In Starr County, Texas, the pandemic has become a “before and after” story, before the state took over, and after it did.
The large but sparsely populated county on the Texas-Mexico border had managed to keep the coronavirus contained in the first few months by imposing 14-day quarantine restrictions on those who tested positive, closed businesses before the state ordered closings, linking with private businesses to provide try and implement a curfew with fines and jail terms.
Then Texas Governor Greg Abbott reversed local decisions and began a gradual reopening of businesses in the state in April.
“They took our teeth out to enforce anything,” said Alberto Pérez, the city manager for Rio Grande City, the county’s largest city with a population of more than 64,000.
In the two months since Abbott exercised his authority, Starr County has observed his handful of cases – on many days there were no new ones – steadily rising and increasing this month.
On June 22, the county, located in the Rio Grande Valley, saw a peak of 75 new cases. There had been no reported deaths from the virus until Tuesday, when there were three. The county had recorded 407 total coronavirus cases as of Friday, compared to the nine cases it had until April 29, the day after Abbott made it clear that its rules prevailed over those of local officials.
“It has been a dramatic change here,” said Dr. José Vásquez, the local health authority and head of the Board at Starr County Memorial Hospital.
As the county was forced to reopen businesses, the reopens created a “false sense that it was okay to get together to go out, to get together with families,” and that led to a significant increase in cases, Vásquez said.
“The governor made a mistake,” said Carlos Martinez, a worker at a restaurant in the city of Rio Grande. “We were doing very well” according to the highest standards.
He recognized that the stricter standards had an economic impact on companies, but said that “health is more important” because “without health there is no economy.”
Across Texas, closings had taken their economic toll and there was pressure to reopen as unemployment increased. The Texas economy was also shaken by falling oil prices.
But Rose Benavidez, president of the Starr County Industrial Foundation, which helps local government and businesses develop the local economy, said the county’s early experience shows that “there is always a way to try to reconcile safety and security. economic needs of our county. ” “
“We know there are metrics to try to get an idea of how things should go, but our community can be an example of how quickly things went wrong,” said Benavidez.
Most of the cases at the start of the pandemic were travel-related, meaning that a person who had traveled from outside the county brought it to Starr County. But over the past month, the county has seen widespread community and family outreach, sometimes through family gatherings, Pérez and Vásquez said.
In one family alone, up to 20 people have been infected, Vásquez said.
“For six or eight weeks in my county, we were able to control the situation very, very well. There was a time when we spent 21 days in a row without any COVID cases. At some point, we had between eight and 10 cases, where in neighboring counties they had around 200 cases, ”said Vásquez.
“That is no longer the situation here after the governor launched activities and went back to business, and the measures we had taken were lifted and the ability to impose restrictions and fines was lifted … We have seen a dramatic increase in our numbers. “, said.
Vasquez said the county has increased the evidence, but said the increases in cases cannot be attributed to the evidence alone.
On Friday, after four consecutive days of more than 5,000 new COVID-19 cases for a total of 22,743, Abbott reduced the capacity allowed for ordered restaurants and bars to close at noon (but allowed them to continue with takeout sales. and delivery), closed rafting and tube businesses that are popular with young people in the summer, particularly in central Texas, and issued requirements to obtain permission to hold certain gatherings of 100 or more people.
“Right now, it is clear that the increase in cases is largely due to certain types of activities, including Texans who congregate in bars,” Abbott said in a statement.
As in other states, the county is seeing many of the new cases in younger people, many in their 20s, who don’t get as sick as older residents. But they still have the potential to pass the virus on to their own parents or grandparents or older residents who will need critical care.
Vasquez said he and other medical personnel are very concerned about whether they could handle an increase in hospitalizations. The county is one of the poorest in the nation and the state, is predominantly Latino, and many are uninsured or underinsured.
The county has a 49-bed hospital. Critical cases generally go to a hospital in McAllen, about 50 minutes away, but neighboring Rio Grande Valley counties are seeing their hospitalizations, and the number of emergency rooms is also increasing, Vásquez said.
Neighboring Hidalgo County has had 2,503 positive cases with 947 in the past four days, while Cameron County, where Brownsville is the largest city, has had 1,881 cases, with 335 between June 23-25.
“Now we have several hospitals that have to reject patients because they are at full capacity,” said Vásquez.
Rural Texas hospitals faced challenges before the coronavirus arrived, but their problems have been amplified by the pandemic, said John Henderson, CEO and president of the Texas Rural and Community Hospital Organization.
Of the 157 rural hospitals in Texas, defined as hospitals in counties with populations of 60,000 or less, about 30 to 40 have no ventilators and many have no ICU beds, he said. Staffing is also a problem because rural areas may lack specialists, such as critical care physicians and pulmonologists.
Henderson said 44 percent of rural Texas hospitals had negative operating margins and in 2019, 60 of 157 in the state had less than 30 days in cash. Congress included money for rural hospitals in the coronavirus relief package that it approved in March to help with pressure on its budgets.
Benavidez said local officials were early able to get the public to follow the guidelines of the Centers for Disease Control and Prevention and accept other precautions.
He said that when the governor reduces his reopening, he could consider one more thing.
“The governor was very smart when he started,” he said, “knowing that officials knew their local community very well and knew what their community was responding to. And if we had more freedom to work on it, I think we would have a much better public response. “