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It’s understandable that many San Antonians are concerned about the relocation of potential coronavirus victims to their city. Some of those concerns are reasonable, many not. The disease is highly contagious, and authorities announced three more confirmed cases among evacuees Monday, bringing the total in San Antonio to six.

But other San Antonians are proud that the city was chosen as part of an ambitious effort to help other Americans stranded at the epicenter of the outbreak in Wuhan, China, and from the Diamond Princess cruise ship where passengers were kept aboard the ship in Japan as the disease spread. 

San Antonio has a long history of temporarily taking in people in need. My first experience came 1967 when I was a senior at St. Mary’s University. In the wake of Hurricane Beulah, which had struck at Brownsville and assaulted the Rio Grande Valley with 130-mph winds, up to 30 inches of rain, and more than 100 tornadoes that killed five people. St. Mary’s Alumni Gym filled up with cots to house mostly low-income Texans escaping the storm. I suspect that was only a small part of the city’s hospitality.

In 2005, Hurricane Katrina forced half of New Orleans to seek shelter elsewhere. Around 30,000 landed in San Antonio, with many sheltered at Kelly Air Force Base, the old Levi Strauss facility on the West Side, and in empty parts of the old Windsor Park Mall on the Northeast Side.

We also offered hospitality to the NFL’s New Orleans Saints, hosting them for three games, including one on Christmas Eve, at the Alamodome after the Louisiana Superdome was devastated by Katrina. 

More recently the city rallied as an influx of Mexican and Central American refugees were released when courts ruled the Trump administration couldn’t separate families and hold children in South Texas lockups. The private sector joined the City of San Antonio with temporary shelter and assistance with traveling to relatives throughout the nation. 

The coronavirus quarantine is a different kind of crisis, one that San Antonio is amply equipped to handle – partly because of another crisis. Back in the 1990s the city was in a panic over the workings of the Base Realignment and Closure Commission, also known as BRAC. At first the decision appeared devastating. San Antonio lost Kelly Air Force Base, which had moved thousands of San Antonians, especially Mexican Americans, into the middle class with jobs in aircraft maintenance and in administration. Ten years later we would lose Brooks Air Force Base, which had played a key role in aviation and space exploration. 

That was the “closure” part of the commission. But the “realignment” part was equally important. It resulted in the nation’s armed forces moving the bulk of their major medical facilities to San Antonio, adding immensely to the city’s already growing medical sector. 

So Lackland Air Force Base, adjacent to Kelly, has enough individual housing units with their own bathrooms to quarantine those who may have been exposed to coronavirus not only from troops and other citizens, but also from each other. And between the massive military medical presence and private and civilian medical institutions, the city has the capacity to deal with a significant, if not unlimited, number of patients who test positive for the virus. 

All of the city’s firefighters have communicable disease training as part of their medical certification, and about 30 have received more extensive training as members of the Infectious Disease Response Unit. The equipment they have in order to deal with patients suspected of having highly communicable diseases includes a dedicated infectious disease ambulance.

In other words, we are much better prepared than we were back in 1895 when the Businessmen’s Club, a prominent booster organization, proposed promoting the city nationally as a great destination for tuberculosis victims. Many doctors around the country were recommending San Antonio to patients with tuberculosis because of its climate, which was less humid when it was a small city, turning it into something of a medical tourism destination. 

Many San Antonio doctors enthusiastically joined the businessmen. Their efforts were undermined when the West Texas Medical Association presented City Council with findings generated by Louis Pasteur’s discovery of germs that tuberculosis was contagious. The businessmen and some local doctors reacted like oilmen to threats of global warming, challenging the science. Happily, they failed.

Still, tuberculosis would come to plague San Antonio. Whether because of medical tourism or terrible sanitary conditions within the city, by 1940 San Antonio had the highest tuberculosis death rate in the nation. Even so, a group of prominent politicians and civic activists called the Taxpayers’ Defense League, sued the city to try to block a tuberculosis hospital whose bonds had been approved by citizens in an election. One of the TDL’s arguments was that downtown traffic congestion was more important. TDL lost its lawsuit.

Happily, tuberculosis was defeated with the advent of antibiotics. But communicable diseases keep morphing. In the wake of the rapid spread of SARS and coronavirus in an ever more connected world, scientists expect the threat of pandemics to increase. San Antonio is in a position to play an outsized role in dealing with this issue.

The city has been, in a sense, commandeered for this role by the federal government. But Mayor Ron Nirenberg and other local officials are working closely with the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services. Telephone conversations involving representatives of those federal organizations, the mayor, and the City’s Metropolitan Health District’s respected new director, Dawn Emerick, take place at least once daily. 

Local officials, including the mayor and Bexar County Judge Nelson Wolff, believe the system can be improved. One example: Both would like to see patients identified with symptoms treated at Lackland, near where they are housed, rather than moving them to an offsite medical facility. Congressional Democrats have been pressing for President Trump to seek more funding for meeting the challenge, and Monday there were news reports that the White House was contemplating a request for $1.8 billion. Looking to the future, a portion of that could go to set up state-of-the-art treatment facilities at Lackland.

If Military City, USA, is going to be drafted for emergencies like this, we should, as a Medical City, prepare ourselves proudly.

Note: For the historical notes above I am indebted to former University of Texas at San Antonio history professor David Johnson, whose much anticipated history, In the Loop: A Political and Economic History of San Antonio, is scheduled for publication by Trinity University Press next September.

Rick Casey

Rick Casey's career spans four decades of award-winning reporting on San Antonio. He previously worked as a metro columnist for the former San Antonio Light and, later, the San Antonio Express-News.