Americans living in Mexico cross border for care, overwhelming small hospitals
California hospitals overwhelmed by American patients from Mexico
WEL CENTRO, Calif. hen Manuel Ochoa started feeling sick — his body sore, his breathing restricted — he drove from his mother’s home in Mexicali, Mexico, to the U.S. border.
The 65-year-old retiree parked his car at the international bridge and tried to drag himself to the country where he has permanent residency, and where his health insurance is valid. Just before he approached the Border Patrol checkpoint, he collapsed in the sun.
That’s when U.S. immigration officials made a call that has become increasingly common during the coronavirus outbreak: for an ambulance to transport a U.S. citizen or resident from the Mexican border to the nearest American hospital.
As Mexico’s health care system has strained under the coronavirus, small community hospitals in Southern California, some of the poorest in the state, have been flooded with Americans who have fallen ill and crossed the border. They are retirees and dual citizens, Americans working in Mexico or visiting family there.
It is an example of how easily the virus moves between countries, even as governments — and particularly the Trump administration — have attempted to shut their borders. And it’s a window into how many American lives span the U.S.-Mexico border, including families who have moved freely across the region since before that line was drawn and whose movement has continued during the pandemic.
Public health issues have always straddled the border here. Texas conducts mosquito-spraying campaigns with the Mexican state of Tamaulipas during dengue outbreaks. Arizona has joint firefighting exercises with Sonora. California and Baja California have long battled a cross-border tuberculosis epidemic together. The San Ysidro International Bridge, south of San Diego, is the busiest ambulance pickup point in the United States.
For years, the U.S.-Mexico Border Health Commission conducted simulations on how the two countries would respond if a pandemic settled on the border. A special procedure was created for Mexican ambulances to transfer patients to U.S. ambulances on American soil.
Then a real pandemic struck. Now, approximately half of the coronavirus patients in several California border hospitals, including El Centro Regional Medical Center, are recent arrivals from Mexico. As a result of that surge, Imperial County, home to El Centro, has a much higher concentration of coronavirus cases — 760 per 100,000 residents — than any other county in California.
“It’s amazing how this disease has taught us that borders don’t exist,” said Adolphe Edward, the chief executive of El Centro Regional. The hospital’s staff includes 60 people who cross the border from Mexicali each day to work.
About 1.5 million Americans live in Mexico, and more than 250,000 of them live in the cities just south of California. Those cities have been hit harder by the coronavirus than almost anywhere else in Mexico.
More than 300 medical personnel in Tijuana and its outskirts have been infected, according to Yanín Rendón Machuca, the head of the local health workers union. At the city’s general hospital, only a quarter of the staff remain at work. Ambulance drivers in Mexicali sometimes wait hours while hospital workers make room in hallways for patients with COVID-19, the disease caused by the novel coronavirus. Some overwhelmed public clinics in the border city are no longer accepting patients.
“We see patients who have been in Mexican hospitals for two, three or four days before they cross the border and come to us,” said Dennis Amundson, the medical director in the intensive care unit at Scripps Mercy Hospital in Chula Vista.
U.S. citizens and green-card holders in northern Mexico started sharing messages and Facebook posts in groups such as “Rosarito Living” and “Expats in Mexico.” If you get sick, they say, cross the border.
So that’s what Ochoa did. He’s been a permanent resident of the United States since 1978. He retired a few years ago after a career as a truck driver in Los Angeles.
On Sunday morning, the ambulance drove him the 10 miles from the international bridge to El Centro Regional, which was already treating 43 coronavirus patients and where a disaster response team was preparing to set up a military-style tent for overflow.
“This is where I have insurance, and it’s where there’s better attention,” he said at the hospital. The machine reading his resting heart rate bounced between 128 and 135 beats per minute.
During the pandemic, the influx of patients from Mexico has posed an unprecedented challenge. El Centro Regional normally serves a county with a population of about 180,000 residents, many of whom live below the poverty line. Suddenly, the hospital was responding to an additional community of Americans in Mexicali, thought to number 100,000 people.
When Edward posted a video update on Facebook last week explaining that his overwhelmed hospital would temporarily stop accepting more COVID-19 patients, he received a stream of messages criticizing him for prioritizing patients from across the border.
“Send them back to Mexico,” one person wrote.
“The border should have been closed from day one,” wrote another.
Edward, a former Air Force physician who helped lead the U.S. military’s medical team in Baghdad, tried to explain that these were Americans he was treating.
“We can pretend that 275,000 American retirees in Baja California don’t exist, but they do. Or the 35,000 military members,” he said.
The spike in cases along the border comes as California is trying to reopen. In San Diego on Memorial Day weekend, restaurants and bars were crowded with people, many not wearing masks. Medical experts warn that relaxing those rules, in addition to the cases coming across the border, could lead to a surge in infections.