EL PASO, Texas (KTRK) -- El Paso has been so depleted by the coronavirus that the county's makeshift morgues are relying on jail inmates to move bodies, and hospitals are nearing a point where health workers could have to decide who gets care and who doesn't.
And in their attempts to stymie the deadly virus with dwindling resources, local officials have faced both passive and active resistance from Texas leaders.
After a plea for help from the Texas Army National Guard to help at the overflowing morgues, Gov. Greg Abbott, who serves as commander-in-chief of Texas military forces, said the guard was available but first directed El Paso County Judge Ricardo Samaniego to use county resources. The governor has also spoken out against the county's now-halted shutdown of nonessential businesses. Attorney General Ken Paxton slammed Samaniego for the order, calling the judge a tyrant trying to kill small businesses and holiday gatherings.
But the region is desperate, Samaniego said.
"We don't have the personnel," he told The Texas Tribune on Monday. "We're at a point where we start thinking of rationing health care - who's going to get what? We're not there yet, but we're pretty close to it."
El Paso has been devastated by the pandemic for more than a month. On Tuesday, the county reported 994 new cases of the virus after reporting 1,550 Monday. The county total of about 76,000 cases this year means El Paso has surpassed Bexar, Travis and Tarrant - counties with far greater populations.
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Of the 1,120 patients currently hospitalized with COVID-19, 313 are in intensive care, according to county statistics. Nearly 800 people have died.
Refrigerated trucks are serving as temporary morgues, and the local convention center has been transformed into a makeshift field hospital, with patients being airlifted to out-of-town facilities to free up bed space in local hospitals. As of Friday, at least 63 patients have been transported from three local hospitals, said Ryan Mielke, a spokesperson for University Medical Center. He added that while there have been discussions of rationing care across the county, local doctors "haven't gotten to that point."
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The U.S.-Mexico border county, which is 83% Hispanic, being so hard hit by the virus is emblematic of the pandemic's racial disparities. About 55% of Texans who have died of COVID-19 were Hispanic, according to state data, while only about 40% of the state population is Hispanic. Experts have noted the disparities stem from Hispanic residents being more likely to work in service jobs, live in multigenerational households that make distancing difficult, and have health problems. They are also less likely to have health insurance.
The tragedy in El Paso was most recently highlighted over the weekend when reports emerged of the county turning to jail inmates to move bodies to the temporary morgues while the medical examiner's office and funeral homes failed to keep up with a rising number of COVID-19 deaths.
The sheriff's department said up to nine inmates from the jail have been working for the medical examiner's office for more than a week. The inmates are paid $2 an hour, a rate offered after none in the jail volunteered to work without pay, Chris Acosta with the El Paso County sheriff's office said Sunday. Samaniego said the inmates are all serving misdemeanor sentences.
The reports raised concerns of exploiting and endangering inmates as well as the untrained handling of bodies. Acosta said the inmates wear protective gear and are being housed together at the jail while they take on the grueling work. At the beginning of the month, the jail had about 2,300 inmates, and as of Tuesday, 62 inmates and 34 jail staff were confirmed to be actively infected with the coronavirus, according to the Texas Commission on Jail Standards.
Some local defense attorneys are hoping the county's misdemeanor judges or Abbott will pardon the volunteer inmates and clear them of their sentences - which for a misdemeanor conviction would be at most one year in jail.
"They're volunteering to do something that I can't imagine what it's doing to them mentally," criminal defense attorney Justin Underwood said. "They're El Pasoans, they live here with us."
An Abbott spokesperson did not respond Tuesday to questions on potential pardons for the inmates.
The county, however, hopes the inmates' work is temporary. Samaniego said the county turned to inmates after other volunteers quickly backed away from the "very traumatic" and physically demanding work. Local emergency management officials have asked for help from the Texas National Guard but as of Tuesday evening were still waiting on an answer.
"It ... sends a signal now for how difficult it is, for us to be using inmates," Samaniego said. "We'd rather move away from it and have the Texas National Guard take over the - I hate to say it, but - fatalities management part of our operation. They're very good at it, they're used to doing it in disasters and earthquakes and things like that."
El Paso Democrat César Blanco, a state representative and state senator-elect, said Tuesday his office was told a 30-person team of National Guard soldiers has been assembled to perform "mortuary duty" in El Paso. He said the exact duties are still unknown, and it's unclear if the team is local National Guard soldiers or troops being sent in from other areas.
Samaniego said Tuesday evening that the county's request for the Texas National Guard to help at the morgues was still pending and that inmates were still working for the medical examiner.
The Texas Military Department had not responded to multiple requests for comment on the county's plea by Tuesday evening. When the governor was asked Monday if he would dispatch Texas military troops to the region, Abbott - who has sent protective gear, testing sites and temporary hospital units to the county - did not make clear if or when the guard would help at the morgues.
"The State of Texas has and will continue to mobilize resources to the El Paso area, including the National Guard, which has been activated since March, and they remain at the ready to assist in any way possible," Abbott spokesperson Renae Eze said in a statement. "In the meantime, the county judge must start using the trained personnel he has at his disposal, such as the local fire department, to assist in this effort."
Fire departments in the city and county of El Paso already have numerous emergency responsibilities during the pandemic, according to fire officials. The El Paso Fire Department is handling testing sites, public education and enforcement and helping with emergency management, a spokesperson said. Roger Esparza, fire marshal for one of the county's emergency services districts, said his unit also handles testing, but its main task has been responding to residents' many emergency calls regarding difficulty breathing or other COVID-19 symptoms.
Samaniego said the county is still waiting to see if the guard will help, noting it's a decision of how to allocate resources. And other parts of the state, like Dallas, are starting to see similar trends of more than a thousand new cases a day in what is expected to be the largest peak of the virus since it hit in March.
"El Paso always gets the short end of the stick when it comes to something from the state," Samaniego said. "What's going to happen when they all need it?"
It's the second time in less than a week that Samaniego has criticized state leadership for slighting El Paso. After Paxton tweeted in celebration of a state appeals court ruling that struck down Samaniego's shutdown of nonessential businesses, the judge questioned whether Paxton considered El Paso an afterthought.
"So unfortunate that Paxton, the 'Texas' Attorney General finds the opportunity to gloat instead of coming to El Paso to walk along side me by the mobile morgues with 144 El Pasoans; or send his condolences to the families of his 741 constituents who died of COVID-19," he tweeted. "I guess El Paso is too far for Paxton to comprehend that we too are his constituents.
Samaniego said that despite the court's ruling, he'd continue to find a legal way to restrict nonessential business operations to curb the outbreak.
But his efforts have also caused a rift between the county and El Paso Mayor Dee Margo. Margo has tried to craft a more balanced approach where businesses remain operational but under stricter guidelines. Last month, he ordered that nonessential businesses scale back to 50% capacity and limited restaurants to offering only takeout after 9 p.m. Abbott said then the mayor was acting under state guidelines.
"Local officials do have levels of flexibility to make sure they are able to contain the spread of COVID-19, and it appears that is exactly what Mayor Margo is doing," Abbott said.
Meanwhile, front-line workers are backing Samaniego's efforts.
National Nurses United, a nationwide organization with more than 2,000 members in El Paso, organized a car caravan protest Monday in support of a temporary shutdown.
"The RNs say the community can help stop the spread of the virus and protect themselves and health care workers by staying home," the local group said in a statement.
The Texas Tribune is a nonprofit, nonpartisan media organization that informs Texans - and engages with them - about public policy, politics, government and statewide issues.
El Paso is fighting the coronavirus and state resistance as officials desperately try to keep up with sick and dying Texans