‘We've got to get moving’: Imperial County’s fight against COVID-19

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Imperial County has one of the highest percentages of COVID-19 deaths in California. The mainly rural, agricultural area shares a border with Arizona and Mexico. Many of the 180,000 residents are Latinx. The area is also among the poorest counties in California. 

KCRW speaks with Dr. Adolphe Edward, CEO of El Centro Regional Medical Center in Imperial County. 

KCRW: Governor Newsom singled out Imperial County for a complete shutdown a little more than a month ago. Patients transferred to other counties in the state because hospitals were stretched. What's the current situation like right now?

Dr. Adolphe Edward: “It's much better, where total numbers are down in terms of our COVID positive. It's 50% down from about a month ago. We're down to 31 COVID positive patients out of the total 92 that we have in beds. And our total ICU numbers are down as well.”

There was an issue with ventilators at one point. Are those still in need?

“Ventilators will always be a need because of the type of patients that we are seeing under COVID. They have a high level of morbidity. They're obese, they're diabetic, they're asthmatic. So the complexity of the clinical care requires us to have vents that are comprehensive. … So definitely vents will continue to be an issue, and we continue on to try to prepare for the next wave.”

Are cases under better control now because of the local shutdown? 

“No, I don't think that just shutdown by itself. Of course it’s needed. Shutdown is a first step. But shutdown plus all of our messaging that we've been doing to the community, we want to actually have the citizens help us to change the behaviors. 

We cannot stop you from having a backyard get-together. But if the backyard get-together generates — out of the 14 that showed up — five or six COVID cases, that's problematic, right? So it's really the behavior of the citizens who are helping us slow down.

Also, the high heat maybe is helping — not because COVID knows heat or doesn't know heat — but because people are not gathering in their backyard anymore. So we're seeing a reduction in number.

We've been begging the population to put the mask on, and it's become more of a political issue. If we can just get over the politics piece of the mask, and just learn to live with the mask, I think that's going to help us greatly. 

So when you put all these pieces together, you start to see that reduction. But we shouldn't rest. We shouldn't think that this is the trend. We don't know what it's going to look like a month from now. And as I've said repeatedly, we're going to see slow down in August and mid-September, we're going to start to crank the numbers back up again. So let's make sure that we don't let our guards down.”

You liken the situation to medical crises you've worked on in other countries. Can you tell us more about that? 

“Absolutely. We are the leaders of the free world. This is the United States. We always rise when there is an issue like a pandemic. We declare war on the pandemic and we'll win, right? But we've got to get moving. 

We cannot continue to treat our patients in tents. This is what we use when we go to third world countries to try to help them. We've had Air Force officers, physicians, intensivists that were carrying ICU backpacks …  going across the world helping patients. 

But that's not what we want to see in the United States. What we want to see here is investment in the health care systems, increasing the capabilities at local levels like ours, because we're a border town. … We've got to look at that and say, ‘Have we made the right investment?’ And since we know the answer is no, when can we start to change that equation?” 

KCRW also hears from Luis Olmedo, Executive Director of Comite Civico del Valle, an environmental health organization in Imperial County.

KCRW: You've said that if there was a poster child for where COVID would thrive, Imperial County is it. What did you mean by that?

Luis Olmedo: “We have been dealing with endemics [epidemics] for a very long time. Many of these … have to do with health inequities, with environmental issues, climate crises, polluted rivers. For us, the pandemic just means that everybody else is experiencing the same thing we're facing. This has been ground zero for all those inequities, all those barriers that elevate the risks of having a severe outcome with COVID, even death.”

Environmental and health equities factor into everything. What role has pollution, for example, played in exacerbating the situation? 

“We have very serious issues, even before COVID. … The United States promises to deliver clean air, as well as California. This is their obligation. We have failed time and time again to deliver clean air to our region. So we do have compromised respiratory systems. COVID is a virus that attacks the respiratory system among all main organs of the body. 

We started this war on COVID with a disadvantage, within an area that is also medically underserved. These environmental issues are plaguing our neighborhoods, our communities. While the strategy has mostly been to the war on COVID at emergency care — triage the situation, rightfully so, save lives — we should have months ago engaged and deputized the nonprofits. [They’re] the organizations that have been dealing with this endemic [sic], addressing the inequities, removing the barriers, creating behavior changes. We're just now starting to see a glimmer of that. 

… Services tend to go to the more populated areas, the larger metropolitan areas. … Our economy here is interconnected and fluid with Mexico. People live in Mexico. Our essential workers come daytime to work here, whether it's agricultural, hospitality, retail, wholesale — all our business. Many people live on both sides. This is one community. 

Yet California looks at us as we’re just rural, sparsely populated. That is so far from the truth. And all these things have worked against us with COVID, put us at a disadvantage.” 

There was a report saying almost half of these farm workers are not receiving masks from employers. Are you seeing any positive changes?

“Yes. … The local agricultural coalitions, and the ag[ricultrual] commissioners, and private donors have been putting a lot of masks out there. Whether they're getting into the hands of the workers, I think there's perhaps some gaps there. … The law needs to mandate that they get replaced regularly, daily, even multiple times a day. 

I think that we're better off today, but we’ve still got a lot of work to do, especially at the border crossing. … We're going to be cooperating with the government of Mexico to get masks across and given to people who are crossing into the U.S., and make sure that when they cross that border that they didn't have any risk in doing so.”

— Written by Erin Senne and Amy Ta, produced by Nihar Patel