TIJUANA, Mexico — Dressed in white protective suits, cemetery workers in Tijuana last week buried dozens of bodies — casualties of the novel coronavirus — as bulldozers cleared land for more in the already-crowded city graveyard.
White crosses dot the rocky hillside in the Valle Redondo, about four miles south of the border in far eastern Tijuana, one of the cities in Mexico with the highest number of documented cases of the novel coronavirus.
Cemetery workers use the protective gear as they bury coffins of confirmed and suspected victims of COVID-19 and to prevent further spread of the highly contagious disease in Tijuana. Afterwards, the gravediggers take turns spraying themselves down with disinfectant.
The images are reminiscent of New York’s burial of COVID-19 victims on Hart Island in early April, pictures that thrust the mass grave for the poor into the national spotlight. More than 17,000 people have died of COVID-19 in the state of New York, according to the latest data from Johns Hopkins University.
In Tijuana, Municipal Cemetery No. 13 is a crowded public cemetery, mostly for the poor and working-class. Because of concerns about the spread of coronavirus, the number of family members allowed to attend funerals there and elsewhere in the city is limited, and mourners are required to stand 10 feet back from graves as part of new rules implemented by the city government.
As of Monday, 123 of Baja California’s 177 confirmed coronavirus deaths happened in Tijuana.
Nora Velasco, 28, buried her father at Municipal Cemetery No. 13 on Monday, eight days after he fell ill. She said Juan Velasco, 69, had a persistent high fever in the days before his death, but initially the family was not too concerned.
“I think maybe his head hurt, but he had no cough,” Velasco said, adding that her father’s fever would break and then return over several days. “He did not present all the symptoms. So we did not worry. We did not think it was the coronavirus.”
Late Tuesday night last week, his condition suddenly worsened.
“He went into the hospital at around 10 at night and by 5 a.m. Wednesday morning, they told us he was in very grave condition. He died later that afternoon,” she said.
Velasco said staff at Hospital General told her they believed her father died of COVID-19.
The public hospital, run by the state with some federal funding, has been grappling with a sudden onslaught of patients in recent weeks and at least a dozen doctors testing positive for coronavirus. A staffing shortage has meant that, on some shifts, no doctors are present on the coronavirus floor.
“We really don’t know anything,” said Velasco, who explained that the only information her family received from the hospital was when her brother went into a restricted area and demanded answers about their father’s death. “We don’t know if they put him on oxygen or out in the street. They started telling us the following day that he was doing very badly, but we believe he had already died at that point.”
Family members wore masks on their faces as they watched workers lower Velasco’s casket into the ground Monday.
Cemetery workers like Miguel Sanchez López, 30, said his job has left him less fearful of death than most other people might be. He said the workers are confident their protective gear is sufficient, but it’s uncomfortable in sweltering weather.
“I don’t have any fear, to be honest. Zero,” said Sanchez, who said he has worked as a gravedigger for the past 13 years. “We’re following every single recommendation, so I’m confident we’re not going to be infected.”
There are 12 other municipal cemeteries in Tijuana, all of which are full, according to Jesús Salvador García, Tijuana’s director of cemeteries, who said as of Sunday there were 35 bodies with confirmed COVID-19 that have been received at Municipal Cemetery No. 13.
“I can’t tell you the total number buried in the whole city because there are also private cemeteries and the option of cremation, which is the decision of the family,” Salvador said.
Sanchez said he believes the pandemic in Mexico could continue for at least a year, “so we better get accustomed to it.”
“Sometimes (government officials) don’t necessarily specify if they died of coronavirus or if they died of something related to COVID like a pneumonia or diabetes but with the coronavirus, too,” Sanchez said, referring to the deceased in the caskets he buries.
Lack of sufficient testing for the coronavirus has been a concern worldwide and in the region. San Diego County has performed 1,044 tests per 100,000 inhabitants. By comparison, Baja California has tested 66 people for every 100,000 residents.
The state had 1,345 confirmed cases as of Monday out of 3,223 tests completed for the state’s 3.3 million residents.
On a scorching hot day for late-April in eastern Tijuana, the gravediggers worked silently on the dry earth with shovels. A bulldozer grumbled in the background.
“The majority of the COVID bodies come wrapped in plastic bags and the boxes (coffins) too are contained in plastic,” said one worker, asked if he was afraid of being infected by the deadly virus.
He added there was almost no chance of the bodies infecting him with the virus, but also said there is too much about the disease that remains unknown.
After burying a body, the workers sometimes strip halfway out of the suits, toweling off their sweat in the shade of a truck, after taking turns spraying each other down with disinfectant.
Tijuana Mayor Arturo González Cruz said last week the issue of “unclaimed cadavers” related to the coronavirus pandemic was a “huge problem.”
“We’ve been in contact with the secretary of health to see if he has a contingency plan about what to do with so many dead bodies,” he said.
What to do with so many dead bodies is an issue Tijuana has faced for almost a decade.
Rapid population growth and high levels of violence prompted the city to add 2.5 acres to the 35-acre Municipal Cemetery No. 12 in 2011 to create No. 13. It rapidly filled up, prompting city workers to bulldoze new spaces for the dead.
Unidentified bodies are buried in a “fosa común,” or a common grave, where three or more bodies are buried together.
González said he did not want to speculate why some families have not collected their deceased loved ones nor did he release numbers on how many unidentified bodies there were. He said the city was streamlining the process of notifying and releasing the dead to their families.
“We are speeding up the delivery of the necessary documentation of the death certificate so that the person can be buried as soon as possible,” the mayor said.
Last week, the city’s medical examiner, César Raúl González Vaca, threatened to stop accepting bodies of suspected COVID-19 patients because he said his staff lacked the proper protective equipment.
Secretary of Health Alonso Pérez Rico responded, saying the state would provide overalls and other gear to the SEMEFO, the city’s morgue and medical examiner’s office.
“They require personal protective equipment,” said Pérez. “There is a general fear of COVID and there are many things that we do not know yet, but that will not stop our work.
“The information right now that I have given to all my directors is that no worker is going to enter a COVID area without protection,” he said, acknowledging there have been cases of the virus infecting doctors and people who handle the dead. “Yesterday, I spoke with the director of the SEMEFO about what he lacks and he said overalls. It is not a large number and giving them will protect our medical brothers.”
Pérez said the number of unclaimed bodies is small with the vast majority of deceased having family members who have turned to private funeral homes to pick up the bodies from the hospitals. He said the private funeral homes are required by the state to follow safety protocols.
A state health inspector said this week that some funeral homes are operating in secret out of rented properties in order to allow family members to see their loved ones during funeral ceremonies. Safety protocols mandate the body remain wrapped in plastic with the coffin sealed.
City and state health officials are trying to shut those operations down to prevent further spread of the disease, said David Gutiérrez with Cofepris, a governmental agency monitoring sanitary risk.
“It’s not just illegal, it’s immoral,” said Gutiérrez, who said the clandestine funeral homes were mostly targeting clients of economically modest means and taking advantage of their grief.
Velasco said she and her family were initially doubtful of the potential damage the coronavirus could do. She said she hopes her father’s story will encourage others to take the threat of the coronavirus more seriously.
“It may be necessary to take precautions because this illness … this is a true disease. This is not a lie of the government,” she said.
San Diego Union-Tribune contributor Yolanda Morales contributed to this report.
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