Trends in COVID-19 Infections during Four Surges in Bexar County, Texas

Background: Bexar County, Texas has experienced four COVID-19 surges during the pandemic. This study investigates trends in COVID-19 infections over the course of pandemic. The objective is to describe the association of COVID-19 infection cases with changes in testing availability, masking, distancing policies, and occurrence of public holidays during the surges. Methods: Cases occurring since May 26th, 2020, until March 31st, 2022, comprise this analysis. Case data were obtained from the Texas NEDSS database. Aggregate hospitalization data were obtained from STRAC (Southwest Texas Regional Advisory Council) for Bexar County hospitals. Analyses were conducted using R-Studio and Excel. Demographic statistics, percentages, case fatality rates were computed. Results: Average age (34 years), female gender (52%), Hispanic ethnicity (69%), residing in the Southern zip codes of Bexar County, and negative vaccination status were associated with the four COVID-19 surges. During all surges, test positivity, hospitalization and mortality rates all increased. Surges coincided with the major public holidays. Conclusion: These findings highlight the association COVID-19 infections with implementing and loosening restrictive policies, along with sociocultural events and public holidays in Bexar County, Texas. Preventative efforts promoted safer behavior and decreased the COVID-19 infection on majority of days during the pandemic except closer to public holidays when a high infection rate was observed in the form of surges. Public Health Significance: Preventative efforts at the local governmental level along with voluntary compliance with restrictive COVID-19 policies by Bexar County Residents are necessary for decreasing community infection and widespread disease.