A steady stream of pedestrians cross the Paso del Norte Bridge from El Paso into Ciudad Juárez in October. Both cities were dealing with a huge increase in COVID-19 cases at the time. (Corrie Boudreaux/El Paso Matters)

When Mexico’s president traveled to the White House last summer, U.S. Rep. Veronica Escobar urged President Donald Trump to put discussion of a binational coronavirus response plan at the top of the agenda.

But that topic didn’t come up during their July 8, 2020, conversation, based on the readout of their first in-person meeting since the pandemic struck.

The virus was a blip in public remarks Trump and Andrés Manuel López Obrador made to mark the start of a revised trade agreement. “We’ve also worked in the battle against the coronavirus together,” Trump said, noting the United States had sent Mexico 600 ventilators with more to come.

Asked what joint federal efforts were made to control the spread of the virus in communities straddling both sides of the U.S.-Mexico border, experts and local officials point to a single endeavor: the border restrictions, in place since March 21, 2020, largely at the behest of the U.S. government.

“I sounded the alarm to the Trump administration very early on, but it couldn’t have been more clear that the former president had no national strategy,” Escobar, D-El Paso, said of her push to keep El Paso-Juárez safe. His strategy, she said, was “to surrender to the virus.”

In the absence of a binational public health strategy, Texas border communities, which have some of the state’s highest poverty rates and large numbers of uninsured residents, were among the hardest hit. Since July 1, El Paso and Hidalgo counties have had the highest COVID-19 death rates of the nation’s urban counties.

An ambulance worker adjusts a patient’s oxygen mask as they wait to find out whether she will be granted admission to the Hospital General in Ciudad Juárez in November 2020. (Corrie Boudreaux/El Paso Matters)

Chihuahua and Texas health officials have reported more than 5,300 deaths in the El Paso-Juárez region, home to 2.2 million people — a count that slightly trails Harris County, which is double in size.

“This is what happens when we don’t adequately think about ourselves as one region that shares our ups and downs, and that needs to happen at the highest levels of government,” Escobar said.

Under-funded, non-existent coordinating agencies

Though the countries share a 2,000-mile-long border, the lack of binational collaboration isn’t a surprise, said Tony Payan, director of the Center for the United States and Mexico at Rice University’s Baker Institute for Public Policy.

“Trump really didn’t believe in working with other countries,” he said.

Trump and López Obrador hold similar outlooks toward the coronavirus, publicly downplaying its severity, eschewing masks and continuing to hold political rallies, even after each contracting the virus. The United States has the world’s highest number of COVID-19 deaths, while Mexico has the third highest.

Binational collaboration was hindered by under-funded and non-existent coordinating agencies, Payan said, pointing to the 2014 closure of the Pan American Health Organization/World Health Organization’s El Paso field office, which focused on communicable diseases in the borderland.

“When you dismantle the organizations that might have had the resources, budget, personnel, expertise and the organizational wherewithal to sit down and think through the pandemic, its patterns and what to do about it, it should not be surprising that the cities and the borderlanders were on their own,” Payan said.

Residents of Juárez hope to buy oxygen in October 2020 for their family members who are sick with COVID-19. Hospitals in Juárez were nearly at capacity and oxygen had become scarce in the city. (Corrie Boudreaux/El Paso Matters)

Escobar is pushing for greater funding for the U.S.-Mexico Border Health Commission, which falls under the U.S. Department of Health and Human Services and provides “the necessary leadership to develop coordinated and binational actions” to improve health across the borderland, according to HHS’s website.

The Trump administration “paralyzed” the U.S. section of the commission, said Eva Moya, an associate professor of social work at the University of Texas at El Paso. The commission’s El Paso office has lost staff and the commission was without a manager for much of the pandemic, she said.

Information on its activities and funding levels is scarce, if non-existent. HHS did not respond to requests to interview U.S.-Mexico Border Health Commission members.

Dr. José Manuel de la Rosa, provost and vice president for outreach and community engagement at Texas Tech University Health Sciences Center El Paso, said he was unable to speak in his role as a commission member. He has served on the commission since President W. Bush appointed him in 2003.

“I don’t see any leadership presence around the U.S.-Mexico border,” Moya said. “I don’t see programming that is (done) jointly with our Mexican counterparts.”

This month, Escobar refiled a bill directing the commission to develop a binational strategic plan for how the borderland “should strengthen its response to COVID-19, with a focus on testing, contact tracing, and other infection prevention and control measures.” The bill also tasks the commission with creating a plan for distributing the vaccine across the borderland.

Local binational pandemic efforts have been limited

Binational coordination has mostly happened at the local level in the form of information sharing between local officials, universities and nonprofit organizations, de la Rosa said.

Chihuahua state health secretary Eduardo Fernández toured University Medical Center of El Paso and UTEP’s mass vaccination sites last month to learn best practices. UTEP has agreed to share its vaccine registration and appointment software with Chihuahua health officials to accelerate the vaccine rollout in Juárez.

Chihuahua state health officials visited the University of Texas at El Paso’s vaccination clinic on Feb. 22 to learn more about best practices to prepare for when there is a steady supply of vaccines in Mexico. (Angela Kocherga/KTEP Public Radio and El Paso Matters)

Mexico’s vaccine rollout has been slow, hampered by shortages and delays in supply. It has vaccinated health care workers and is now focused on people over age 60.

El Paso officials were limited in their ability to create a cohesive health strategy with their Juárez counterparts, El Paso County Judge Ricardo Samaniego said.

“The moment that we would have gone into a regional focus, then we could have created regional guidelines — you can’t really create regional guidelines in such an informal relationship of fighting COVID-19,” he said.

Over the summer, Júarez Mayor Armando Cabada asked El Paso’s mayor and county judge for help supplying his city with testing materials, but federal restrictions limited El Paso from doing so, as well as from sharing other medical supplies.

With limited public testing and private tests out of reach for many, Juárez instead focused on a prevention campaign.

Though the cities’ coronavirus measures have at times closely mirrored one another, they diverged after Texas Gov. Greg Abbott stripped local officials of their ability to set restrictions on businesses.

Impact of border crossing restrictions

Solely closing the U.S.-Mexico land border to “non-essential” traffic was a flawed approach to curb the spread of the virus, experts say.

U.S. citizens, legal permanent residents and work visa holders are still able to cross freely. Though crossings are not at pre-pandemic levels, tens of thousands of people cross monthly, so much so that Juárez’s mayor implored the Mexican government — unsuccessfully — to ban U.S. citizens from entering the country for “non-essential” travel at the outset of the fall case spike.

The restrictions are currently in place through April 21. As of Friday, Mexico said it will also restrict non-essential travel at its northern and southern borders, though it appeared Friday the new restrictions weren’t being implemented at Juárez’s ports of entry, the El Paso Times reported.

Escobar is hopeful the Biden administration will adopt meaningful binational measures to eliminate the virus along the border. She was encouraged by López Obrador’s request for help securing vaccines when the presidents met virtually March 1.

“I think that’s a good step that the Mexican president acknowledges that we’ve got to work together,” Escobar said. “But I do want Mexico to prioritize (vaccinating) border communities because if we’re going to help our neighbor, my perspective is that help has got to flood areas where we are most closely intertwined.”

The White House on Thursday said the United States plans to loan 2.5 million AstraZeneca vaccine doses to Mexico, which is home to close to 130 million people. That vaccine has yet to be approved for use in the United States.

The Biden administration has said it will share surplus vaccines with other countries once every American is vaccinated.

Beyond sharing vaccines, the United States needs to rebuild its channels of binational communication and coordination, Moya said.

“Sickness and disease risks know no borders — they travel at will, they impact at will and they kill at will,” she said. “In health, we have an incredible opportunity to cooperate, collaborate and communicate.”

Cover photo: A steady stream of pedestrians cross the Paso del Norte International Bridge into Ciudad Juárez in October 2020. Both cities were dealing with a huge increase in COVID-19 cases at the time. (Corrie Boudreaux/El Paso Matters)

This story was produced as part of the Puente News Collaborative, a binational partnership of news organizations in Ciudad Juárez and El Paso. 

Molly Smith has been a reporter for the El Paso Times and The (McAllen) Monitor. She’s covered education, criminal justice and local government. A Seattle native, she’s lived in Texas since 2014.