South Texas is a bad algorithm right now

Border Report Tour

A display shows occupied and available beds at a COVID-19 unit at DHR Health, Wednesday, July 29, 2020, in McAllen, Texas. The blue symbols represent beds occupied by COVID-19 patients. (AP Photo/Eric Gay)

Editor’s note: This piece was written in partnership with the Columbia Journalism Review and the Delacorte Review, the literary nonfiction journal of the Columbia Journalism School. The project focuses on the stories and conversations going on in communities leading up to the November election.

The out-of-control COVID-19 crisis in South Texas is a deadly numbers game gone frighteningly wrong.

It has resulted in over 1,400 deaths and 44,000 coronavirus cases in the region. The positivity rate has far surpassed the statewide recommendation of 10% and bodies are stacking up in refrigerated trucks parked outside hospitals and alongside the interstate. Resources are starting to trickle into the region, but it could be too little, too late.

In the Rio Grande Valley, the situation has been inflamed by fighting among various communities over CARES Act disbursement funds––Coronavirus Aid, Relief, and Economic Security Act––from county and state officials, slow testing and tracking methods, and two questionable recovery field hospitals supported by federal money to two companies that cull favor among the Trump Administration––one a nonprofit that runs migrant detention facilities for children, and the other a for-profit that builds border walls. In Hidalgo County, one of the nation’s worst hot spots for coronavirus, County Judge Richard Cortez has likened the pandemic to a “tsunami” that has quadrupled in cases since June.

A month ago, the county only had a dozen or so health investigators to conduct contact tracing for over seven thousand active cases, the county’s health authority told me. More have since been added due to resources provided by Governor Greg Abbott. But many people here were asymptomatic and completely unaware of the contagions they carried and brought to their families, co-workers, and those they passed by on the streets.

July 21 was the deadliest day in the county’s history of this virus. Forty-nine people died from the novel coronavirus and 339 new cases were identified. There were 7,286 active cases that day and 1,080 were hospitalized, including 257 in intensive care units, the county reported.

My husband was one of the lucky ones who walked out of an area hospital that day after spending ten days hospitalized for COVID-19. During this time, he received two life-saving doses of plasma donated from other coronavirus survivors. One batch came from a New York donor, we were told.

He may have caught coronavirus at a June 29 news conference where the county’s health authority left early to take an urgent phone call where he learned that he himself had COVID-19. Two days later in the middle of the night, my husband began running a fever and our odyssey with this virus began. He self-isolated for twelve days before he finally admitted that he needed to go to the hospital. (Read my last Year of Fear installment.) Since his release, he has remained self-isolated on oxygen. We have been told that he could test positive for up to ninety days.

Imagine my family’s dismay when my three adult children and I all received early morning phone calls on Sunday, August 2 from different state-funded contact tracers to alert us all that we “may have been exposed to coronavirus.”

My husband had been hospitalized and tested positive twenty-one days prior. According to CDC guidelines, we should have been informed within three days of his diagnosis so we could mitigate community spread. Of course we knew he had COVID-19 and we all self-isolated and monitored ourselves for symptoms in our McAllen home. He had actually been isolated in a wing of the house since he first began feeling feverish on July 1, despite getting negative results on two COVID-19 tests. How many people could he have infected if he had relied on the faulty tests? How many other families or friends of those infected went weeks before learning?

Region is a tinderbox

More resources were repeatedly requested by hospital administrators and three local county judges who met for a roundtable discussion with US Senator John Cornyn on August 11 at the University of Texas Rio Grande Valley’s Regional Academic Health Center in Harlingen. UTRGV President Dr. Guy Bailey said that the university’s School of Medicine is running four COVID-19 testing facilities in South Texas. The university also is state-funded to conduct contact tracing and in the past few weeks hired 191 contact tracers to locate and inform call those who have been in contact with someone with coronavirus in South Texas.

“If there was ever a time to be grateful for a School of Medicine, this is it,” Bailey said. “I couldn’t be prouder of what our School of Medicine has done to adapt and work with this crisis.” Indeed it is a point of pride, but as Dr. John Krouse, dean of the School of Medicine, told the group: “Testing without contact tracing is ineffective.”

And that is basically what happened here in Hidalgo County for several weeks. Krouse said that UTRGV is now testing about 1,200 people per day and 35 percent are positive––that’s one in every three people tested and that’s far more than the state-recommended 10 percent positivity rate. Krouse said tests now “have a 24-hour turnaround.”

But just a few weeks ago, test results were taking upwards of seven to ten days and that led to higher infection rates and community spread, Cortez said. “It’s a disaster and we cannot continue this way,” he told Cornyn on August 11. “We need rapid, rapid testing.”

My eldest son and I waited seven days to learn we were negative after testing on July 16. We self-isolated, but it’s scary to imagine how many people circulated in the community spreading the germs unchecked before they got results.

With news media from all over the world here reporting on what is happening, it’s clear that infections in South Texas is a bad algorithm that is repeating and replicating with uncontrolled speed. Cornyn said the Rio Grande Valley has been sent $530 million to help hospitals, public schools, public transportation, airports and even public housing, as part of CARES Act funds.

And while there is no doubt that this money will help, it seems like a lot, a lot too late. Most hospitals have been at capacity for several weeks. The death and infection count rises daily, and when we think we have reached our shock maximum, another day brings even worse news.

Local hospital administrators told me that the lower-level acute care available at these facilities is not what patients need: They need high-level ICU facilities, for which these facilities are not licensed.”

There are also serious questions about how many millions of dollars are being spent on two step-down facilities that have been virtually unused because they are set up for low-acuity patients while hundreds are in ICUs, not ready for these convalescent facilities, one at the converted McAllen Convention Center, the other in Harlingen at a converted conference facility. The Texas Division of Emergency Management (TDEM) issued a contract to the Harlingen field hospital to a for-profit company that builds border wall segments throughout the Southwest. The McAllen facility is being run by a nonprofit that operates controversial migrant detention facilities for children, two of which have been shut down.

As I reported for Border Report, BCFS Health and Human Services has converted the McAllen Convention Center into a 250-bed capacity facility for recovering COVID-19 patients. But as of August 11, only eight patients had been sent for free care at the facility, which is paid for with CARES Act funds. The converted Casa de Amistad conference center in Harlingen is being run by SLSCO, which has received over half a billion dollars in federal government contracts to build segments of border wall throughout Texas and southern California. The facility had not helped a single patient as of August 11.

Local hospital administrators told me that the lower-level acute care available at these facilities is not what patients need: They need high-level ICU facilities, for which these facilities are not licensed.

So has this been a good use of federal funds? I put the question to Senator Cornyn at a news conference on August 11 immediately following the roundtable discussion, and he responded: “The big concern with the spike in cases was that it would overrun the hospital facilities, hospital ICU beds, the number of ventilators and the like, and so we worked to bend that curve. The possibility that there would need to be additional surge facilities built is what those facilities are for, and the fact that they are not widely needed is actually good news. But they are there if they are needed.”

Yes, but how many families do they help if they remain virtually empty?

I have submitted several requests with the state for information on how much these contracts are worth and the names of other companies that also put in bids and for how much, but the information has not been provided. My daily requests to Texas Division of Emergency Management go largely unacknowledged and unanswered. Hopefully they will get back to me. I find it curious that no other companies seem to be getting big-dollar border contracts, even during a pandemic.

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