Presidio has had four deaths since June — but no new testing sites

"People call and ask me, 'When is the next scheduled testing?' It breaks my heart that everything is being done in Marfa, and not in Presidio."

PRESIDIO — Presidio and Marfa have so far had about the same number of total confirmed coronavirus cases, but Presidio has accounted for all of the county’s four deaths. It’s a troubling piece of data that indicates larger problems in Texas’s COVID-19 response.

The border city saw its first death in late July, when a 91-year-old man with coronavirus died at the Medical Center Hospital in Odessa on July 31. Within days, it would see two more: 72-year-old and 41-year-old male residents of Presidio.

On Monday of this week, Presidio County Judge Cinderela Guevara announced a fourth county death: a 71-year-old male Presidio resident died at the Lubbock Medical Center on August 7, according to the news release. Meanwhile, Marfa has had no deaths.

In terms of sheer numbers, Presidio appears to be doing better than Marfa. At press time, the border city had 27 cases, compared to 34 in Marfa, despite the fact that Presidio has more than twice as many residents.

But looking at other statistics, the data from Presidio doesn’t add up. If Presidio really had just 27 cases, then those four deaths would give it one of the highest death counts in the world, at around 15%.

For comparison, the average national death rate in the United States is just 3.1%, according to data from Johns Hopkins University. Even Italy, where the virus hit hard early among the country’s elderly population, was lower, at 13%.

Based on current state-provided information, Presidio County ranks number 10 among Texas counties for the highest rates of deaths per reported cases. When a death rate is that far off from average, it’s likely that either the population is more vulnerable, that a large number of infected people haven’t been tested, or both. Across the state, testing and reporting struggles are keeping case counts low and death rates high.

Texas now has the 15th-lowest testing rates per capita in the country — a rate better than June, when it had the seventh-lowest testing in the United States, but nonetheless lagging behind the country’s average. And it has seen a slew of other problems as well, from backlogs of tests and results to issues with some of the companies it’s hired for testing.

Testing might not seem so bad in Marfa and Alpine, where residents have recently seen testing sites every two weeks. But in Presidio, where the last public testing site was in June, local officials are sounding the alarm about the need to gather more and better data on Presidio city infections.

Currently, with no drive-through testing scheduled in Presidio, residents seeking testing will either need to travel to get free testing, or visit Presidio’s Preventative Care Health Services clinic, which is providing tests to those who have coronavirus symptoms.

But even as drive-through sites have dwindled, PCHS hasn’t seen a big uptick in the number of people asking to be tested there. “It’s been low, like three or four patients a week, so there’s not a lot of people who have been tested,” said Linda Molinar, CEO of PCHS. “We have a lot of people that call wondering if there’s random tests, but for us it’s [about] taking care of the people who are really sick.”

And at PCHS, many will have to open their wallets — a deterrent for some looking to get tested. “Most insurance companies are paying for it,” Molinar said, and “if you have no insurance, the federal government allows us to temporarily bill directly to them and they’ll reimburse us for that.” Still, the appointment that decides whether you need a test can cost anywhere from $25 (if a patient has no insurance and is low income) to $200.

Presidio could try to fund and run its own testing sites with funding from the Federal Emergency Management Agency or the CARES (Coronavirus Aid, Relief and Economic Security) Act. Gary Mitschke, the emergency management coordinator, has said he’s considering using CARES Act money to buy limited tests for first-responders.

But it’s unclear if cash-strapped Presidio could pay to regularly test its residents — not least as the coronavirus crisis continues to stretch budgets. At a meeting in April, City Administrator Joe Portillo estimated the city would see a shortfall of around $800,000 due to coronavirus and coronavirus lockdowns, or around 25% of the city’s normal budget.

As cases and deaths have climbed in Presidio, officials in the city are growing impatient with the lack of testing, as The Big Bend Sentinel previously reported.

“Presidio has a bigger population than Marfa,” Malynda Richardson, the city’s EMS director, said. “Presidio has people that are moving back and forth across the border more frequently — and we have a population that’s very at risk.”

So far in the coronavirus crisis, Marfa has had eight testing sites, while Presidio has had four. At a Presidio City Council meeting last week, after officials announced another testing site in Presidio County, Portillo lamented the fact that “the location, again, is in Marfa.” He said he’d spoken about the issue with Presidio County Emergency Management Coordinator Gary Mitschke, who told him the Texas Division of Emergency Management, which runs the testing sites, was “overwhelmed” and “short on people” and wanted testing sites in central locations.

For now, that means Marfa and Alpine are getting tests rather than any of the more far-flung towns in Presidio or Brewster counties. In a phone call on Tuesday, Stephanie Elmore, the emergency management coordinator for Brewster County, confirmed she was also having trouble getting more testing for Terlingua and Marathon rather than just Alpine.

In an email last week, Elmore asked a TDEM official if there was “any way” she could request testing for Brewster County’s smaller communities, so that residents didn’t have to travel to Alpine for testing. But the TDEM official explained that unfortunately, the answer was probably no.

“We would like to honor your request for additional testing in Marathon and Terlingua,” he wrote, “but since we are down to one team for 35 counties, not including El Paso County, it is hard to schedule this.”

“I know that TDEM would like to schedule testing at additional locations,” he added, “but until something changes, we are limited on the testing sites for all our counties in Region 4.”

At the city council meeting, Portillo said he understood why officials wanted testing in Alpine. But “in Presidio County,” he stressed, “the most populous city is Presidio.”

Marfa residents could easily get to Alpine, Portillo said. But for Presidio residents, getting tested in Marfa could mean a two-hour round trip drive.

Alcee Tavarez, mayor pro tem, said residents have been asking him when they could next get tested. “It breaks my heart that everything is being done in Marfa and not Presidio,” he said.

Mitschke has said he’s tried to schedule more testing in Presidio city. But TDEM, he said, wants to consolidate and centralize testing locations.

In a statement to The Big Bend Sentinel, a TDEM spokesperson confirmed this was true — though he stressed that, with private contractors like Honu and Curative now helping out state efforts, there were the same number of testing resources as ever.

“In west Texas we are working with local emergency management officials to centralize testing so that the test sites are accessible to as many Texans as possible in the region,” the statement read. “We appreciate the continued partnership with local officials from across the state as we work together to corral COVID-19.”

In an interview on Tuesday, Judge Guevara said she’d “definitely” like to see more state testing resources in Presidio. The border city, she noted, has “a lot more citizens.”

When Governor Greg Abbott visited El Paso last week, Guevara said regional officials brought this issue up with state ones. But at that meeting, Judge Guevara said, state officials once again reiterated that they were centralizing testing.

Guevara wasn’t satisfied. “We definitely need to get a better picture of what’s happening in Presidio,” she said, “even if that means that [Marfa and Presidio] take turns.”

For now, county and state officials appear stuck in gridlock. State agencies like TDEM say they’re centralizing testing to reach as many residents as possible, while county officials like Guevara are continuing to call for more Presidio testing.

It remains to be seen if that will change anytime soon, or if Presidio County will find a workaround. But in the meantime, Judge Guevara is continuing to urge residents to protect themselves. In her news release this week,  she urged residents to practice the “three W’s”: wearing masks, washing hands and watching their distance around other people.

Ultimately, Presidio’s continued lack of testing may come down to geographic luck. Marfa is at the crossroads of two highways, with easy access to nearby towns like Fort Davis, Valentine and Van Horn. Presidio, on the other hand, is the last stop before Mexico, and has few nearby stateside neighbors except for small borderline ghost towns like Candelaria and Ruidosa.

Still, the lack of testing fits into another troubling pattern in Texas, in which borderlands communities seem to be disproportionately impacted by coronavirus. Take the Rio Grande Valley on the other side of the state, where Peter Hotez, a prominent disease researcher from Houston, has said a lack of medical resources and state support have created a “humanitarian tragedy.”

On Tuesday, Presidio County’s numbers spiked again, as county officials announced 12 new cases — bringing the total count to 62. The news was already out-of-date, with at least seven of those 12 new patients already released from quarantine. Currently, there are six active cases in Presidio.

On Wednesday, officials at Presidio Independent School District learned that a high school student had tested positive for coronavirus, Ray Vasquez, the district’s superintendent, said in an email. PISD notified local health authorities and closed all campus buildings as a precaution.

Meanwhile, an employee at Presidio City Hall also tested positive, city officials learned Wednesday. The city is currently working on its response to both incidents.