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Horowitz: Border state surge: Rise in serious southwestern cases driven by border-crossers from Mexico



Guillermo Arias/AFP/Getty Images

Why should Americans in border states have to go back into lockdown and be treated like criminals by a government that failed to lock down the border when Mexico experienced its worst surge of coronavirus in late May?

Despite the mounting evidence that the worst part of the surge in the southwest is the result of cross-border travel beginning in May, government officials continue to act as if this is a domestic problem and that somehow Americans have been careless in mitigating the virus. They are using the results of their failure to lock down the border as a pretext to lock down Americans. Talk about chutzpah.

Nobody captured the essence of what is going on at the border better than Brownsville public health director Arturo Rodriguez. While explaining the rising cases and even deaths, he recently said, "In other words, you have three rates: the U.S., Mexico and your border rate."

America experienced its peak in March and April. Mexico experienced its peak in May and June. The border states, which were barely affected by the original American epidemiological curve, are now getting nailed by Mexico's curve.

Just how prominent is the surge on the border relative to the rest of the country? Data analyst and sportscaster Kyle Lamb, who joined my podcast last Friday, prepared a chart showing the rise in cases over 21 days through June 23:

What you see is an unmistakable surge in southern California, southern Arizona, and the Rio Grande Valley counties in southeast Texas, which all share a border with the towns in Mexico that were hardest hit beginning in late May. The other counties flagged in the interior of the country are mainly small rural counties that have state or federal prisons, and the numbers are dramatically distorted by those counts, as states tested prisons in recent weeks.

Even before any speculation about the possible spread from illegal immigrants, it is now an open fact that green card holders and dual citizens were completely exempt from the travel ban and came here to access our hospitals. There are thorough reports from the New York Times, Washington Post, Reuters, and Kaiser Health News about very sick patients flooding our border hospitals and even being sent into the larger city hospitals for care beginning in late May. That is exactly when the American epidemiological curve was waning, but the Mexican curve was beginning to spike.

Todd Bensman of the Center for Immigration Studies reported on a video of a Riverside County nurse saying that patients were being helicoptered from the border to the hospital in her county.

Thus, while most of the surge in most states is superficial and illusory – more a function of people coming back to hospitals for regular care, universal testing, and a modest spread of a milder form of the virus – the border counties have been hit with the re-importation of the serious first round from Mexico. This is why we are seeing increased ICU usage and deaths primarily in the border counties and nowhere else. California and Arizona now account for 40% of the reported ICU census, and it's no coincidence:

There is a huge difference between the rate of infection in the northern counties of Arizona and the border counties:

The same dynamic is unfolding in California, where 80.5% of ICU usage is in California's nine southernmost counties.

I'm sure many Americans would like to know how many of those beds are being filled with those crossing the Mexican border. We know that 60% of all hospital beds in one Imperial County hospital were recent arrivals from Mexico as of June 2. If you look at the Imperial County dashboard, you will find that just 1.5% of all known cases are non-Hispanic (where 48% are of unknown ethnicity). That is a dead giveaway as to the culprit behind the surge and where it's coming from.

Also, in Texas, we are seeing an ICU shortage – where? In Laredo, which is right at the border. It's no mystery why Laredo and southeast Texas are getting hit. Just as the hot spots in Mexicali and Tijuana in May led to a surge in California hospitalizations from cross-border medical tourists, we are seeing the same thing in southeast Texas. According to ValleyCentral.com, travel has continued to flow back and forth across from McAllen to Reynosa and Brownsville to Matamoras. Those two Mexican cities have the highest number of cases in the state of Tamaulipas.

The travel ban, which was implemented at the border on March 21, never applied to dual citizens and green card holders, evidently, even if they were coming for COVID-19 care at U.S. hospitals. However, a source at CBP's office of field operations (OFO) who works at a port of entry in Texas told me he is concerned that we don't seem to automatically test or screen anyone who comes over the border unless they are showing symptoms – even non-green card holders. Many of them are deemed essential and have questionable documents showing they perform essential work.

"At the inception of the nonessential travel ban, CBP officers have been told by management that it is none of their business if the travelers are traveling for essential purposes and if they are wearing proper PPE," complained the veteran customs agent in southeast Texas. The agent reached out to CR to express his concerns but must remain anonymous because he is not authorized to speak to the media.

Hundreds of Mexicans cross daily claiming their travel is considered as trade and commerce because they simply provide a typed letter of employment with a fancy letterhead and a Mexican-made employment identification card. CBP officers have had no formal training about such Mexican documents other than the Mexican passport. Many Mexican tourists are using this method as a loophole to gain entry into the United States of America during the COVID-19 pandemic. CBP officers suspect many of these letters of employment and employment identification cards are fraudulent, but management continues to allow them to enter without the proper vetting. As a result, traffic has increased drastically since the nonessential travel ban.

But they are at least screened for the virus, right?

"Presently, travelers coming from Mexico are still not being medically screened at the Hidalgo, Texas, port of entry, Anzalduas port of entry, and Pharr port of entry," charged the customs agent.

If CBP agents see someone who is sick, they will refer him to the CDC, but it appears that there is no automatic testing or even temperature readings of those who come across the border as essential visa holders, much less green card holders or citizens.

When I asked a CBP spokesman if he could verify whether CBP automatically tests or takes the temperature of those entering, he responded with the following:

U.S. citizens and lawful permanent residents are exempt from the restrictions on entry at U.S. land borders. These individuals will receive the same processing, evaluation and potential Centers for Disease Control and Prevention (CDC) medical screening that all entrants undergo at U.S. ports of entry. If CBP identifies a traveler who exhibits symptoms of COVID-19 or who otherwise meets the CDC's COVID-19 screening guidelines, then CBP will refer that traveler to the CDC or local health officials for enhanced health screening. These medical professionals take travelers' temperatures as necessary.

Thus, the referrals to the CDC are only if they "identify" anyone with symptoms and temperatures are only taken "as necessary." Many Americans would be surprised that with mandated testing to go back to work and to do so many things domestically, we still do not have universal automatic testing at the border, even though Mexico became a hot spot beginning in May.

And again, green card holders and dual citizens are completely exempt, as are those who are coming for medical purposes. I did not receive a response from CBP to the following question: "What happens if they are seeking medical care, not a heart or cancer surgery, but for the express purpose of obtaining COVID treatment at a U.S. hospital?"

As of this writing, the CDC has not replied to CR's request for comment on the procedures for COVID-19 patients crossing the border.

We already know the answer to this question regarding green card holders and dual citizens, from public material and from the obvious data reports from border hospitals. The question is how many with other visas, border crossing cards, or even those without any valid documentation are waived through to come to our hospitals.

According to my source at the OFO, "Management has allowed some Mexican citizens to enter the United States of America with a humanitarian waiver 212(D)(4)."

We know that many very sick patients came in for care in our hospitals, but how many others spread the virus inside the border? Remember, it's the sickest ones who are likely the most contagious. Time will tell whether the border travel affects the rest of the country, but it clearly has reintroduced some serious cases into hospitals near the border.

This all raises the obvious question: How can a travel ban that was designed to keep out international spread of COVID-19 be manipulated as a humanitarian mission to give medical care to many people in Mexico who have COVID-19 and flee north due to subpar medical care? How can Americans be expected to shoulder the burden of both a reintroduction of the virus into the country and the lockdown policies as a result? Wouldn't it have been better for the CDC to open a field hospital right at the border to treat these patients rather than bringing them into the interior?

One thing is clear: With all the panicked media stories and political decisions built on the surge in cases in the southwest, the most serious factor driving the surge continues to be ignored.

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