As of right now, there are no confirmed cases of COVID-19 in the Big Bend area. As health officials have said since March, testing across West Texas has been severely limited, and Texas as a whole has one of the worst rates for testing per capita in the country.
But while there aren’t confirmed cases, local health officials have identified presumptive cases in the tri-county area. These presumptive diagnoses are given to individuals who likely have the coronavirus but are exhibiting milder symptoms and don't meet the local threshold for testing.
"We don't have any confirmed cases, no test from any resident in the Big Bend region has been positive, which is great," said Dr. Katie Ray, a physician with Preventative Care Health Services. "However, we do presume that some people that have presented with mild, COVID-like symptoms do have the virus."
What Are Presumptive Cases?
The coronavirus can cause a range of symptoms like high fever, trouble breathing, and dry cough. However, there are also asymptomatic carriers — people who test positive for COVID-19 but have never experienced any of the symptoms common with the disease. Patients with mild or moderate symptoms could have seasonal flu, a seasonal cold, or the coronavirus, says Dr. Ray.
But since these patients don't meet the threshold for testing — which is being reserved for the most severe cases — doctors are presuming that these individuals have been infected.
"[W]e will operate under the assumption that they have COVID, especially if they have any high-risk factors, specifically travel-related for the most part, in hopes to minimize or contain any viral exposure that we have in our region," says Dr. Ray.
Local healthcare officials are advising patients they presume to have the coronavirus and members of their household to self-quarantine and to instead have friends or other family members bring them any supplies they may need.
Tri-county residents who meet the threshold for testing include the elderly with an underlying respiratory disease, people with severe symptoms, or anyone hospitalized due to symptoms consistent with the coronavirus.
What Determines A Presumptive Case?
Dr. Ray says, based on information that's come out about the coronavirus and its symptoms, local health officials are basing presumptive cases on three main criteria: a dry cough, fever and recent travel history.
"We've had several residents of the region come back from places with higher infection rate, and then shortly thereafter develop symptoms," says Dr. Ray. "Luckily, most of those people — on returning from those regions — had already been self-quarantining, so we think that their exposure to other residents in our region was pretty minimal."
Because the virus has been so widespread, area doctors are currently considering any travel out of the tri-county area to be high risk.
So There Are Presumptive Cases In The Big Bend. What's Next?
Healthcare professionals across the region say it's important for residents to continue practicing social distancing and to wear masks when out in public places like the grocery store or the post office. Dr. Ray and the region's doctors are strongly encouraging anyone with a presumptive case of the coronavirus to stay at home.
"We're trusting people to be responsible citizens," says Dr. Ray. "At some point, we will have a positive test out here, that's inevitable."
Dr. Ray says the region will be able to handle the coronavirus if cases "trickle into the region."
"If we get one severe case at a time, we're going to be able to manage that," she says. "If we get eight severe cases at a time, we're going to have a problem."
In preparation for a potential increase in severe coronavirus patients, the local COVID-19 task force has been working on a surge plan that will be enacted if Big Bend Regional Medical Center, the region's only hospital, has four patients on ventilators. The Alpine hospital has two ventilators and 25 beds.
Texas is expected to reach its peak for coronavirus cases at the end of April. But for rural Texas, that peak may not come until weeks after, when metropolitan areas in the state begin to loosen their restrictions.
"As you get further out from those metropolitan areas, that peak number of cases is getting pushed farther and farther back, later," says Dr. Ray.
Although there's little data to determine when the Big Bend region's peak could be, Dr. Ray says based on other projections, it could be maybe late May or even early June.
