Medical Examiner

The Horror of El Paso’s Latest COVID Surge

Medical workers in gowns and masks stand outside a refrigerated trailer.
Health workers stand around refrigerated trailers outside the County of El Paso Medical Examiner’s Office in El Paso, Texas, on Monday. Ivan Pierre Aguirre/File Photo/Reuters

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The tragic impact of the latest COVID-19 surge has been seen very visibly in El Paso, Texas. A video recently made the rounds in which a local nurse described how overwhelmed hospitals have been lately. Bob Moore, founder of the news website El Paso Matters, has been reporting on more horrific details, from the numbers of dead people in morgues and funeral homes to the workers, like front-line doctors and undertakers, who have had to handle all of this. To figure out why this third wave of infections has been so devastating, I spoke with Moore for Tuesday’s episode of What Next. Our conversation has been edited and condensed for clarity.

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Mary Harris: You’ve said that over the last two weeks, El Paso averaged more than 23 COVID deaths a day. And you compared that toll to the number of people killed in the El Paso Walmart shooting, except this is happening every day, again and again.

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Bob Moore: Every day. Every day. For two weeks now, we’ve experienced a human loss equivalent to what happened on our darkest day. I don’t mean to compare the two events because they are quite different. But the human toll that we’re seeing right now is just unimaginable in many senses. I’m trying to give it a scale that people may be able to comprehend. This is a community that has been through so much in the past few years. Family separations started here. The migrant crisis—really the humanitarian crisis—in 2018–19 played out more in El Paso than anyplace else. This community responded with love and caring and said, “We’re going to feed and clothe these people.” Then we had the terror attack from a white supremacist last Aug. 3, and now COVID. I think in many ways, El Paso long ago reached a breaking point with crisis after crisis after crisis. But one of the things El Paso has shown throughout these various crises is that we’re a very loving and supportive community. And I think that will serve us well in what lies ahead for the next three or four weeks, because as bad as it’s been up till now, it’s going to get much, much worse, especially in terms of human loss.

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The state government has basically stripped local government of any power to take meaningful steps to abate the spread. So we’ve seen this to the point where 50,000 have been infected with COVID-19 in the past six weeks. I think we’ve become something of unwitting guinea pigs in an experiment on herd immunity, and the price we’re going to pay for that—we’ve already lost, by my best estimates, about 1,100 people. We’re going to lose another thousand or more between now and Christmas.

And you’re estimating because it’s hard to know how many people have died of COVID. so you’re factoring in cases that are still being investigated, right? 

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Right. El Paso has been very, very slow to confirm deaths. When they do issue the daily counter, they have to point out that some of these people died yesterday or weeks ago. So the city’s official estimate is somewhere around 780 deaths so far. We know from the data they put out on deaths under investigation that that’s a massive undercount. So, as I said, the truer number right now is probably about 1,100.

You’ve said a number of factors make El Paso uniquely susceptible to major outbreaks, like the city’s dependence on blue-collar workers.

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It’s a crucial reality of El Paso: We are a low-income working-class community. Thirty percent of all our private sector jobs are in the retail or hospitality industries. Those people have to go to work. They can’t stay home. And if they lose their job, there’s not that extra relief that was there for people in the springtime. The virus has exposed or amplified a lot of problems, and one of the things it’s clearly amplifying here is the way we’ve structured our economy in El Paso, where we’re so reliant on these low-wage jobs.

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El Paso is 81 percent Latino. I wonder if you have a sense that the city is experiencing a surge in a different way than other cities because people in Black and brown communities are especially vulnerable. 

Ninety percent of our cases, and 90-plus percent of our deaths, have been among Latinos. And again, this virus is exposing some systemic issues. Texas did not expand Medicaid under Obamacare; as a result, about a third of the people in El Paso don’t have health insurance, so they don’t regularly get health care or checkups, so they tend to build up a lot of underlying conditions. Diabetes is a huge, huge issue here, because people don’t have access to the education and health care they need.

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I think it’s worth reminding people that in Texas, there’s that problem where you can make too much to qualify for Medicaid but too little to be able to get on the exchange, so there’s no way to access health care. 

Right, and a lot of retail and hospitality jobs don’t come with health care benefits, so we have this huge gap. I think Texas has the largest uninsured population in the country. And the border areas, which are almost exclusively Latino, have the highest uninsured rates in Texas.

You’ve alluded to the fact that local politics are complicated and you have different actors trying to manage COVID in different ways. Mayor Dee Margo is in this interesting position because at the beginning of all this, my understanding is he was in favor of masks, but then you could see him shifting his position. And when the county judge got involved earlier this year and tried to have more of a lockdown in El Paso, Margo resisted it. Can you tell the story of this push and pull?

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The mayor actually imposed lockdown orders very early in the pandemic and supported the governor’s measures in March and April to close off the economy to try to slow the spread. And it’s worth noting that, by and large, that worked. It really helped contain the spread. But as we went along, I think Republican leadership in the state made it really clear we weren’t going to do any more lockdowns. And the governor, Greg Abbott, took all the power away from local governments to implement many of their orders.

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In June, Abbott issued an executive order that superseded conflicting orders from local officials. It rolled back restrictions on businesses that the state as a whole wanted kept open, like houses of worship, barber shops, and massage parlors. This order essentially tied the hands of county judges—basically the governors of each county—all across the state. And that created confusion on the local level.  

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Texas law gives county judges a lot of power in emergencies and even makes clear that if there’s a disagreement between a county judge and a mayor, the county judge prevails. So the county judge, at the end of October, because he was so concerned about what we were seeing with the rising caseloads, decided to basically defy the governor and issue a lockdown order. The city initially said it would not enforce the order, but then, after a week or so, a district judge ruled that the county judge’s order was legal. The city then said, “OK, we’ll start enforcing it,” which it did for a couple of days. Then an appeals court said the trial judge was in error and told him to issue a temporary restraining order blocking the order. At that point, the county judge just said, “I’m not going to press this further,” and dropped the appeals. But you had El Pasoans caught in this mass confusion, not knowing what they’re supposed to do. Are they supposed to go to work tomorrow or not? Are they supposed to open for business tomorrow or not? I think that undermined a lot of the effectiveness. But as you mentioned earlier, we did, for the first time, begin to see our infection rate go down this week. I think one of the factors behind that was the stay-at-home order the county judge issued, even though it was not universally enforced.

Margo held a press conference last week where he read letters he’d gotten from people in the business community saying, “Please don’t shut us down, because if you shut us down, we may not be able to reopen. We’re going to have all these employees out of work.”

A big part of that press conference was relitigating his disagreements with the county judge, which is a waste of time. The message about business is an important message, but here’s where all of this begins to break down: It’s not the shutdown that’s affecting businesses; it’s the virus. You cannot have hundreds of cases a day coming up and expect your business community to flourish. People have begun altering their behavior. They don’t dine in in restaurants. They don’t shop as much as they once did. So in September, we began to see our unemployment numbers go back up again. The October numbers aren’t out yet, but I’m sure that those will have gone up too—and there weren’t shutdowns in September or October. So there’s this false choice that’s been put out: that we can either choose a healthy economy or a healthy population. Until we get the virus under control, we’re not going to have a healthy economy. Back in the spring, there was at least the CARES Act funding and other steps that Congress had taken to provide some relief for both businesses and workers. But now that relief isn’t here. All of these national policy failures really begin to show up in a place like El Paso. So people have to go to work. In some cases, they have to go to work even when they know they’re sick. Businesses have to keep their doors open because even 25 percent of their revenue is that much more than they’d have if they shut down. We’ve created a health catastrophe and an economic catastrophe, but at the same time, we’re somehow trying to pretend that they’re different.

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I’m wondering if, with hospital capacity getting swamped the way it is now, you’re seeing doctors, hospitals, CEOs start to speak out in ways you wouldn’t usually.

I think one of the things that’s become clear is the public’s not listening to politicians because they don’t trust them, and people are really looking to health care workers, particularly front-line workers and nurses, to tell them what’s going on. Our political systems are so broken that others have had to step in to fill the void, these health care workers who have a lot on their plate already.

Part of what I find so difficult to communicate about COVID is that the worst consequence for all of us is when the hospitals are overwhelmed and then no one can get help for anything. The problem is harder to see for a lot of people because they’re not inside the hospitals. So unless you have people speaking out—for whom that can be very hard because there are privacy rules—you don’t necessarily see it until it’s too late.

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One of the things we’ve taken for granted is if I do get sick and have to go to the hospital, there’ll be a bed there for me. That may not be true anymore. The government’s not coming to save us. There is no cavalry that’s coming to save El Paso. We have to save ourselves. I think you’re seeing more and more health care officials and front-line workers trying to get that message out, that a lot of things we take for granted just aren’t true right now because the health care system has been overwhelmed.

We talked a little bit about how the infection rate is now going down in El Paso. Does that give you hope about where things are headed over the next few weeks and months, or are there things that you think mean this could get worse? 

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It gives me some hope heading into the new year, if we can sustain this, but I am, as you may have detected, incredibly concerned about Thanksgiving and what could happen there, that just as we’re starting to tamp out some of this wildfire, that we basically go get jugs of kerosene and throw it on the fire with these family gatherings.

I get the sense that you see a holiday coming and you have this dread.

The doctors do. I’ll tell you that. There are two big days circled on their calendars right now: Thanksgiving and Christmas, back to back. At least with the Fourth of July and Labor Day, we had a couple of months in between. Here you’ve got the biggest family-gathering holidays coming within four weeks of each other. It is terrifying.

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