EL PASO, Texas — The coronavirus has overwhelmed El Paso for months, with few signs of abating.
Inmates were paid to move hundreds of bodies into mobile morgues; the National Guard is now in charge of the grim task. Funeral homes have turned storage closets into freezers to hold the dead. A crematorium broke down from overuse. The city’s convention center has been transformed into a field hospital. The county judge wonders whether the community has enough gravesites.
But for those not on the front lines, the same kind of finger-pointing politics, virus denial, boredom and fear of losing livelihoods that have so divided the country is compromising the collective will of a community that is mourning tragedy upon tragedy.
The city unified in the face of hatred last year, adopting the “El Paso Strong” ethos after 23 people were killed in an allegedly racist attack at a Walmart. El Paso is now struggling to summon the solidarity to transcend indifference and fatigue as scores of people are dying each day in a persisting pandemic.
“Unfortunately, as human beings, we want to see things for ourselves. We physically watched the shooting and could see the danger,” said Ana Lilia Holman, whose 86-year-old father, William Howard Holman, died of covid-19 on Nov. 12. “But we can’t see this virus, so people tend to doubt how severe it really is.”
Officials fear the holidays will lead to more carnage for El Paso’s mostly Hispanic families, who instinctively draw close at a time when doing so can be deadly. Mask-wearing is pervasive and curfews are in place, but life continues – people dine and imbibe indoors and take family trips to big-box retailers. Residents said virus deniers are growing louder on social media and people are becoming numb to risk.
“At the beginning of the year, we were called health care heroes,” Ashley Bartholomew, a nurse in a covid-19 intensive care unit who recently quit her job. “And now it seems as if people have either given up or they have doubt at what we have to say, but we’re still living this horror every day.”
In a normal winter, influenza pushes El Paso’s underserved health care system to capacity. This year, each holiday has brought a new spike of coronavirus infections. Health care workers are now creating contingency plans for rationing care, said Hector Ocaranza of the El Paso Department of Public Health. The color-coded risk meters across the state are sliding into fire-engine-red territory and threatening to stretch limited state health care resources thin – and away from El Paso. Residents sick with ailments other than covid-19 are forgoing treatment to avoid hospitals, doctors said.
“I’m hoping that my community sees the crisis that we’re living in,” said El Paso pulmonologist Emilio González-Ayala. “I hope they can hear the pleas of restraint we’re voicing. I don’t think this was inevitable.”
Even as they make contingency plans, officials are hopeful that a rapid buildup in medical capacity, state and federal help and the use of an monoclonal antibody recently approved by the Food and Drug Administration to protect people with mild covid-19 cases from developing severe illnesses could help reduce health care pressures. El Paso’s new case numbers declined for the first time in 55 days last week, according to city statistics, but the death count will inevitably climb.
The whiteboard outside Christopher Lujan’s new walk-in refrigeration unit at Sunset Funeral Homes has 12 names on it. All but one have a little plus sign next to them, signaling they died of covid-19, the disease caused by the coronavirus. The company, which has four locations, has far exceeded its average of 1,200 funerals a year. It bought two hearses and had to rent two more. There are three new mortuary refrigerators.
Lujan understood how bad things had gotten when he realized he was seeing the same families coming back every week in smaller numbers. He recently sat across the table from a newly single mother and two young children discussing arrangements for their father. They attended funerals for three other relatives in recent weeks.
“El Paso is a strong community,” said Lujan, whose company, along with other funeral homes, helped cover costs for the August 2019 shooting victims. “But we are at a breaking point.”
Nearly 84,000 people in El Paso County have tested positive for the coronavirus and 1,048 have died, according to Washington Post data.
El Paso is also grappling with a politicized response to the virus, widening a chasm that had been growing ahead of the presidential election. County Judge Ricardo Samaniego, a Democrat, and Mayor Dee Margo, a Republican, sparred after Samaniego enacted a stay-at-home order that closed nonessential businesses, triggering partisan recriminations and legal challenges.
Texas Attorney General Ken Paxton, a Republican, called Samaniego a “tyrant” for enacting the order. Republican Gov. Greg Abbott, who said no new shutdowns would be enacted in the state, accused Samaniego of not enforcing existing rules. Samaniego’s order was struck down by a court.
“They are happy to help us when things are out of control, but I wanted to prevent this from getting out of control in the first place,” Samaniego said of state leaders. He has instituted a curfew from 10 p.m. to 5 a.m. through Monday.
Margo said he is managing an “unequal balancing act” between the city’s physical and financial health. He said a stay-at-home order would unfairly hurt small businesses and would not have stopped people heading to places such as Walmart that are deemed essential.
“I’ve done the best I could,” Margo said. “I get calls from businesses who tell me they won’t make it. I get calls from families who lost loved ones. I’ve never politicized this, and I don’t intend to.”
El Paso evaded the worst of the pandemic in the spring with strict stay-at-home orders, mask mandates and indoor occupancy limits. Commerce and travel continued but slowed across the border into its sister city of Juárez, Mexico. The efforts worked but came at a cost for many who lost wages, jobs or, in some cases, businesses.
Cases began rising after Texas reopened in May. Bonnie Soria Najera’s mother, Rosie Soria, tested positive for the coronavirus shortly after Mother’s Day. The 64-year-old sent recordings of her dry cough to her daughter. Soria was soon hospitalized and on a ventilator. She died days later.
Soria’s husband, Leo, soon fell ill and was hospitalized. He was placed on a ventilator the day his wife died, though he did not know at the time that she was gone. He improved and wanted to go home to see his wife; then their daughter told him. Nurses set up a live stream of the funeral for Leo. His heart stopped less than an hour before the ceremony was to begin.
El Paso’s cases initially peaked in mid-July, when Soria Najera tested positive. She was hospitalized and came close to dying. By the time she recovered near the end of July, new case counts had fallen and about 40 patients were in local intensive care units, health officials said.
“We were at the point that we shut down the covid unit for two days,'” said Juan Anchondo, a registered nurse at Las Palmas Medical Center. “Then it just exploded.”
Local leaders tried to plan for a worst-case scenario, but few could have expected the exponential growth in cases that begin shortly after Labor Day in El Paso and in Juárez. Many residents consider the cities one large, united community.
In a matter of weeks, more than 200 patients were in the ICU in El Paso. The sick were airlifted hundreds of miles to hospitals in Austin and Tucson. The field hospital opened at the convention center. More than 1,500 nurses, therapists and doctors arrived to staff the additional beds. State officials brought in nine mobile morgues and several dozen ventilators. The city recorded a sixfold increase in patients in a matter of weeks.
“We added somewhere around 600 new beds to our hospitals in total across the community. That’s like building two whole new hospitals,” said Ed Michelson, chief of emergency medicine at University Medical Center, the city’s public hospital. “We’ve kept up with the demand but barely.”
González-Ayala, the pulmonologist, said physicians are holding on, but every morning he is assaulted by thoughts about patients close to death. Some evenings he doesn’t sleep, because his phone is ringing every half-hour or more.
He said he worried about a man who had been a patient since 1996, when the doctor opened his private practice. When he started a two-week hospital rotation he was surprised to see the man in the ICU. The man struggled for 35 days. González-Ayala reported back to his family.
“Is he going to survive the night?” the doctor thought each day. The man died Nov. 21.
The Rev. Michael Lewis is part of a small group of young Catholic priests who administer sacraments and last rites. He gets called several times to the “pit” – large, open rooms with multiple beds that allow doctors and nurses at University Medical Center to provide immediate care to the most acute cases.
Lewis adapts the rituals to circumstance, uttering farewell prayers from a distance, sometimes from behind glass or the doorway of a hospital room, to represent the families who cannot be there to see their loved ones.
There are backlogs at the medical examiner’s office, at the crematorium and at funeral companies such as Lujan’s, which has more than 50 families waiting. Salvador Perches had at least two funeral-home staffers die in El Paso and in Juárez, where his company began. Cases and deaths have also surged in Juárez, where cemeteries and funeral homes are overrun and curfews are in effect, though they are hard to enforce. The city’s mayor tested positive for the coronavirus twice.
Angel Gomez of the community-based nonprofit Operation H.O.P.E. has worked closely with Lujan and Perches to offer families reduced rates or free funerals. But the volume has been so great – they’ve helped more than 520 families this far – they wonder whether funds will keep up.
The city now finds itself in financial straits. Small businesses have seen a 18% decline in revenue and more than 15,000 jobs have been lost since last year, Margo said, citing economic development data. The food bank has fed nearly 150,000 El Pasoans, while nearly 32,000 have sought unemployment benefits.
Spa owner Jennifer Ybarra wonders whether protecting people requires an all-or-nothing approach pitting the economy against public health. She decided to close her business, Blush, before state authorities ordered it in the spring. Blush offered at-home facial kits, delivered products directly and hosted virtual training for clientele.
Ybarra’s small business stayed afloat with federal paycheck-protection help, but its finances were in the red. She reopened slowly with safety guidelines that included sanitizing rooms between clients, prohibiting the use of spa lockers and valet parking.
But the back and forth between local and state leaders was frustrating. Blush closed and reopened within two weeks this month while other businesses defied Samaniego’s order as it was being litigated.
“You didn’t know what to do or who to believe. And even on top of that, what is the right thing?” Ybarra said. “If El Paso, as an entire community, as a city, would have been paying attention and following protocols months ago, we would not be in the predicament we are in now.”
Without more congressional help, Ybarra said, she feels immense pressure on her own to figure out how to keep providing jobs while protecting her community.
Fabrizzio Delgado, a psychiatrist with Texas Tech Physicians of El Paso, said the severity and frequency of suicide attempts have increased, driven in part by the isolation of past shutdowns and financial stress of lost jobs, businesses or wages. He said leaders don’t have good options, only tough choices.
Margo said he watches all the numbers. “I wake up with covid-19 and go to bed with covid-19,” the mayor said. “I think it’s just taking people time to fully grasp the severity.”
Abbott said through a spokesperson that the state’s existing restrictions proved effective in keeping people safe and containing the disease. He promised to swiftly distribute the new antibody therapy statewide.
But U.S. Rep. Veronica Escobar, D-Texas, who lives in El Paso, said Abbott surrendered to the virus months ago, prioritizing the economy over lives in vulnerable communities with large rates of uninsured residents. No one drug is going to solve El Paso’s problems today, she said.
“I don’t think any one of us should hold our breath and think that there’s a secret weapon that’s on the way that’s going to save all of us in two weeks,” Escobar said. “I think we need to operate under the assumption that this is going to get worse.”
Safety is relative, Delgado said, adding that the collective trauma and mental health repercussions from the pandemic will continue for year.
“We didn’t have enough time to complete the grieving process as a community, after the shooting, Delgado said. “So in the future, probably once covid is under control, we’re going to see a resurgence of symptoms of the attack not only from this pandemic but from our previous attack.”
Soria Najera, who has lost two aunts, an uncle and a cousin to covid-19 since she fell ill, said she questions the point of repeating warnings about the virus if people are going to ignore them. She wrote about her family and about her own sickness and did local news interviews, but she said people didn’t change their behavior. So she stopped, moved away from Facebook and unfriended the virus deniers.
One old friend noticed she had been removed and decided to send Soria Najera a message asking why. She explained that it was stressful to see posts on her timeline from people refusing to wear masks.
“It breaks my heart,” Soria Najera replied. “After everything that I’ve been through and my family’s been through, I can’t see how people can be that way.”
The woman left it at that. Then, she sent an ominous message earlier this month.
“I just want to say you were right about the virus,” Soria Najera read, noting that there was no explanation from the woman. “Forgive me.”
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