TUCSON – “Honestly, when a vaccine comes out, things might normalize.”
So said Robert Guerrero, chief of the Office of Border Health within the Arizona Department of Health Services (AzDHS), in a virtual meeting Friday as he talked about a future with COVID-19 hosted by the Border Community Alliance program director Alex LaPierre.
Guerrero heard a National Public Radio (NPR) broadcast in which it was suggested 30 percent of the U.S. population would not get vaccinated and it concerned him as it has Dr. Anthony Fauci, director of National Institute of Allergy and Infectious Diseases. Fauci recently opined that striving for herd immunity would “have a staggering death toll.”
In a conversation he had with a Vietnam veteran who could not take vaccinations due to Agent Orange exposure, Guerrero told him, “Then it’s important for me to get them to protect you.”
He pointed out there were no political divides when it came to the vaccinations for polio and to have a split now over COVID-19 made “no sense.”
“This virus will probably be around for a long time to come,” Guerrero said. “It will probably mutate more. And, like measles, we will have outbreaks because people did not get the vaccinations.”
While the United States is still seeing an influx of cases which gives it the No. 1 rank in the world with 5.3 million cases of the virus, Guerrero said our neighbor to the south, Mexico, has far fewer, a little over half a million, and took a far different path to deal with the crisis.
Authorities there went through a lockdown with COVID-19 and made it an individual priority to “take care of your own backyard,” he said. They told people to “just worry about themselves” and provided public updates and announcements to keep the people informed.
Even though in Mexico, the health system has nowhere near the capabilities of the U.S. from available physicians to hospital ICU rooms, ventilators and testing, they were able to control the spread of the virus.
He knows all this because he and his Mexican counterparts in Sonora and at the federal level in Mexico City swap statistics every day. Over the years in his job, he has built “strong relationships” with Arizona’s neighbor to the south.
Dealing with U.S. visitors who come home with various stomach ailments due to eating raw shellfish or not drinking bottled water, to detained immigrants with tuberculosis to Zika, Dengue and now this latest viral assault, Guerrero and his counterparts recognize the importance of remaining in contact.
“Some people in our border communities go back and forth every day,” he explained. “So, it’s important to have relationships. We rely on our Mexican colleagues to be our eyes and ears and they rely on us.”
And, he emphasized there were far more people going from the U.S. to Mexico for non-important reasons than people from there coming to the U.S., even though the border was closed except for “essential travel,” like working in the U.S. while living in Sonora.
“They are more afraid of catching the virus from us,” he added. “The first red flag was in Yuma County. Every day there was a line of cars going south for non-essential reasons, like going to the hairdressers. We had to talk about the dangers of spreading the virus and now Customs and Border Protection enforces the non-essential traffic mandate.”
To promote a healthy border, AzDHS formed the Border Infectious Disease Surveillance (BIDS) to provide a regional surveillance system for monitoring infectious diseases along the U.S.-Mexico border, he said.
It promotes binational communication, exchanges of epidemiologic data and improves cross-border public health infrastructure through collaboration with local, state, federal, academic and international partners. Data and information gathered from BIDS provides for effective binational disease prevention and control strategies.
He talked about the growing problem in Nogales and Hermosillo, Son., as cases there had overwhelmed the hospitals. Mexican authorities are not sending people to the U.S. for health care.
At the start of the spread of COVID-19, Cochise County officials were concerned with a possible surge of patients coming from Sonora and suggested setting up a field hospital at Bisbee Douglas International Airport off of Highway 191 by the state prison. Guerrero believed the hospital would be an unnecessary waste of money and the idea was scrapped.
He said he also received calls from Canyon Vista Medical Center in Sierra Vista and Copper Queen Community Hospital, with locations in Bisbee and Douglas, who were also concerned about a surge in cases.
“A small town surge was not going to happen,” he said.
Guerrero and Sonora also team up on other things, like teen pregnancy, addiction, obesity and diabetes because of the uniqueness of the border communities and the commonalities.
AZDHS has also established a program called the Medical Electronic Disease Surveillance Intelligence System (MEDSIS), which includes Sonora, to track possible health problems. He noted, “We call Sonora our 16th county in the state. We added them to our system.”
MEDSIS has been invaluable in the continuity of care for migrants who when screened test positive for tuberculosis (TB). Treating the disease can take six months, so it is important for these people to maintain the regimen, he continued.
When migrants are screened at the border, they can be put on a treatment program while waiting to be deported and thanks to MEDSIS, the Sonoran medical community can continue the treatment and not be a danger to others in the communities.
“If we can build and manage relationships to do mundane day to day programs, then in a medical emergency, we can move forward,” he said. “What happens on one side of the border, happens on the other.”