SAN DIEGO — Chula Vista’s two hospitals are grappling with an increase in coronavirus cases not seen elsewhere in the county, leading many to wonder whether the area’s proximity to the U.S.-Mexico border and long-established cross-border lifestyles are a factor.
The question became more urgent this week as long lines formed at the San Ysidro Port of Entry despite bans on nonessential cross border travel — an indication that some people are tiring of stay-home policies in both countries.
But pinpointing the reason for the upticks in Chula Vista coronavirus hospital admissions is anything but simple.
A task force made up of representatives from local, state and federal organizations in San Diego examined South Bay admissions and found that only 5% were American citizens “who spend time on both sides of the border, have addresses on both sides of the border,” said Dr. Eric McDonald, medical director of epidemiology and immunization services for the county.
The remaining 95% were county residents.
“At this point, we are losing our patience,” said Chula Vista Mayor Mary Casillas Salas during a Thursday news conference. “We want answers and we want to know specifically what is being done in the county and state level to protect our citizens.”
She was joined by the mayors of two other South Bay cities — National City and Imperial Beach — along with San Diego’s District 8 councilwoman to demand more testing and an elevated public health response.
“What’s clear is that residents of south San Diego County are suffering disproportionately from this crisis,” said Imperial Beach Mayor Serge Dedina. “We want to make sure that all of our residents are protected.”
And the health care situation is bidirectional, Mexican officials say.
Luis Moreno Hernández, chairman of Baja California’s state Congress, said U.S. citizens are crossing into Tijuana and seeking treatment for their coronavirus symptoms at private hospitals.
“They have been sickened by COVID and they cross (the border) to look for treatment in Mexico because either they don’t have health insurance in the United States or because they can’t pay the high price of hospitalization there,” said Moreno, who also serves as the chair of the Border Affairs Commission.
Baja California Secretary of Health Alonso Pérez Rico confirmed that U.S. patients are crossing into Mexico for healthcare after being sickened with coronavirus-like symptoms, but he did not provide numbers.
Paulo Yberri, CEO of Tijuana’s Hospital Angeles, questioned the notion of large numbers of American coronavirus patients seeking treatment in Mexico.
“We’re definitely not overwhelmed in any way by U.S. citizens flooding our ER looking for treatment for the coronavirus,” said Yberri, whose hospital caters to U.S. citizens and often provides services for weight loss, orthopedic and plastic surgery.
Yberri said his hospital may have some patients covered by SIMNSA, a Tijuana medical facility and health plan that covers some San Diegans.
The situation at public hospitals in Tijuana is starkly different.
On Thursday morning, Baja California public hospitals appeared to be buckling under the strain of treating coronavirus patients because of limited ventilators and personal protection equipment.
Busier in Chula VistaIt’s clear that Sharp Chula Vista Medical Center and Scripps Mercy Hospital Chula Vista are starting to see significant upticks in COVID patients at rates that are significantly higher than is the case for other facilities in San Diego County.
On Thursday, all 24 beds in the designated medical and surgical unit at Scripps Chula Vista were filled, and the hospital had transferred two patients to its sister facility, Scripps Mercy Hospital in Hillcrest, just that morning.
A walk through the hospital’s emergency department showed the situation most clearly. Twelve beds set aside for non-COVID patients were mostly empty while 12 designated for patients with symptoms indicating they might be infected were nearly full.
Dr. Juan Tovar, an emergency medicine specialist and physician chief operations executive at Scripps Chula Vista, said everyone has been bracing for the current situation for weeks.
“We’ve been seeing this thing with the border for about a month, month and a half,” Tovar said. “We’ve been getting people ready and making sure that they understand that our peak was not going to be San Diego’s peak, because Mexico’s going to blow up, and, unfortunately, that’s what’s happened.”
The hospital’s intensive care unit has been busy but is not yet full. The staff, busy in the afternoon when a new patient was brought in for immediate ventilation, had enough personal protective gear available to handle the caseload without risk to staff. They also took a few moments to celebrate, lining the ICU hallway and cheering as a patient who had been on a ventilator for about three weeks was finally moved to a lower level of care.
It has been busy at Sharp Chula Vista as well, though not yet busy enough to force transfer of patients north to sister facilities in San Diego.
Dan Gross, Sharp’s executive vice president of operations, said that, while admissions have generally inched up day by day, there was a sudden spike last Friday evening when five COVID-19 patients appeared in need of medical help in less than an hour, followed by four more over the next few hours.
“Those admissions arrived quicker than what we had seen previously,” Gross said.
It looked for a moment like the beginning of a surge, and three additional mechanical ventilators, accompanied by three additional nurses, were dispatched south from Sharp Memorial Hospital in Kearny Mesa. But the pace slowed right back down again.
Coronavirus cases have also increased faster among South Bay residents compared to the rest of San Diego County, according to recent data.
Cases in San Ysidro grew 111% between April 14 and April 20, increasing from 32 cases to 59 in the span of seven days. By comparison, the number of coronavirus cases across the entire county are doubling every 24 days.
The 92154 zip code, which includes all of Otay Mesa, has 173 cases, the most number of any single zip code in the county, as of Thursday. That tally includes detainees at Otay Mesa Detention Center, where at least 97 have tested positive, according to facility documents.
It’s important to note, though, that zipcode data does not come close to painting a full picture of who’s sick because it counts only those who have tested positive, and the vast majority with mild symptoms are not being tested.
National City is home to 2% of the county’s population, but has nearly 3% of confirmed cases. Chula Vista residents make up 8% of the county’s population but have 11% of its confirmed COVID-19 cases, data shows.
Chula Vista’s mayor said many factors could be at play besides the border. The most impacted areas include zip codes with some of the lowest incomes in the city, she noted.
“It could be because we have a higher number of essential workers working both in the city and other locations,” Salas said.
In the South Bay, a heavily Latino community where many families have strong ties to Baja California, the border between Tijuana and San Diego County is often much more blurred than those who live outside the region can understand.
For example, the family of the governor of Baja California lives in the Rancho del Rey community of Chula Vista, where many other wealthy Mexican families have long had strong roots. Hospital and restaurant workers, who find affordable housing in Tijuana, cross northbound daily to provide essential services in the U.S.
Pre-pandemic, 90,000 people cross the Tijuana-San Ysidro border daily. But when the travel ban went into effect March 21, border crossings initially dropped by 70 percent, according to a Department of Homeland Security official.
The border restrictions do not apply to U.S. citizens, legal permanent residents and those with work visas, as well as international trade. Border-crossings for non-essential travel such as recreation and tourism were banned.
For weeks, those restrictions visibly lessened the number of vehicles and people crossing into the county from Mexico. However, this past week, regular border-crossers noticed surprisingly longer border wait times.
Northbound vehicle traffic backed up for at least a mile with a two-and-a-half hour wait for drivers near the front of the line around 10 a.m. Tuesday morning.
Many drivers and pedestrians told The San Diego Union-Tribune they delayed crossing for as long as they could, but now they needed essentials after a month of restrictions.
Cesar Crespo, a 54-year-old dual citizen who lives in Ensenada, said Tuesday was the first time he tried to cross into the United States since the announcement of the border restrictions.
“This surprised me. I got to the border today and I thought ‘Where are all these people going?’” said Crespo, who said he was going to the bank and to check his mail.
“I didn’t need to cross the border for a few weeks, but now I’m running out of money, groceries and essential items,” he said.
U.S. Ambassador to Mexico Christopher Landau reminded residents living near the border Tuesday that visiting family on the other side is not considered essential travel.
According to a U.S. Customs and Border Protection spokesperson, 90 to 94% of travelers entering in vehicles and on foot last week were U.S. citizens or lawful permanent residents.
Moreno, the Baja California congressman, said in recent days Mexican officials have tracked groups of Tijuana residents, who are also U.S. citizens, traveling northbound to purchase items not available in Baja California. They will make shopping runs for clients for a $10 to $20 charge.
Moreno said the increased border traffic means people could be carrying the virus to their loved ones or strangers on either side.
“In this moment, it’s creating a situation where people can transmit the virus from one side to the other,” he said.
Between Tuesday and Wednesday, Baja California health officials documented 123 new confirmed coronavirus cases, bringing the tally to 975. Health experts believe the actual number of cases is much higher because of severely limited testing.
A total of 133 people have died.
Moreno said he’s requested southbound health screening checkpoints at the California-Mexico border crossings to identify people “who continue to import the virus to Baja California border towns.”
Pérez Rico, the top health official for Baja California, said the border could be the reason why Tijuana has more cases than any other city across Mexico.
“To consider us two different countries, two different entities, is a mistake,” said Pérez Rico. “We are the same community experiencing this health emergency.”
(Staff writers Kate Morrissey and Gustavo Solis contributed to this report.)
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