primary treatment for any allergy is to avoid the allergen, Gonzalez said. But that’s difficult as people seek any way to get a little fresh air under a stay-at-home order.

While Gonzalez would not recommend against going outside, she did advise people with allergies to avoid peak pollen times early in the morning. She also said taking an antihistamine 30 minutes before going outside can alleviate symptoms.

Plus, those masks we’re all being asked to wear will decrease our exposure to pollen, she said.

There has been plenty of pollen to avoid this year.

Gonzalez noted that oak allergen counts reached a peak of about 3,000 last week, the highest in at least 10 years. On Tuesday, oak — the pollen that leaves a yellow powder behind — counts stood at 2,380.

Expect the high pollen levels to stay with us through April, then dwindle in the beginning of May. The levels tend to rise two to three days after rain.

Gonzalez said people who suffer from allergies can start with over-the-counter medications, before moving to nasal sprays or allergy shots if necessary.

High Pollen Counts Provoke Angst for Those With Allergies

High Pollen Counts Provoke Angst for Those With Allergies

This story was originally published by San Antonio Report and can be found here

San Antonio saw whopping pollen counts over the past week, with oak dust skyrocketing to 30,900+ parts per billion on March 30 – some of the highest counts in a decade.

The severe pollen load has made those who suffer from allergies wonder if they are more vulnerable to the novel coronavirus than those who manage to escape the seasonal sniffling, sneezing and itchy eyes common to the Alamo City, which is considered an allergy hotspot.

“I’m probably super paranoid like most since all this COVID-19 viral pandemic, but I started feeling a sore throat coming on and I’m freaking myself out,” Nikki Rabon posted in the San Antonio Covid-19 Coronavirus Community Care Facebook group. “Anyone else? Probably just allergies….”

Rabon’s comment generated 143 comments, including this one from Anne Therese Cakins: “I suffer from allergies and asthma…I freak myself out on the daily! Trying to stay calm, though.”

“People are rightful to be anxious,” said Dr. Erika Gonzalez, CEO and president of South Texas Allergy & Asthma Medical Professional. Symptoms for allergies and coronavirus are similar, but the immune mechanism behind allergies is not the same one that would be involved with coronavirus.

Generally, those with seasonal allergies endure itchy eyes, runny nose, sneezing and wheezing and possible shortness of breath. Coronavirus symptoms generally include dry cough, tiredness, and fever.

“If you get a fever, it’s not allergies, but some type of viral infection,” said Gonzalez. “Sneezing and itching – those are ‘good signs’ that it’s allergies and not viral.”

People with allergies generally have stronger immune systems than nonallergic folks, since their bodies are overreacting to perceived threats, said Dr. Robert Ramirez, immunologist with the Certified Allergy Asthma and Immunology Center.

“It takes a strong well-coordinated immune system to pick out allergens in our environment to mount immunity against,” said Ramirez.  “I often use the word ‘bias’ when describing how and why the immune system would attack these seemingly harmless targets.”

That said, when pollen levels get this high, even people who are not allergic to oak will begin to have allergy-like symptoms. “This reaction is more of an irritant or pollutant response rather than an allergic mechanism,” Gonzalez said.

Those receiving allergy treatment, however, are wondering if it’s wise to continue receiving allergy shots given coronavirus social distancing guidelines.

allergy serums
Allergy serums are ready for use in treating seasonal allergies. Credit: Courtesy / South Texas Allergy and Asthma Medical Professionals

Typically, allergy treatment involves getting injections of specially concocted serums that allow patients to gradually build their immunity to allergy-causing compounds. At the beginning of treatment, injections are generally administered multiple times a week. Over time, the dose is increased and frequency reduced. This can take several years, involving a shot once every month or less.

A routine allergy shot requires heading to a doctor’s office, signing in, waiting your turn, getting an injection, then sitting for 30 minutes in the waiting room to make sure no adverse reaction to the shot occurs.

Allergy doctors have had to adapt to a new reality in the wake of the coronavirus pandemic. Ramirez is administering allergy shots and injectable biologics in the office breezeway of his practice’s Lincoln Heights location.

“They drive up, they call us, we come outside and meet them in the covered breezeway, and they wait the 30 minutes in their car,” said registered nurse Jackie Sorenson, adding that the office only takes one patient at a time.

Gonzalez is offering “drive-thru allergy shots.”

Established patients call the doctor’s office from the parking lot. A medical assistant draws up the patient’s custom allergy serum, dons PPE, then goes out to the car to administer the shot.

“The patient then waits in the car for the appropriate amount of time, and upon completion of their waiting period, our medical assistant goes out to the car to check in on them and discharge them home,” said Gonzalez.

If patients prefer to come into the clinic, they can stay in the waiting room where chairs are spaced at least six feet apart. “We keep the number of patients at a minimum and don’t have more than one or two patients in the clinic at the same time,” said Gonzalez.

When consultations are necessary, doctors are adopting telemedicine.

“Telemedicine is something that a lot of doctors have considered incorporating at some point in their careers,” said Ramirez. “Now, with the loosening of restrictions by Governor Greg Abbott, it’s easier to implement,” he said, referring to the governor’s March 17 waiver of restrictions on telemedicine. Doctors and insurance companies can now charge and collect for phone visits just as they would for in-person visits.

With recent rains, sunny days, and longer, hotter seasons ahead, high pollen counts will continue through May, perhaps longer.

“Global warming has prolonged all our pollen seasons and made them worse in the sense that they linger for a longer time,” said Gonzalez.

In the meantime, doctors recommend those with allergies embrace the same best practices as the general public.

“Wash your hands. Stay home. Be nice to each other. We will get through this,” said Ramirez.

Monika Maeckle

MONIKA MAECKLE

San Antonio Report co-founder Monika Maeckle writes about pollinators, native plants, and the ecosystems that sustain them at the Texas Butterfly Ranch website. She is also the founder and director of… 

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