El Paso Matters – Podcast: How emails revealed confusion, coordination failures during El Paso measles outbreak response

How government lapses delayed a response to a meas | RSS.com

Diego Mendoza-Moyers: Today, we’re talking about measles and an alarming lack of government coordination to contain the spread of the infectious disease in El Paso.

After we’ve seen multiple measles outbreaks in West Texas since last year – tied in part to federal migrant detention centers – unearthed emails show how public health officials at different levels of government were flying blind when it came to containing measles in El Paso.

Some ambulance drivers were unaware of their passenger patient’s measles status, while local public health officials said the federal government hasn’t been routinely sharing medical information about migrant detainees.

I’m going to talk with El Paso Matters health reporter Priscilla Totiyapungprasert about her detailed reporting on the breakdown in processes meant to contain the spread of measles in El Paso.

But first, this El Paso Matters Podcast episode is brought to you by our podcast title sponsor, Tawney, Acosta and Chaparro, Truck Crash and Injury Attorneys. Their team of local, seasoned trial attorneys are ready to help if you’ve been injured in a crash.

And you can sign up for El Paso Matters’ newsletter and read our free reporting at our website, elpasomatters.org.

Priscilla, I appreciate you joining me.

Priscilla Totiyapungprasert: Thanks for having me.

Diego: So, you wrote a very in-depth and detailed story describing multiple instances of breakdowns in tracing and communication about several different measles cases in the El Paso area. And, so, I want to get all into that, but can you just start off by telling us how you got turned onto this story and how you got started reporting?

Priscilla: So, I started reporting on measles last year. If you recall, that was actually our first podcast together. There was that big outbreak that was happening, and this is our second outbreak in two years.

And when we found out from the city that there were measles cases again, at the time the city told us that those cases were not tied to Camp East Montana. And I thought that was curious, because a lot of the cases at the time appeared to be happening at Camp East Montana.

Diego: And Camp East Montana is a migrant detention facility in East El Paso County.

Priscilla: Yes. And then, later in March, early March, we find out that there’s more measles cases. So, out of curiosity, I wanted to know how was El Paso responding to the outbreak? What was going on behind the scenes? So, I made a records request for emails.

Diego: And the emails showed a lot of communication breakdowns and questions and confusion, right?

Priscilla: Yeah, the emails were enlightening. There were hundreds of pages that I went through and going through all the back and forth communication, I was putting together this timeline and it showed a breakdown in communication across various entities.

So, when you have a measles response, there are a lot of players involved. There’s the local hospitals, there’s the health department. And in this case, there were federal detainees. So, there’s a lot of jurisdictions involved with this. And, so, the email showed a lot of communication happening across various stages.

Diego: Yeah, so just kind of walk through your reporting and what you found? You really highlighted several different scenarios of cases and different government entities confused over whose responsibility it is and just everything. So, talk us through your story and the different scenarios you uncovered, I guess.

Priscilla: So, with the first patient, we saw that they were transferred to Del Sol Medical Center. And it appeared, based on the summary emails within the health department, that this person was not isolated for a period of time while they were getting tested and they were waiting for results. And it looks like the Del Sol Medical Center also did not notify the health department. The health department found out through the state. And, so, this person was in a hospital, partly not isolated, for two nights before the city found out and could begin contact tracing. And the city ended up doing their own testing. So, there was that issue.

And then, at that time, when the city found out that patient tested positive for measles, there was another patient who was also tested that day. This one was at (University Medical Center of El Paso) where they did do a protocol or were put in isolation. And this is where the timeline gets kind of hazy, because for contact tracing, the city’s epidemiologist, they need all information. They need to know like, where was this person? Who did they expose? Like, where were they? And this person, their rash onset was February 7. And with measles, when you have a rash onset, you’re contagious four days before and four days after. They were not in the hospital until February 11th. So, my question was, where were they between February 7th and February 11th?

And that’s where you kind of start getting this piecemeal information coming in, that they may have been at the downtown jail, that they may have exposed people at the court, that they were at Camp East, Montana, but which days? It’s not 100% certain. So this kind of shows that the health department didn’t have very certain, 100% information.

Diego: And part of the problem was that the federal government itself isn’t really effectively tracking who’s coming in and out of the various detention facilities, where they’re coming from, where they’re going. There’s just kind of an absence of information about the detainees. Is that right?

Priscilla: That’s what the emails show from the health officials, that there were questions internally about what’s the vaccination status? And there was a deputy health director who said they don’t have information on the ins and outs and that the federal authorities don’t know who’s coming in and out, how many people are there. They’re not routinely getting this information. They don’t know the vaccination status of people who are exposed, of the detainees themselves. That kind of makes it – not kind of, but it does make it hard for the health official to do their job.

Diego: So, OK – just to back up a little bit. Why are these detention facilities some of the hubs, I guess, of measles outbreaks or measles cases? What is it about these facilities? Who’s there and why is this where the source of measles is coming from?

Priscilla: So, when people are under federal custody, immigrants, they tend to transfer between different facilities. So, you have a lot of movement going back and forth. You are first detained, you’re in a holding facility where you’re being processed, you might go to Camp East Montana. You also have people coming from Minnesota, for example, coming into El Paso to go to Camp East Montana, and you’re transferred to outside facilities, outside of the state even including the Sierra Blanca facility where most of the cases are. There were more than 130 cases reported so far at the Sierra Blanca facility.

And then these are congregate settings, so hundreds of people living in close confinement together. So, this is a kind of a very ripe area for disease outbreak.

Diego: Yeah. And you mentioned in your story a stash house in Juárez that maybe has played a role. Just curious if you can touch on that for a second?

Priscilla: Yes, so, the first patient that was identified in El Paso, he was in a stash house in Juárez before he came into El Paso. And he did say that there were sick and dying people in the stash house. However, we can’t confirm – we don’t know if this was an area where measles were spreading. He could have gotten it while he was in El Paso. This, we don’t know.

And I also don’t want to create a stigma around what I would call a vulnerable population. As we saw, like last year, for example, there was a massive outbreak in Mexico, and that started from somebody in Texas traveling to Chihuahua. So, I don’t want to kind of put a blame on people who are immigrating here.

Diego: Sure, I hear you. Of course, the transmission of disease goes both ways for sure.

Priscilla: Yeah, there’s no – for when it comes to diseases, there’s no borders or jurisdictions for diseases.

Diego: Yeah. And I want to talk about some of the jurisdictional issues here. But just first, Priscilla, based on your reporting, what do you view as the risk to the El Paso community from these measles cases that have happened here? And how many community cases are we talking about? Because there’s a real distinction between how many cases are among detainees and how many are among the workers and people who live in El Paso, right?

Priscilla: So, first off, some positive news is that El Paso has a pretty high vaccination rate compared to the other major counties in Texas. El Paso, we just have a very high vaccination rate here. And, so, we have a layer of protection from measles.

And in El Paso, there were 24 cases reported and eight were people in the community. So, people who were not in the detention facilities. And then 16 were at Camp East Montana. And then there were the 136, I believe, that were in the West Texas detention facility in Sierra Blanca, which is outside of El Paso.

Diego: And, so, with the community cases, they’re mainly employees of the detention centers, right? Is that a fair description?

Priscilla: Yes. So, the eight community cases, they were people who worked at the Sierra Blanca facility. They were CBP, U.S. Marshal. And what’s interesting is that the city mentions the Camp East Montana cases, and they mention the community cases. In their press releases, they don’t mention the Sierra Blanca cases, which is interesting because people in El Paso work at that facility. They also don’t mention that the community cases are tied to the Sierra Blanca cases.

Diego: And the people who – the community cases, quote unquote, right – the people who live in El Paso but contracted a case of measles from their employment at one of these facilities, they were out and about in El Paso, right? I mean, people who tested positive for measles?

Priscilla: Yeah. If you look at the exposure list, the city had a measles dashboard and it showed a list of exposure sites. I mean, the sites were like Cielo Vista, Cici’s Pizza, the outlet mall, another restaurant. So, people are out and about in the community. But also the detainees, before the detention facilities were put into lockdown, they were being transferred to El Paso area hospitals. So, even though those cases were happening outside of El Paso, they’re coming into our city.

Diego: Yeah, which is alarming, right? As a resident of El Paso, just kind of thinking that this disease is sort of out there in the community without a widespread awareness, I guess.

Talk a little bit more about the jurisdictional aspect of the story, Priscilla, which sounds boring, but it led to, I think, some of the confusion and breakdown, right, in public awareness. Because we’ve got El Paso County, we’ve got Hudspeth County. There’s obviously a flow of people between the two. You’ve got maybe migrants arriving at the border, right? So there’s different jurisdictions here.

And I guess, as I read your story, one takeaway I had was it wasn’t clear who is responsible? It felt like the different levels of government were passing the buck. And I just wonder, can you talk about who’s responsible for this for contact tracing and so forth? And then, also, where’s the federal government in all of this?

Priscilla: So, our health director actually says in one of the emails that their job is coordination with state and federal authorities. And they are in charge of the cases that are El Paso residents, but the cases that are happening at the Sierra Blanca facility, for example, that is not their, I would say it’s not their jurisdiction. That’s a term that they use a lot. “It’s not our jurisdiction.”

And we have ICE, which is overseeing the facilities, but the Sierra Blanca facility is privately owned by LaSalle, and they have a subcontractor that takes care of medical needs there and healthcare, and that’s called Loyal Source. So, Loyal Source is the subcontractor for health there, but also at Camp East Montana. And, so, they’re heavily involved with what would be providing health information, medical information to city epidemiologists if they’re trying to do contact tracing.

Diego: So, that’s really interesting. They’re the private provider of that service. But I mean, where were they in this whole process? They didn’t respond to you, right, when you reached out to them?

Priscilla: No, they didn’t respond to me. They were in communication with the city, as was the health epidemiologist. And it looks like the city was also in communication with CBP, ICE, U.S. Marshals as well. So, you can see that this is why they’re getting information in piecemeal. And that’s the difficulty with detainees, because they’re being transferred to different authorities. And it’s really hard to kind of figure out where somebody was, what’s their status, all that information. And unfortunately, the federal authorities didn’t respond to me. They said they were working on my questions, but I didn’t get a response.

Diego: In some of the emails you uncovered, I think the phrase was that the federal government was not routinely sharing medical information of detainees. Is that right?

Priscilla: Right. And the lead epidemiologist in El Paso said that they cannot do contact tracing if they don’t have accurate information. And it’s not just information like with the city. We also saw that in one email, a deputy health director talks about how hospitals are not getting info about the measles status of patients because there’s no form or anything that’s coming with them.

So, it looks like sometimes there was even a breakdown in communication between the detention facilities and the local hospitals. That’s kind of a big deal. Like, if you’re getting a patient that’s coming into a hospital, they need to know because they need to start doing isolation protocols. Like, there are certain things that you do if somebody’s coming in with an infectious disease.

Diego: And when you asked El Paso’s public health director, Hector Ocaranza, his answer was basically, “It’s up to every hospital to have their own process. Like we, as a public entity, have our recommendations, but we don’t control what the hospitals do when they receive a patient,” right?

Priscilla: Yeah, that’s the basic response from the city. They can’t tell the detention facilities how to do disease protocol. They can’t tell the hospitals. They can only recommend.

Diego: And what did you think? Just curious, what was your takeaway when you realized that the city was not highlighting some of the cases in Hudspeth County of people who live in El Paso, right, and sort of saying, “Hey, those cases are in a different jurisdiction. They’re not our responsibility.”

Obviously, as I said, there’s a flow of people between two counties. I just wondered, what was your takeaway when you read those emails and saw maybe the city wasn’t fully communicating the scope of the measles cases, right?

Priscilla: It didn’t seem transparent to me, especially because we asked if they were tied to Camp East Montana, which was the only facility mentioned in their press release. And I thought that it was telling that they didn’t offer that information either. As I said before, people work at that facility. It’s a very rural community over there. So, people from El Paso commute to go work there. Detainees are coming to the hospitals with the first patient. There were exposures at Del Sol Medical Center.

And, so, this idea that that’s not our jurisdiction, it just doesn’t seem very transparent to me, considering that there is a direct connection between the two, between El Paso and Hudspeth County.

Diego: Yeah, sure. And, Priscilla, can you take us into the reporting process a little bit? Like, you’re reviewing all of these emails and from different levels of government and different parts of the government and so forth. Like, what were you thinking as you’re reading this and going, “Man, I may have a story on my hands.” Just curious what was going through your head?

Priscilla: I guess I was surprised by what information the city didn’t have. And going through it all – and it was interesting seeing even the disagreement between the city spokesperson and the health director about how to communicate this outbreak to the public. I thought it was very eye-opening to see all this. Especially because I, not working in the health department, I don’t actually know exactly what goes on behind the scenes and what do they do when a disease is reported in the community? And, so, it was interesting to see the process. And it looked like the epidemiologists were trying very hard to summarize all the information and communicate with different people about this.

Diego: Yeah, it was a little bit interesting to see the behind-the-scenes of how you have the subject matter expert and the public health officials, but then you’ve got the communication people at the city and how do they coordinate their information and the flow of information to the public? It was kind of interesting to pull the curtain back a little bit.

Priscilla: Yeah, especially even with what was happening in the communication between Del Sol Medical Center and the city. Del Sol is a private hospital, so we can’t make records requests and find out information from them. But because they communicated with the city, we were able to find out a little bit of what was going on, at least at the hospital, at least definitely with the first patient.

Diego: Yeah. And just another side issue, Priscilla, to confirm, if listeners are vaccinated from the measles, would you say they’re essentially protected from a severe infection? Or is that not really the case?

Priscilla: Yes. It’s not 100%, but you are definitely much better off if you are vaccinated than unvaccinated.

Diego: Yeah. OK, we’ll wrap up here, Priscilla. Again, it’s just interesting to kind of shed light on some of the lack of transparency here.

But, I wonder, what do you expect going forward, right? Like, you mentioned the previous measles outbreak that you’ve reported on and we’ve podcasted about in the past. But do you expect to continue to see issues with measles outbreaks popping up periodically in our region?

And just wonder, could we see the authorities maybe better handle the outbreaks and maybe manage the flow of information better? Just generally curious what you expect as it relates to measles for the near term?

Priscilla: These are questions that I wish I had answers to. I definitely asked DHS and ICE and CBP and the health subcontractor and the city and the state as well, the state health department, what are the big lessons that have come from this outbreak? What’s going to change in the future? If anything, what changes have you already made? And unfortunately, I didn’t really get answers to that question.

But I do know that this is not the only health issue going on in detention facilities. We reported on the tuberculosis cases, for example, at Camp East Montana. We have reported as well on a woman who was denied surgery for an ovarian cyst. There are reports of a man who did not get chemotherapy while he was detained at Camp East Montana.

And speaking to Veronica Escobar, our representative, she has said that she doesn’t really trust basically what’s happening at Camp East Montana. Is that healthcare adequate at these facilities? That’s the big question. Whether or not people are getting adequate medical care in these facilities.

Diego: I guess just one more thing, Priscilla. I mean, are you worried as somebody familiar with the healthcare system and familiar with health in El Paso generally? Does this worry you knowing that maybe there’s not the closest attention being paid to the people in these facilities and their medical situations? Are you worried about this or how do you feel in general?

Priscilla: As a human being, I am concerned about this. Regardless if it’s an infectious disease going into the community or whether a person is getting their healthcare, their treatment for life-threatening diseases or other conditions, like as a human being, I do care about what’s happening. And I think that this is something that we should be paying attention to.

As far as measles in the greater community, I don’t think this will be the last outbreak. We have seen that there’s outbreaks happening outside of El Paso, outside of Texas, and vaccine hesitancy is rising. And, so, with all these sort of combinations of factors, I don’t think this is the last that we’ll see of diseases spreading.

Diego: Yeah, we’ll leave it there, Priscilla. A little bit of a maybe concerning final note, but I just appreciate your reporting on this and really trying to keep people informed on how our government’s trying to tackle the incidence of measles that we see locally. And, we’ll just look to you to keep us informed on all of these outbreaks we’re seeing and so forth.

Priscilla: Thanks.

The post Podcast: How emails revealed confusion, coordination failures during El Paso measles outbreak response appeared first on El Paso Matters.

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