LAREDO, Texas – Every day, around 6 pm, Dr. Ricardo Cigarroa goes through the same dark ritual. He sits at his desk and counts the dead.
“Five to seven death certificates, that’s how I sign it every day,” said Cigarroa, a 62-year-old cardiologist, as he looked at the paperwork that was piling up one afternoon last week. “It only gets worse.”
During the deadliest month of the pandemic, Laredo maintained the bleak distinction of having the most serious outbreak of any city in the United States in the past two weeks. As cases increase, the death toll in the overwhelming Latin city of 277,000 now stands at more than 630 – including at least 126 in January.
When the virus reached the border almost a year ago, Dr. Cigarroa, wearing glasses, could have simply crouched down. He could have focused on his lucrative cardiology practice, which has 80 employees. He could have been quiet.
Instead, Dr. Cigarroa became the main crusader and de facto authority over the pandemic along this stretch of the Mexican border.
On regional television stations, he calmly explains in his baritone voice, in English and Spanish, how the virus is evolving. Known for making home calls from Covid-19 in Laredo in his old Toyota Tacoma pickup, he is interviewed so often that Texas Monthly calls him “Dr. Fauci of South Texas”, comparing him to Dr. Anthony S Fauci, the best in the country specializing in infectious diseases – although he has no official government license.
Lately, Dr. Cigarroa has lost his temper.
Looking exhausted in a video posted on Facebook, he criticized political leaders for allowing the virus to spread throughout this part of southern Texas. Dr. Cigarroa has appointed Governor Greg Abbott, a Republican, for refusing to allow Laredo to impose stricter mitigation measures.
“For the governor: it’s okay to swallow your pride,” said Cigarroa, stunning some viewers with a warning that the virus could kill 1 in 250 laredoans by the middle of the year. “It’s okay to say you’re not going to do this and then do it to save lives.”
Pleading with the people of Laredo to consider civil disobedience in the way of staying home without working if politicians do not act, he added: “The only thing that will save lives right now is to stay home and close the city.”
But his battle is not just with the governor: although the city is 95% Latin, a group that has suffered a disproportionately high number of cases and deaths, many local leaders have been reluctant to close deals, and some among the general public still flock to bars. , restaurants and holiday gatherings.
Republicans who dominate state politics in Texas seem indifferent to calls for more regulation. Abbott reduced occupancy in bars and restaurants and imposed a masking mandate in most of the state. But he said in November that he was ruling out “any other blockages,” determined to keep Texas – even parts of the state reeling under the effects of the virus – open for business.
“Increasing restrictions will do nothing to mitigate Covid-19 and protect communities without supervision,” said Renae Eze, a spokesman for the governor, of the requests for tougher restrictions in Laredo.
She said that restaurant and bar occupancy policies and face masks, adopted after consultation with medical experts, have proved effective in delaying the spread of the virus during the summer. They can also work, she argued, in communities that have peaked in recent weeks. “They can continue to work, but only if they are fulfilled,” she said.
Her implication – and Dr. Cigarroa admits it is not entirely wrong – was that local authorities were not aggressive enough to hold business owners and members of the public accountable for complying with the limited social distance measures in place. But Dr. Cigarroa said that “a strong leader” is needed to guide cities through the crisis.
Near Laredo, Dr. Cigarroa sometimes enters this void. Early in the pandemic, he said he faced members of a local bicycle club gathered in a taqueria after a long journey. “I don’t know why you bothered to take a 40-mile ride on your bike to stay healthy,” he said, as he told the story. “You are sitting here without masks and I promise that within a month several of you will have Covid and can be intubated.”
Dr. Cigarroa said “he has no qualms about telling people that they need to protect themselves”. But he emphasized that Laredonians have greatly improved the use of masks as the crisis has worsened.
However, not everyone shares the same sense of urgency. Hundreds of families are mourning their loved ones, while restaurant chains like Olive Garden and IHOP remain busy with indoor restaurants.
The bars are still open, and the parking lots of stores like Walmart, Target and HEB, a supermarket chain, are packed with cars. Some execution orders, such as moving the city in January to temporarily close two popular bars that undercover cops violated Covid-19 restrictions, have angered local businesses.
The growing number of deaths has revealed the vulnerability of a city that is not just a hectic center for cross-border trade, but a place where many people are at risk from diseases like diabetes and obesity. Many generations live in the same house in Laredo, limiting social distance.
Similar challenges exist across the border, in the Mexican city of Nuevo Laredo, where Dr. Cigarroa also makes home visits occasionally. He said cartel members had begun to control the oxygen tank trade. Some families in Nuevo Laredo, said Cigarroa, are begging doctors to list pneumonia instead of Covid-19 as the cause of death, so they can circumvent regulations that prohibit family members from attending Covid-19 burials, a phenomenon that he said he was contributing to a lower count of the number of pandemic victims along the border.
Sergio Mora, the host of the political podcast Frontera Radio de Laredo, said the crisis hit his home recently when in the space of a few days he lost two people close to him – an esteemed longtime employee of his other family’s towing company side of the border, in Nuevo Laredo and his grandmother.
“Dr. Cigarroa is a respected voice that is ringing the alarm, ”said Mora. “People just need to listen.”
Shaking off the spread of the virus is natural for Dr. Cigarroa, a fourth-generation Mexican-American whose family forged one of Texas’s most notable medical dynasties.
Both Dr. Cigarroa’s father and uncle were influential doctors who led the effort to bring Texas A&M International University to Laredo at a time when state officials thought the city could not maintain a four-year university.
Born into a family of 10 children, two of Dr. Cigarroa’s brothers are nurses and three are doctors, including his brother, Francisco, a transplant surgeon and former University of Texas System Chancellor. Dr. Cigarroa’s son, also a doctor, now works at the same cardiology clinic as he does.
When Laredo hospitals began to struggle with the influx of coronavirus patients, Dr. Cigarroa, a graduate of Princeton University and Harvard Medical School, took an unconventional step to convert his clinic into an improvised Covid-19 clinic.
Every night, after Dr. Cigarroa signs death certificates, patients from around Laredo go to the clinic where they are diagnosed, treated and sometimes promptly hospitalized in an adjacent part of the medical complex.
Many do not have insurance, but Dr. Cigarroa treats them anyway. He said his goal during the pandemic was not to make a profit, but to remain financially while paying his employees’ salaries.
The daily routine of such a routine takes its own toll. In July, Dr. Cigarroa himself contracted Covid-19. At first, he thought it would be a relatively mild case of “corona light” and chose to rest at home for a few days.
But then he woke up breathless, in a panic. Weighing in on his thoughts, said Cigarroa, were the deaths just days before two doctors in Nuevo Laredo who contracted the virus.
Suspicious of using any of the last remaining doses of remdesivir from Laredo, the antiviral used to treat Covid-19, he chose to be referred to San Antonio University Hospital, where his brother is a doctor.
“I fell like a dog barking at the moon,” said Dr. Cigarroa. “I was a little insensitive before that. I returned a much better doctor. “
After recovering from what proved to be an intense Covid-19 attack, Dr. Cigarroa went back to work, treating patients while redoubling his efforts to educate the public about the pandemic. Although the recent arrival of vaccines has generated some hope, he is demanding answers as to why the Webb County, where Laredo is located, is still being hit so hard.
In his office interview, Dr. Cigarroa questioned whether racism was a factor in the way the crisis was being handled in Texas. He asked why Republican state officials have allocated far more doses of vaccine in recent weeks to a county like Lubbock, which has a population comparable to that of Webb County, but is proportionately less Latin.
“Is it back to MALDEF and discrimination?” Dr. Cigarroa asked, citing the ingrained racism in Texas that prompted state lawyers to create a pioneering civil rights organization, the Mexican American Legal Defense and Education Fund, in the 1960s.
One reason for the lower allocation may be that Laredo has fewer thousands of health workers targeted for the first rounds of vaccination than Lubbock, some local officials have suggested.
Dr. Cigarroa said the state’s “total disorganization” is certainly one of the biggest problems.
So he started a very organized campaign of his own.
Her videos asking for help from state officials are posted on Laredo Contra Covid 19 (Laredo Contra Covid-19), a Facebook page created by her daughter, Alyssa, when the virus started to spread throughout the city in 2020. So, Ms. Cigarroa, a painter involved in urban revitalization projects, ran as a candidate for a seat in the City Council.
She sailed to victory in November, displacing a holder with 84% of the vote. At a heated emergency board meeting in January, at which members debated replacing Governor Abbott’s relatively loose restrictions – a move that would almost certainly trigger a legal battle with the state – in the city.
Pausing to reflect on how the pandemic is reshaping life along the border, Dr. Cigarroa smiled for a moment with pride at his daughter’s foray into politics. Then he seemed to remember what they were up against: political leaders, as well as some in their own cities who still seem unsure about what the biggest threat is – the virus, or the loss of an appearance of normalcy and a way to make a living .
Dr. Cigarroa has made it his mission to ensure that they understand what is at stake.
“This virus will continue to pierce, pierce and pierce until people realize that they will have no employees,” he said. “Until we make the right decisions, it’s a question of money versus life.”