Horowitz: Texas border counties hospitalization rate is 5 times the national average

Horowitz: Texas border counties hospitalization rate is 5 times the national average


July 9, 2020

Daniel Horowitz


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America is unique in its experience of coronavirus in that it appears it will have to undergo both its own epidemiological curve and Mexico’s, because the two countries are evidently more closely tied together than even individual U.S. states are to each other.

I have written a three-part series showing how the most serious cases that began to surface in the country in late May/early June – after we had already experienced our peak – came from Mexico. You can read the series here, here, and here. Now there is more shocking evidence of this phenomenon.

The data from border counties is astounding

The three Rio Grande Valley counties – Starr, Hidalgo, and Cameron – have 1,139 hospitalizations currently listed as COVID-19 patients. In total, as of yesterday, they had 4,070 active cases when combining the county dashboard data of the three counties. That is a 29% hospitalization-to-case ratio. As of June 27, that rate for the country was 5.8% (14.7K hospitalizations out of roughly 253,000 active cases).
Hidalgo County recorded just 23 virus deaths from the beginning of March through June 23, but 80 deaths in the two weeks since then. The three border counties are 4.4 percent of Texas’ population but account for 12 percent of the hospitalizations. We don’t know at this point how many more from the border were transferred to the larger cities up north, as we saw with the border-crossers in California who were sent to the larger city hospitals.

That is simply an astounding number and reveals once again that the Mexican side of the border is likely the biggest culprit driving the growth of the most serious cases, which we are not really seeing in most other parts of the country. It’s not natural that counties sitting at the border would mysteriously get hit with a strain of the virus causing so much more hospitalization than anywhere else. What this clearly demonstrates is a case drain flowing from across the border, where the most seriously ill patients are crossing over for care.

We are finding this dynamic across the border. Imperial County is one of California’s least densely populated counties, yet at 40.1 hospitalizations per 100,000 residents, it had the highest rate of coronavirus hospitalizations in the state. That is more than twice the rate of Los Angeles County, which is the largest county in the country and is 57 times more populous and 69 times more densely populated than Imperial County.

The rate of increase in positive tests has also grown five times quicker in Hidalgo County, the main border county in southeast Texas, than in Harris County (Houston). The same dynamic is playing out on California’s border with Mexico, where the border areas of San Diego County have the most cases per capita:


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The Tijuana-California border as well as the Hidalgo County, Texas-Mexico border have the most cross-border travel from citizens on both sides. It doesn’t take Sherlock Holmes to figure out why these parts of America, which never had much of a problem in March and April, got hit around the same time Mexico began to surge:


The same story across the border … except for New Mexico

Arizona border towns also have a cross-travel culture with Mexico. Thus, we see zip codes in Yuma that had more cases than in Phoenix. The 85350 zip code of Yuma has 2,461 reported cases, more than 30 percent higher than the largest tally in Phoenix’s top zip code (85033), even though the latter is nearly three times more populous.


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Also, it’s very likely that Yuma border cases were transferred to the hospitals in Phoenix and might have added to their numbers as well because the small border towns didn’t have capacity to deal with them, just as we saw in California. It would be interesting to find out how many of the border patients got transferred to Texas’s larger cities as well.

The shocking contrast to these three border states is the fourth one – New Mexico. New Mexico has barely experienced any deaths outside the Indian reservation areas and never experienced the hospitalization surge in June. New Mexico is the perfect control group when studying the effects of the border. The demographics are similar to the other three states, as are the weather and latitude. However, the difference is that although three counties in New Mexico touch the Mexican border, there is absolutely no civilization in the Mexican desert across the border. You have to travel much farther east to Juarez before you get to a city. Juarez is a sister city of El Paso, Texas, which is why anyone coming for care would go there, not to New Mexico. Moreover, there are no sister cities across the border for Americans living in New Mexico to work in or shop at and, in doing so, bring in Mexico’s later coronavirus hit.

The contrasting data are jarring. Doña Ana County, New Mexico’s main border county, experienced just 11 deaths. That is 1/10 the number of El Paso deaths(111), even though El Paso County is only three times larger, and 1/7 the number of deaths (71) in Cameron County (Brownsville), which is only two times larger.

Cochise County, Arizona, which is next door to New Mexico, had 20 deaths, but is half the size of Doña Ana County. According to Cochise County’s dashboard, most of that is being driven by the city of Douglas, which is right at the border and is a sister city of Agua Prieta in Mexico. Yuma County, Arizona, has roughly the same population as Doña Ana and has 124 deaths, 11 times greater. That’s because there is a sister city in Mexico and numerous green card holders and dual citizens came for treatment. The New York Times reported in early June, “Border towns in Arizona are experiencing an increase in infections that health officials believe is tied to people coming in from Sonora state.”

It’s the border, not the reopening from the lockdown

More circumstantial evidence that this is related to the border comes from demographic information on the county dashboards. In Cochise County, 72 percent of all cases where the ethnicity of the infected individual is known are Hispanic, even though Hispanics compose just 35.7 percent of the county’s population.

Thus, the enormous dichotomy between New Mexico and the other border states cannot be ignored and clearly demonstrates that border crossings from Mexico – both Mexican residents coming for treatment and Americans traveling back and forth – were responsible for the surge in the three larger border counties.

The notion that the reopening and not the border is the culprit for the spike in the three other border states is absurd. As Axios showed, Arizona experienced one of the most severe slowdowns in social mobility, and its shutdown appears to be much deeper than New Mexico’s. Moreover, California had the strictest and longest lockdown. L.A. still has severe restrictions to this day, yet it reported 65 deaths on Wednesday.

Take a look at this chart of the social mobility scores of the four border states as compared to the national average, based on Google mobility data.


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As you can see, New Mexico actually consistently had the most mobility and was the only state that had a score consistently above the national average.

Hence, it’s all about the border, not the reopening.

Finally, coming back to the Texas border, it’s important to remember that right during the target weeks when we would have expected deaths to rise from the reopening, there was not a single death recorded in Hidalgo County from May 15 to June 15. On the other hand, there were 80 deaths since June 23, coinciding perfectly with the timing of the Mexican coronavirus surge.

The real story is that while these politicians are busy infringing upon liberties of Americans, they forgot to do the one thing that actually helps: stop cross-border travel. In March, Governor Greg Abbott had no problem issuing a mandatory quarantine for those traveling back from California; Connecticut; New York; New Jersey; Washington; Atlanta, Georgia; Chicago, Illinois; Detroit, Michigan; or Miami, Florida. He even set up checkpoints on the roads leading into Texas from Louisiana to screen people and enforce the mandatory quarantine, as if Louisiana were an international border.


Yet, to this day, when it comes to the international border itself, while the hospitals in Mexico are failing to cope with the peak that began in late May, states refuse to issue a mandatory quarantine. Now, Americans are getting blamed.

Second-class citizens, indeed.


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