Focus on Arts and Ecology

AMY GOODMAN: Over 1,700 people died from COVID Tuesday in the United States. It’s the deadliest day of the pandemic in at least six months. As public health officials across the country brace for a COVID-19 surge from the Thanksgiving holiday and already record-high infection rates, some Republican governors are dropping their resistance to mask mandates, including Iowa Governor Kim Reynolds, who imposed a limited mask mandate Tuesday. But many of these same governors continue to hold off on implementing other public health measures.

In Texas, where coronavirus cases have reached record highs for a second time in the pandemic, Governor Greg Abbott says no new lockdown is coming. He’s even pushing back on local policies in places like El Paso County along the Mexico border, which is facing one of the worst COVID-19 outbreaks in the country. After the Texas attorney general sued to stop an order closing nonessential businesses in El Paso, a Texas appeals court agreed with the challenge Thursday, which allowed businesses to open the next day. About 80% of El Paso residents are Latinx. The county now has 10 mobile morgues to hold bodies. Some prisoners are being paid just $2 an hour to move the bodies as the numbers of cases and deaths has completely overwhelmed the hospitals. They are moving the corpses.

A traveling nurse who worked at the El Paso University Medical Center spoke out about what she called a “horrific” scene for patients with COVID-19. In a Facebook video earlier this month, Lawanna Rivers also described a room she calls “The Pit,” where she says patients were sent to die with minimal treatment.

LAWANNA RIVERS: They did not aggressively treat them as they should have. And according to their staff, the doctors at that hospital wasn’t aggressive before COVID, but even with COVID. So, I saw a lot of people die that I feel like shouldn’t have died. Y’all, that assignment there broke me. I was put in what’s called a “Pit.” And in this Pit was eight patients, all COVID-positive. My first day of orientation, I was told that whatever patients go into the Pit, they only come out in a body bag. …

The patients that we coded, we were not allowed to bag them, because we would get too much exposure, which I hadn’t seen. And because they were COVID-positive, this hospital’s policy was they only get three rounds of CPR, which is only six minutes. This, out of all the codes that we had there, there’s not a single patient that made it. Y’all, when I say this assignment here, like, literally almost destroyed me. Like, I called my husband from there. I called my best friend from there. And I just cried, and I just said, “What I’m seeing here is just not right.”

AMY GOODMAN: That’s visiting nurse Lawanna Rivers describing a hospital in El Paso.

Well, for more, we go to El Paso to speak with Dr. Emilio Gonzalez-Ayala, a leading pulmonary disease and critical care specialist.

Thanks so much for taking the time, Dr. Ayala, to speak to us today. If you can start off by describing the situation in el Paso, so extreme that the county administrator tried to put major restrictions in El Paso, and the governor prevented them from being implemented?

DR. EMILIO GONZALEZ-AYALA: Yeah. Unfortunately, we’ve been facing these decisions by the government of the state. And, obviously, as you mentioned before, the mandate to close nonessential businesses has impacted us in a significant way, because we continue to see the surge of numbers in the hospitals, in the ERs throughout the city, and we’re at capacity. We’re beyond the limit where we can continue to admit to the hospital patients that come in critically ill, and we’re flying them out directly from the ER to other hospitals in the state where they can be admitted and treated. We are keeping a large number of intubated, mechanically ventilated patients in the ER, waiting for beds to open in the ICU. But sometimes these patients are too unstable and too critically ill to continue waiting there, so we need to make space for them by either moving the stable patient in the ICU or flying out the stable ones that are in the ER.

JUAN GONZÁLEZ: And, Dr. Gonzalez, I wanted to ask you about also the situation in Juárez, which is across the border, right across the border. It’s often called the sister city of El Paso. It’s actually — some people would argue that El Paso is actually a suburb of Juárez, which is a much, much bigger city. Your sense of how the close relationship between these two cities has affected the COVID pandemic one way or the other?

DR. EMILIO GONZALEZ-AYALA: Well, it’s the same city, in essence. It’s called a metroplex, Juárez-El Paso. And, obviously, we have a lot of patients that are U.S. residents and U.S. citizens that reside in the other side of the border, and they can come in legally, obviously, and request to be seen and treated in El Paso, as they’re rightly citizens or residents. And, obviously, we’re seeing those patients come across the border. That impacts also our ability to continue to treat patients in the hospital. And they’re at capacity, as well. There is no place in Juárez, no hospital in Juárez, that has available beds. So, it’s the same situation, in essence.

JUAN GONZÁLEZ: And this whole —

AMY GOODMAN: Dr. Gonzalez — oh, sorry. Go ahead, Juan.

JUAN GONZÁLEZ: This whole issue of the refusal of state officials to allow the municipality and the local officials to implement the kinds of restrictions on public gatherings that you want to have, what’s the impact of that on your being able to curb the pandemic?

DR. EMILIO GONZALEZ-AYALA: Well, obviously, we are not going to be able to curb that surge in numbers without those mandates. Obviously, we’re entering the influenza season, and we already are seeing patients presenting with both infections, with influenza and with COVID. Obviously, that doesn’t help at all.

We’re pleading with the public to avoid visiting or bringing in visitors during the holidays. Thanksgiving is in the next couple of weeks. We’re asking them not to relax precautions, and to avoid getting even their neighbors into their houses to celebrate. I think if we want to continue to celebrate these holidays next year, we need to sit out this one.

AMY GOODMAN: Can you talk, Dr. Gonzalez-Ayala, about the rationing that we’re hearing? We’re hearing that the county judge, Ricardo Samaniego, has said that care is being rationed in El Paso hospitals. And can you talk about what that traveling nurse said, the horror of nurses working in “The Pit,” leaving — doctors not being able to go into that area, or not going into that area, people just being left to die, and then prisoners being paid something like $2 an hour to move corpses — we’re talking 10 mobile morgues that have been set up — all of this?

DR. EMILIO GONZALEZ-AYALA: So, I am in private practice. Although I have privileges at University Medical Center, I don’t practice there, so I cannot speak to the situation at UMC. I haven’t been there in a while. I am familiar with the Facebook video that this nurse posted. I know my colleagues in UMC and Texas Tech University Health Sciences Center, which staff that hospital, very well. And I’m not sure that I can fully believe that account. These are very humane, very ethical, very professional physicians. I don’t see that really happening. I doubt it, but I haven’t been there.

I can tell you that care is not being rationed in the private hospitals where I practice. Yes, we’re overstretched. We are having to receive help from FEMA with physicians, nurses, respiratory therapists, nurse practitioners. We’re grateful that we’re receiving this help to staff the hospitals and continue to deliver the care that we, alone, the people that live here in El Paso, the physicians that work here in El Paso, cannot provide on our own without that help. But we are not rationing care. I mean, we’re limited by the number of beds we have available, but we’re not deciding who lives and who dies. And that would be unethical and illegal. So, I don’t see that happening at this point in the facilities where I practice.

JUAN GONZÁLEZ: And, Dr. Gonzalez, I wanted to ask you about the — as a frontline worker facing this pandemic, not only the problems that you see at the state level, but also at the national level, when you find that the White House itself often makes contradictory statements to those of the health professionals at the Centers for Disease Control and the National Institutes of Health. Your sense of what the impact of these mixed messages from the political leadership has, the impact it has on your ability to work on the frontlines?

DR. EMILIO GONZALEZ-AYALA: Well, I think that the medical community has better judgment and understands that when, for example, Dr. Fauci speaks, he speaks with the truth. And I think we mostly follow his advice. He’s an authority not only in the country, but worldwide. And even though we have a lot of political [inaudible] coming out from Washington, for the most part, what comes out of Dr. Fauci and most of what the CDC puts out is good advice, and we tend to follow it, for the most part. When I hear this political messaging, I filter out what doesn’t make sense to us from a scientific or medical standpoint.

AMY GOODMAN: Can you talk, Dr. Gonzalez-Ayala, about Thanksgiving and what this means for El Paso? What message are you putting out right now? And also, if you could talk about being a pulmonologist and what that means, the kind of deadly combination, if you could talk more about the flu, as well as COVID?

DR. EMILIO GONZALEZ-AYALA: Well, the message we’re trying to send, again, is, please, to everybody, avoid celebrating in person. It sounds terrible. It sounds like a draconian measure. But we’re asking people not to go and visit anybody. I’m following up with patients that have recovered already from COVID over the last few months in my office via telephone encounters, and I have a lot of patients asking, “Hey, Dr. Gonzalez, can I go and visit my relatives in Houston or my relatives in California?” I’m pleading with them, “Please, don’t go anywhere. Stay put. Even though you already caught COVID and we assume you have some immunity, you can still catch another virus. You can catch influenza. Stay put. Don’t go anywhere. And sit out this holiday so you can celebrate next year.”

Now, to the question of what it means to be a pulmonologist and dealing with this, I think that it’s the experience that I had never been exposed to. We’re seeing this go completely beyond the point where we usually see it with the influenza peak in the months of January and February, where we have, yes, a lot of patients waiting for beds in the ER, but never to this extent. It’s way beyond. Never seen it before anywhere, and I’ve worked in Miami, and I worked in Houston and, obviously, here in El Paso. I have never encountered these kinds of extremes, where we’re overrun with patients that are critically ill.

AMY GOODMAN: Well, Dr. Emilio Gonzalez-Ayala, we want to thank you so much for being with us, leading pulmonary disease and critical care specialist.

This is Democracy Now! When we come back, we go from El Paso, which is one of the hot spots of this country, to North Dakota, which currently has the highest COVID-19 death rate in the world. We will talk with a member of the Standing Rock Sioux Tribe, and we’ll go to Navajo Nation in Arizona, which is now going through yet another lockdown. Stay with us.