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While health officials across Texas expressed relief that the latest COVID-19 surge appeared to be declining last week, Laredo resident Marcela DeJean was helping her sick husband write a will.
He was vaccinated nearly a year ago but caught COVID-19 last week. He was so sick, she nearly took him to the hospital — although at the time, this border city of about a quarter-million people had few beds available.
DeJean, a school district speech therapist, was terrified that her husband, a father of two and an agent with the U.S. Border Patrol, was going to die.
“He sounded very, very bad,” DeJean, 45, said. “I was like, what if he just randomly, quickly takes a turn for the worse? You just never know. It was very scary.”
Statewide, the COVID-19 positivity rate and the number of new cases and hospitalizations are plummeting. But on Texas’ southern border with Mexico, Laredo remains in the grip of its fourth surge — fueled by the omicron variant that burned through the state over the holidays and fed by historically scarce health resources, a medically vulnerable population, economics and geography.
At one point in late January, the hospital region Laredo is in had a higher share of hospital beds taken up by COVID-19 patients — more than 36% — than anywhere else in the state. Last week, the rate dropped below 20% for the first time since December.
“We’ve been to hell and back. And back again,” said Laredo Mayor Pete Saenz. “And back out.”
It’s a slow climb out.
While only about 12% of tests statewide are coming back positive for COVID as of Tuesday, Laredo’s positivity rate is still at nearly 30% — down from 47% in late January but still higher than in any of the previous surges.
And even though the seven-day average of new confirmed cases has begun to drop, Webb County still has one of the highest rates in the state.
The region’s two hospitals, Doctors Hospital Laredo and Laredo Medical Center, are both reporting that their ICUs are nearly full — for the 52nd day in a row. Hospital intensive care units in Laredo have been operating at or above 90% capacity since Thanksgiving.
“We’re not out of the woods yet,” Dr. Victor Trevino, Laredo health authority, said.
He and other officials are concerned about the annual binational Washington’s Birthday Celebration happening this weekend, a Presidents' Day tradition that includes Laredo and Mexico's Nuevo Laredo on the other side of the Rio Grande, meeting in a parade in the middle of the Gateway to the Americas International Bridge that connects the two cities’ downtowns.
The event, which began more than 120 years ago, typically draws some 400,000 attendees from all over the United States and Mexico each year.
Called off last year for the pandemic, the festival is “going in full swing” for most of February, culminating this holiday weekend, Saenz said.
“There’s a concern always when we have activities that facilitate people gathering that we may end up with another spike,” he said. “But hopefully, you know, it won’t be as bad as before.”
Trevino hopes people who attend the festival will remember the devastating roller coaster the region has been on for the past two years and stay vigilant.
“We should not actually say we are over it because we have been here before in this situation,” Trevino said. “When we say the numbers are going down so everybody relaxes, and it’s the same thing or another variant comes along.”
Two countries, one community, bigger risks
In November 2021, the U.S. government reopened the Gateway to the Americas bridge in downtown Laredo to nonessential visitors for the first since it shut down to most traffic early in 2020.
Two weeks later, the highly contagious omicron variant hit Texas.
As omicron took hold in December, the federal government recorded some 1.5 million border crossings into the city at Laredo’s four bridges.
They included shoppers, tourists and family members who hadn’t seen each other since the bridge closed 19 months earlier.
Although the visitors didn’t seem to be winding up in the hospitals — full vaccination is required of anyone crossing from Mexico into the U.S. — many were coming from regions of Mexico with low vaccination rates, which may have contributed to the spread of the virus, experts here said. During the first week of January, the surge got so bad in Nuevo Laredo, where the vaccination rate is still much lower than Laredo’s, that the city went on lockdown.
“Individuals crossing from areas of Mexico with lower vaccination rates can impact the health care system,” said Hilary Watt, CEO of Coastal Bend Regional Advisory Council, which tracks medical resources in the South Texas area.
Because of this, the largest land port along the 2,000-mile Texas-Mexico border needs cross-border solutions to its pandemic struggles.
Trevino has run a binational vaccination program since December, inoculating hundreds of Mexican residents every day at Laredo’s international border crossings. He estimates that well over 100,000 people have been vaccinated through the program using nearly expired doses donated from across the state.
The program was so successful that it’s being credited with driving up Mexican border state vaccine rates to some of the highest in Mexico. Trevino was recently honored with the key to the city by Nuevo Laredo’s mayor for the program.
In Laredo, Saenz said civic leaders in his city are about to do the same thing. It would have happened earlier, he said, but it keeps being bumped by surges.
“Hopefully we can get it done this time,” he said.
Laredo and Webb County, which is 90% fully vaccinated, and the rest of the border community have always been ahead of the state and the nation in terms of getting vaccinated quickly. And although the effect of such a high rate is dulled by the lower rates across the river, Trevino said, vaccination is still the biggest reason that Laredo didn't get hit much worse during the omicron surge.
“A lot of people are going to attribute that to, ‘Oh, omicron was not that severe’ and this and that,” Trevino said. “That’s not it. The fact is, we have more vaccinations now. That’s what has kept people out of the hospital.”
Scientists believe that omicron is less deadly than the previous variants. At one point during a previous surge, Laredo had the highest death rate in the country.
But Trevino and other local experts say that residents in Laredo are more vulnerable to COVID-19 than those in other parts of the state and are more likely to enter the hospital even with a less severe virus circulating.
Some 95% of Laredo residents are Hispanic, a population that is disproportionately more likely to die from or be hospitalized by COVID-19.
From a health standpoint, many Laredoans are at higher risk from the virus. South Texas is plagued by some of the nation’s highest rates of obesity, hypertension, diabetes — all considered underlying health issues that can factor for serious illness from COVID-19, Watt said.
“A lot of those things are pretty prevalent in our area, and so as a population, there’s a higher risk because of those things,” Watt said.
There are also no public hospitals here, reducing Laredo's access to health care, and it has far fewer doctors needed for adequate health care access, officials say.
The two private hospitals in Laredo reach a service area with a population of 300,000 people, plus those in surrounding rural counties.
“It’s always hard for Laredo because we’re such a significantly medically underserved community,” said state Sen. Judith Zaffirini, D-Laredo. “These last two years have been a very difficult strain on hospitals nationwide, but especially in Laredo because Laredo facilities were already struggling to keep up with a growing city.”
The area also has one of the highest uninsured rates in Texas, a state that has the highest uninsured rate in the country. An estimated one-third of the residents here have no coverage, compared with about one in five Texans statewide.
“It’s not like if you live in an affluent neighborhood and you call your doctor and he gives you treatment right away,” Zaffirini said. “These people who are underinsured, without any health insurance or Medicaid or anything, eventually wind up in the hospital when they are very sick. So that leads them into a morbidity and mortality rate that’s higher than everybody else.”
And that leads to enormous strain on hospital staff, Watt said.
In fact, according to federal data, the Laredo Medical Center has operated at 90% or higher occupancy for all but about three months, collectively, throughout the entire pandemic.
“Hospitals, at times, may have empty beds, but if they don't have the staff to care for patients they would place in those beds, then they’re in a predicament, especially when you’re talking about ICU patients, very sick people, who require smaller staff-to-patient ratios,” Watt said. “This becomes problematic. We’ve been through many surges that highlighted that.”
Saenz said the city is in the process of looking for a contractor to conduct a study of how the pandemic strained the medical resources of the area and come up with potential solutions for the future.
It’s a complex problem. A new hospital, for example, would also bring the need for more staff, which is currently the biggest challenge facing the existing hospitals already, officials said.
Zaffrini said she was “delighted that the city is paying attention to that at this point in time” and encouraged by the decision to hire a consultant.
At the state level, however, Texas should expand eligibility to Medicaid to cover more low-income people and get them access to quality health care, which would also lower pressure on hospitals in a time of crisis, Zaffirini said.
Those are all longer-term solutions, however.
Right now, Zaffirini said, especially with George Washington festivities happening this weekend, people should not act as though the pandemic is over just because the numbers are dipping.
“I hope people will remember the importance of being cautious, of being very conservative, not taking anything for granted,” she said. “Not assuming that we’re doing better and making sure we don’t get worse.”
DeJean, the Laredo speech therapist, is not feeling the optimism just yet either.
At her house, it’s not just her husband who has COVID-19. Both of their elementary-age children have it right now, too. So far, she has not tested positive and continues to do her job as a speech therapist in several schools while her sick husband stays home with the kids, who are not symptomatic.
When he goes back to work next week, she’ll have to take time off from her job to be with the kids if they are still testing positive.
She doesn’t want her parents to help, even though they live down the street, because they are in their 70s and 80s and more vulnerable to the virus.
For DeJean, it almost seems like an insult that all this exhausting difficulty would happen after two years of masking and negative test results, of being careful and getting vaccinated.
“We’ve never had to deal with any of it before now,” DeJean said. “I’m very agitated and I’m over it. I just want things to go back to normal. It’s very frustrating.”
Jose Luis Martinez and Chris Essig contributed to this report.