Are Hispanics disproportionately dying in El Paso because of the lack of proper healthcare?
This is an important question that El Pasoans should be asking themselves today.
Texas was the first state to reach 1 million Covid-19 cases in the nation. Cases of Covid-19 have been surging over the last few weeks in El Paso to the point that hospitals are overwhelmed and mobile morgues have been deployed.  Although more than 20,000 cases of Covid-19 have been linked to colleges in Texas, in El Paso the likely clusters are the big-box retailers like Walmart, Target and Home Depot, according to mayor Dee Margo.  News media reports reported in recent days that several Walmart and Sam’s Club stores have temporarily closed in El Paso for sanitation purposes.
On at least two occasions, the City of El Paso has voted not to publish the Covid-19 cluster data. El Paso is also currently under a curfew order to control the rising pandemic numbers.
Of the cities in Texas facing rising infection rates of the Coronavirus, El Paso has the highest rate. 
Hispanics Facing Disproportionately Higher Infection Rates
According to a Centers for Disease Control and Prevention (CDC) analysis, 24% of patients who died of Covid-19 between May and August were Hispanic. Because Hispanics comprise about 18% of the national population, the death rate is disproportionally higher. 
El Paso Hispanics account for about 80% of city’s population, yet they account for 90% of the infection cases and deaths from Covid-19, according to the City/County of El Paso COVID-19 Results online dashboard. (last accessed on November 13, 2020)
To be sure, high Hispanic numbers appear in most of the country. In San Antonio, which has an Hispanic population of about 60%, as of November 9, almost 66% of the Covid-19 deaths are Hispanics. Over 75% of the infection cases were among the Hispanic population. This according to the San Antonio Covid-19 tracking dashboard. (last accessed on November 15, 2020)
Although lifestyle and culture are generally considered as the reason behind the higher rates in Hispanics, the disproportionately rate may also suggest that the quality of healthcare in El Paso disproportionately favors certain patients with a higher social-economic bracket over others. A video from a nurse who worked at the University Medical Center of El Paso (UMC), the taxpayer-funded public hospital, has forced El Pasoans to consider whether the ability to pay for medical care is affecting El Paso’s Hispanic population disproportionally.
On November 7, 2020, Lawanna Rivers, a nurse posted an almost one-hour long video on Facebook alleging several problems at the University Medical Center (UMC). According to the video, Rivers worked at UMC for about a month. Rivers says in the video that she has been a nurse for over 13 years.
El Paso Politics extracted 5 minutes of the video. The following are what we considered the most important parts of Rivers’ video.
Note: the video may be difficult for some viewers to watch.
Selected snips of the Lawanna Rivers video posted on November 7, 2020.
According to Lawanna Rivers, people that are put into the “pit” only leave in body bags.
Rivers goes on to discuss how the policies at UMC is to limit the amount of interaction the medical staff has with dying patients to keep them from being infected by Covid-19 positive patients. UMC has also limited the amount of CPR cycles to six of two-minutes each, according to the nurse. This was unheard of in her experience, says Rivers in her video.
The nurse goes on to explain that her nursing experience shows that “all measures are exhausted” in trying to save patients. This is not the case at UMC. Instead UMC, according to Rivers, has limited the amount of medical care provided to the patients in “the pit”.
UMC Policy Limits Survival
According to the nurse, University Medical Center (UMC) not only limits the number of cardiopulmonary resuscitation (CPR) rounds given to patients, but the patients are not being bagged because of the risk of exposure.
The nurse goes on to explain that UMC’s policy is to limit the life-saving measures provided to patients. This includes basic measures like CPR.
El Paso Politics asked a medical professional in Florida, who works for a local hospital and wished not to be named about their thoughts about the CPR protocol described in the video. The medical professional said that they were puzzled by the lack of mention of a “crash cart” in the Rivers video. The clinician told us that in a hospital setting, CPR is performed until the crash cart is brought to continue the attempts to resuscitate the patient. The person we spoke to wondered if there is a lack of crash carts at UMC or if the “the pit” was where the terminally ill patients are located with orders to not resuscitate.
Regardless, the medical professional added that bagging a patient is part of the usual protocol once CPR has been initiated. They added that bagging the patient provides an additional level of protection to the medical providers as the patient’s nose and mouth are covered.
Is CPR dangerous for health providers during Covid-19?
The Coronavirus has forced the medical regulatory agencies to reconsider ethics in medical providers because of the shortage of protective gear for the medical providers and the dangers the virus poses to them. In a May 2020 paper published by the U.S. National Institute of Health, the question of the “safety of clinicians during cardiopulmonary resuscitation” is addressed. The paper offered guidelines for both patients suspected of Covid-19 infections and those confirmed to be infected. It suggested that CPR be performed “as safely as possible.” The paper added that “more data are needed to comment on whether CPR on COVID-19 patients is likely to benefit the patient or harming the health care provider more.” 
Beaumont Health hospital in Royal Oak, Michigan studied 1,309 patients diagnosed with Covid-19 between March 15 and April 3, 2020 to understand if CPR helped the patient survive. According to the research paper, before Covid-19, “25% of patients who underwent in-hospital cardiac arrest (IHCA) survived” to be discharged.
According to the research, about 4% of the Covid-19 patients at the hospital required CPR. Of those, 53.7% of the patients who were given CPR were revived. The “overall median duration of CPR was 10 minutes.” However, the study found that none of the 54 patients given CPR survived to discharge from the hospital. It should be noted that the study makes no conclusion as to whether CPR should not be performed on infected patients and that the “outcome was likely to be poor” because of other underlining medical conditions in the study group. 
Additionally, the study age sample of the study group was almost 62 years old. 
Doctors Refusing to See Covd-19 Patients
The nurse adds on her video that the UMC doctors refuse to personally see Covid-19 patients who are Covid-19 positive. “Not once did I see a doctor come into the room,” she states on her video.
UMC doctors appear to not be treating patients, instead leaving them in “the pit” to die.
The El Paso Politics could not find any reference of doctors refusing to provide medical care to Covid-19 patients online, other than legal and other entities opining that doctors should not face investigations for refusing to see patients because of inadequate protective gear.
Several medical professionals that El Paso Politics spoke to stated that they had not heard of any doctor refusing to see infected patients.
UMC Has Two Types of Patients
According to Rivers, UMC classifies patients into two classes of patients – the VIP and the rest of the patients. Only the VIP patient made it out of the intensive care unit, according to her. The rest apparently died.
Classifying patients into two classes, one of them being a VIP suggests that UMC is providing two standards of care. According to the nurse’s video, the patient, classified as a VIP improved while the rest of her patients left in body bags.
“I saw a lot of people die who I felt shouldn’t have died,” Rivers said in her video.
About the VIP patient, the nurse added, “and when I say they pulled out all the stops for that woman, it was nothing that they didn’t do for that woman and guess what she was the one patient that made it out of that ICU alive.”
UMC Responds To Video
UMC told KTSM, that “after watching the video, while we cannot fully verify the thoughts and events expressed, we empathize and sympathize with the difficult, physical and emotional toll that this pandemic takes on thousands of healthcare workers here and throughout our country”  UMC provided the same response to KVIA the following day. 
It should be noted that the UMC response does not deny the allegations made by Rivers in her video. Instead the taxpayer-funded hospital offers a canned response about the “physical and emotional toll” on healthcare workers because of the national emergency.
El Paso Doctor Confirms Nurse’s Video
The El Paso Politics spoke to a doctor in El Paso about the video. The doctor stated that what the nurse said, “is true.” The doctor has decades of experience in the El Paso area and is knowledgeable of the practices at UMC. 
UMC Is Supposed To Be The Hospital For The Poor
Although all hospitals are supposed to treat all patients equally regardless of their ability to pay for treatment, the University Medical Center of El Paso (UMC) is a taxpayer funded hospital intended to treat those without medical insurance and without regard to the patient’s socio-economic status.
Yet, according to the nurse’s video, UMC classifies patients into two tiers, the VIPs, and the rest. A doctor has confirmed to El Paso Politics that what Rivers posted about the VIP patients on the video is true. 
With the disproportional amount of pandemic infections and deaths by Hispanics, the question that is important for the community to know is whether UMC is treating patients equally regardless of their ability to pay for treatment. This is especially true for the community’s only Level 1 Trauma Center.
El Paso Lawyers Looking At Video
The El Paso Politics spoke to Luis Yañez, an El Paso attorney. Yañez told the El Paso Politics that the video “does not shock” him because he knows how UMC operates “based on prior history.” The attorney added that the video “should be shocking to everyone.” 
Luis Yañez told us that classifying some patients as “VIP, frankly, should be illegal.” Yañez added that UMC has “been run” like this “for years.” 
El Paso Politics asked if his law firm was going to purse any action against UMC, Yañez responded that he “is investigating” and “are going to be looking” at the situation. 
Another attorney, who spoke to us on the condition that we not name them, told us that the law firm is aware of the video and is looking closely to see if patients were harmed. The lawyer refused to address whether they were in contact with patients’ families when asked.
UMC History Of Lawsuits About Medical Care
Lawanna Rivers says that UMC’s actions are not unique to the national emergency. Rivers says that UMC staff told her that this is normal at UMC.
Like many hospitals across the nation, the University Medical Center of El Paso (UMC) has a history of medical malpractice lawsuits filed against it. In the case of UMC, in addition to malpractice lawsuits involving medical care, there are other lawsuits alleging discrimination against indigent and Hispanic patients.
In 1985, nine El Paso residents filed a lawsuit against Thomason Hospital, now known as UMC, alleging that UMC refused to provide medical services to “low-income Spanish surname residents” who were refused treatment “because they could not convince hospital personnel of their U.S. residency.” 
In 2013, a woman who is a U.S. citizen filed a lawsuit against UMC for performing an illegal cavity search on her by hospital medical staff. The 54-year old woman was taken to UMC by Border Patrol agents. At UMC, for “approximately six hours” she was subjected to “demeaning and highly invasive searches” at UMC. The woman was released without charges. UMC, however, sent her a bill for $5,000 for performing the invasive searches she had not consented to. 
In 2014, UMC paid $1.1 million to settle the lawsuit.  Customs and Border Patrol settled the lawsuit in 2016 by paying the woman $475,000. 
For El Paso taxpayers, in addition to the possibility of funding substandard medical care, they also face the liability of paying for UMC’s medical failures.
Not only is UMC possibly liable for the alleged failure to provide proper medical care as alleged by the Rivers’ video, but there are pending lawsuits against El Paso Children’s Hospital for medical malpractice. One lawsuit involves the death of a three-year-old girl. El Paso Children’s Hospital is a subsidiary of UMC.
The Question That Needs An Answer
The Rivers’ video alleges that the local public hospital classifies patients into two groups. One group receives care where “all the stops are pulled,” and another group goes to the pit to die. Rivers’ also alleged that the doctors at UMC are not treating patients infected with Covid-19.
The University Medical Center of El Paso is supposed to be the hospital for El Pasoans without medical insurance as well as the premier hospital of the city. UMC is a teaching hospital that has a Level 1 Trauma designation. Are the higher than Hispanic cases of Covid-19 deaths because of underlining medical conditions or because of inadequate healthcare? It should be noted that although El Paso’s Hispanic population is over 80%, infection and death rates because of the pandemic virus are higher among Hispanics than the rest of the community’s population.
- Ashley Killough and Omar Jimenez, “Closed storefronts, overwhelmed hospitals and mobile morgues: El Paso residents hit hard by coronavirus,” CNN, November 11, 2020.
- Vic Kolenc, “Walmart temporarily closes some El Paso stores for COVID-19 sanitizing,” El Paso Times, November 6, 2020.
- Jala Washington, “Millions of federal, state aid sent to El Paso as it becomes new epicenter of COVID-19,” KFOX14, November 12, 2020.
- Erin Coulehan, “Hospitalized COVID-19 patients in El Paso are not being treated aggressively enough to save lives, says nurse in emotional post,” KTSM, November 12, 2020.
- JC Navarrete, “Traveling nurse says El Paso’s Covid-19 crisis is worse than it was New York City,” KVIA, November 13, 2020.
- El Paso doctor text message exchange with the author on November 12, 2020. El Paso Politics agreed to not name the doctor over fears of retaliation.
- Luis Yañez, Attorney, telephone conversation with author on November 13, 2020.
- Molly Fennell, “Suit says Thomason refused to tend patients without papers,” El Paso Times, March 14, 1985.
- Russell Contreras, “Lawsuit: woman faced illegal body cavity search,” The New Mexican, December 19, 2013.
- “Hospital settles with New Mexico woman over search,” The Associated Press via The Brownsville Herald, July 8, 2014.
- Reid Wilson, “CDC: Blacks, Hispanics dying of COVID-19 at disproportionately high rates,” The Hill, October 16, 2020.
- Indu Kapoor, MD., Hemanshu Prabhakar, MD, PhD, and Charu Mahajan, MD, DM, “Cardiopulmonary resuscitation in COVID-19 patients, To do or not to?,” Journal of clinical anesthesia vol. 65, May 19, 2020.
- Shrinjaya B. Thapa, MD., Tanya S. Kakar, MD., Corey Mayer, DO, MBA, et al, “Clinical Outcomes of In-Hospital Cardia Arrest in COVID-19,” JAMA Internal Medicine, September 28, 2020.