Sun Sentinel Palm Beach Edition
W. Texas cannot escape COVID-19
Remote Big Bend region turning into a major hot spot
ALPINE, Texas — It is one of the fastest-growing coronavirus hot spots in the nation, but there are no long lines of cars piled up for drive-thru testing and no rush of appointments to get swabbed at CVS.
That’s because in the rugged, rural expanse of far West Texas, there is no county health department to conduct daily testing and no CVS for more than 100 miles. A handful of clinics offer testing to those who are able to make an appointment.
The Big Bend region of Texas is one of the most remote parts of the mainland United States and one of the least equipped to handle an infectious disease outbreak. There is just one hospital for 12,000 square miles and no heart or lung specialists to treat serious cases of COVID-19.
But in a sign that the virus is surging nearly everywhere, the counties that include Big Bend ranked among the top 20 in the nation last week for the most new cases per capita.
“There is no neurologist; there is no long-term care specialist,” said Dr. J.P. Schwartz, the health authority in Big Bend’s Presidio County and a physician at a local clinic. “We have no care to help them whatsoever. There is not even a nursing home out here.”
Even as hospitalizations and deaths in Texas near their summer peaks, local officials fear they have little power to intervene beyond the measures that Gov. Greg Abbott, a Republican, has put in place.
“My hands are tied,” said Eleazar Cano, the county judge in Brewster County, who said he had been
advised against imposing a stay-at-home order or other stricter measures that could violate the governor’s order.
Cano, a Democrat, compared governing through the pandemic to driving his truck through the desert on an empty gas tank, with no cellphone service to call for help.
In Brewster County, with 9,200 people spread across 6,000 square miles, more than half of the 700-plus known cases have been identified in the past month. In neighboring Presidio County, with 6,700 people near the border with Mexico, cases have quadrupled in the past two months, from less than 100 to more than 470. Both communities skew older.“The numbers are going straight up at this point,” said Malynda Rich
ardson, emergency medical services director for the city of Presidio, who coughed sporadically as she herself recovered from the icy chills and knockout fatigue of COVID-19.
There are a number of reasons for the spike.
The area is so remote that local residents have to travel to El Paso or Odessa for doctor’s appointments and to buy necessities at Walmart. With cases soaring across West Texas, the virus may have traveled back with them. Officials also cited everyday movement to and from Mexico, cases among young people at Sul Ross State University and a surge of tourists undeterred by the pandemic.
The area’s limited contact tracing shows more localized spread — in bars, in
multigenerational homes and through people who ignore positive test results and continue to work and socialize as normal.
In Alpine, the largest city, with a population of 5,900, residents wear masks with their cowboy hats to shop at Porter’s grocery store but take them off to eat indoors at restaurants in town. There is far from universal agreement about whether masks are necessary and effective. In a sign of the dispute that has played out on and off social media, the county was left without a local health authority when the doctor in the position, a pediatrician working on a volunteer basis, quit this fall after facing pushback from residents who opposed mask orders and other restrictions.
Brewster County, which includes Alpine, has already instructed bars to close and reduced indoor dining at restaurants from 75% capacity to 50%, as required by the governor’s order for counties with a high proportion of COVID-19 hospitalizations. But enforcement is spotty, and the governor has barred local officials from imposing rules that are stricter than his own.
With resources scarce, local health clinics are a primary option for testing, but even then, the swabs have to be driven three hours to El Paso and flown for processing near Dallas. For those who do get seriously sick, the Big Bend Regional Medical Center in Alpine has just 25 beds and a makeshift COVID ward where patients have been
sequestered at the end of the lone hallway.
Dr. John Ray, a family practitioner who works shifts at the hospital, said the hospital on one recent day got back-to-back calls about incoming coronavirus patients. One of them had to be transferred to a bigger hospital in Odessa to receive specialized care.
Not long afterward, Ray said, he saw the patient’s obituary in the paper.
“I don’t want to see Alpine like the pictures you see in New York, just people dying in hallways waiting for a bed,” said Ray, 44, who grew up in the small East Texas town of Troup, moved to Wisconsin for his residency and returned to Texas afterward, settling in the Big Bend region in 2013 for the beauty and the people.