Departure of top health official leaves tri-county struggling with data 

ALPINE — It’s now been more than two weeks since Brewster County had a local health authority, after Dr. Ekta Escovar, a pediatrician at the Big Bend Regional Medical Center, resigned in September. And finding a replacement has been a struggle, Eleazar Cano, the county judge for Brewster County, said at a county commissioners court meeting this week.

Before Dr. Escovar resigned, she was a regular target of anger and criticism from those in the tri-county who opposed mask orders and other precautions, as The Big Bend Sentinel previously reported. And those issues have made other doctors wary about signing up for the role, Cano said.

After speaking to five doctors, Cano said that so far at least, “there are no takers.” He noted that doctors are already busy, that the position is unpaid and that many did not want to deal with the drama of becoming a public health official in a region where coronavirus precautions are a source of arguments and controversy.

“They felt like the community was not supportive [to Escovar] and that it was real tough to be in that position,” Cano explained. There was “criticism with not a lot of support.”

In the meantime, the tri-county has had to make do with less good data. When Brewster County still had a health authority, the county gave daily updates on everything from hospitalizations and deaths to pending test numbers.

Dr. Escovar also gave regular presentations to city and county officials, relaying in simple terms how the region was doing. And because Brewster County has the largest population in the tri-county as well as the only university and hospital, government officials and journalists throughout the region also benefited from those updates.

Now, the region is getting less accurate numbers. At the commissioners court meeting, Stephanie Elmore, the emergency management coordinator for Brewster County, said she could only get certain updates from the state, including deaths, active case counts and total case counts. Much of the other state data contains private medical information and therefore is not available to non-doctors, she said.

Mike Pallanez, a commissioner, asked why he was seeing higher local numbers on CBS 7. At press time, the county was reporting 226 confirmed cases in Brewster County and the state was reporting 233. But the numbers he saw on television for the county were higher, he said.

“When we did have an LHA [local health authority], the numbers were more accurate and to-date,” Elmore agreed. But with Dr. Escovar out as local health authority, “we don’t have that access.”

Judge Cano agreed, noting that Dr. Escovar “went above and beyond” in her duties. The types of data issues Brewster County was now experiencing were “more typical” for small counties, he said.

Big counties like Houston’s Harris County have health workers who sort through this information, he said — but Brewster County just had Dr. Escovar. “We were almost kind of spoiled,” Cano said. “Now, we’re feeling the pinch.”

In the meantime, Dr. Rachel Sonne, the administrator of DSHS Region 9/10, is acting as Brewster County’s fill-in local health authority. But when The Big Bend Sentinel called her for comment this week, an employee at Region 9/10 said that, because Sonne is an employee of DSHS, all questions had to be directed through the state media office in Austin.


These troubles are happening at the same moment that Texas officials are fumbling state data and the tri-county is seeing a rise in cases. Last week, at least 10 cases were identified at Marfa public schools. But by Monday, those cases still weren’t included in state data.

By Tuesday, the state numbers were at least mostly up-to-date. But in the meantime, the lack of information is adding to concerns in the region.

Almost 1,000 people were tested in the tri-county last week. At press time, though, it’s still unclear how many of those tests are pending. It’s not even clear how many people have so far received positive results.

Elmore, the emergency management coordinator, helps put together Brewster County’s daily coronavirus updates on social media. But with Elmore not serving as a health official — and therefore depending on Dr. Escovar to get confidential local data — she was no longer getting as much information, she said.

Coupled with rising local case numbers, the issue is already affecting official decision-making in the region. Erik Zimmer, the city manager of Alpine, said the city was having to make do with less data.

“Since Ekta stepped down, the county hasn’t provided anything,” Zimmer said. “Right now, I’m concerned.”