Mexican insurer catering to cross-border workers will expand COVID testing in Baja

San Diego Union-Tribune (CA)

A private health insurer and medical provider that delivers health care to U.S. patients in Mexico said Monday it plans to offer free COVID-19 testing in Tijuana.

SIMNSA is a California-registered medical provider and health insurance plan that mostly serves U.S. citizens and residents who either live south of the border or wish to get their health care in Tijuana. Testing will start later this month at SIMNSA's hospital just south of San Ysidro Port of Entry.

Frank Carrillo, the company's founder and CEO, said he is hoping to show the rate of infection in Tijuana is similar to that of San Diego.

"If you only take care of one side of the border and not the other side, you will never be able to contain this infection," Carrillo said Monday during an interview.

"We need to open the borders. If we discover that the rate of infection on the Tijuana side is significantly higher than in San Diego, then keep it closed. But right now, we don't know."

Baja California health officials have avoided widespread testing to contain the deadly coronavirus. They have relied more on disease modeling, arguing it is a more efficient use of medical resources. The strategy aims to identify when and where the virus starts to grow exponentially and attack it in specific locations by tracing and isolating likely carriers.

"You can test three million people and then what are you going to do the next day? Test three million people again?" said Dr. Alonso Perez Rico, the state secretary of health, in arguing against widespread testing earlier this month.

His strategy is an extension of Mexico's national approach. Hugo López-Gatell, the country's coronavirus czar, has compared it to predicting the outcome of a presidential election.

"You don't call 300 million Americans and ask each of them how they are going to vote," he said during a regular news briefing streamed online from Mexico City in March. Instead, you use a scientific method to get an accurate poll, explained López-Gatell, a well-respected epidemiologist who has a doctorate from Johns Hopkins University.

As of Sunday, Baja California health officials had completed 27,440 COVID-19 tests whereas officials in San Diego report 824,909 completed tests. The populations of San Diego County and Baja California are roughly similar in size.

There have been at least 16,836 people infected with the coronavirus in the northern Mexican state and 3,127 people have died, but even Baja state health officials say the true infection rate could be as much as eight times higher because they do not test asymptomatic people. By comparison, San Diego County health officials have documented 38,300 cases, with 682 deaths.

Carrillo, who says he is ready to start widespread testing of both symptomatic and asymptomatic patients, warns "the biggest problem is yet to come" in terms of economic damage from the pandemic in Tijuana.

The foundation arm of his company has been giving out grocery bags of food, providing close to half a million meals, but people are beginning to starve in the industrial border city after months of economic turmoil, he said.

"On the U.S. side, we have the advantage of the government subsidizing wages and loans and freezing the rents and preventing evictions, but all of those things are not present on this side of the border. There is no assistance to people," Carrillo explained.

Cross-border spread of the disease brought the busiest land border in the world to a screeching halt. Last week, a Trump administration crackdown on nonessential travel created massive bottlenecks at the border, with some essential workers reporting 10-hour lines to get into the U.S.

Uncertainty about the partial border closures is devastating to the intertwined economies of San Diego and Tijuana, with 13 percent of businesses in San Ysidro near the San Diego-Tijuana crossing permanently closing their doors in recent weeks, according to the San Ysidro Chamber of Commerce. On the Tijuana side, nearly every single business on the street leading to the shuttered El Chaparral pedestrian crossing is now closed.

"They're gone and and they cannot be resuscitated," said Carrillo, referring to the border businesses. "They may be able to come back in two or three or five years, but it's not going to be any time soon."

Carrillo said he wants San Diego health officials and local universities involved in the expanded COVID-19 testing, so there is no concern the data will be manipulated.

Dr. Priscilla Gonzalez, a coordinator for COVID-19 care for SIMNSA, said she is still seeing patients come in severely ill, but overall the number of COVID patients has dropped off by about 50 percent from several weeks ago. SIMNSA transfers COVID-19 patients to a partner hospital.

"We haven't had to transfer any patients today," she said on Monday. "But sometimes we have maybe three to four patients (a shift) to be transferred to our hospitals."

"Three weeks ago, we were getting approximately 120 to 150 patients a day on the morning shift" who show COVID-19 symptoms. "Now we're getting about 60 to 70 patients on the morning shift from 7 a.m. to 2 p.m.," said Gonzalez.

Carrillo said with prolonged border shutdowns he worries about his ability to continue serving the cross-border population and the regional economy as a whole. He said Tijuana residents are facing "not only secondary health effects, but also social problems like divorces, child abuse, domestic violence."

"The border cannot stop an infection from going from north-to-south or from south-to-north. We have seen that already with hepatitis, with HIV and now we have COVID-19," said Carrillo.

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