Experts predict ’largest spike’ of COVID-19 in Baja region

SAN DIEGO - The next couple of weeks will be crucial in Tijuana's fight against COVID-19 as experts anticipate a sharp increase in the number of cases and deaths in the border city of 1.3 million.


"Data indicates that the first two weeks of May will have the largest spike of viral transmissions and fatalities," reads a presentation from San Diego County health officials obtained exclusively by The San Diego Union-Tribune.


That presentation, which also says that Tijuana's hospital system is unprepared for a surge, was part of a report that county Public Health Officer Dr. Wilma Wooten and Supervisor Greg Cox gave to the mayors of Chula Vista, Imperial Beach and National City last week.


According to the presentation, experts on the north side of the border believe that Tijuana's COVID-19 surge could impact hospitals in San Diego County. Roughly 265,000 U.S. citizens live in Baja California.


"The Baja California hospital system is facing significant challenges, and this could influence an increase in individuals crossing the border in need of medical care," the presentation states. "At present, we have capacity in our hospital system to support an increase in patients."


Monday afternoon, county health officials confirmed they are keeping an eye on the situation. Apart from that, there appear to be no plans to proactively prevent or prepare for a potential surge.


"That information is being monitored," Wooten said at the county's daily press conference. "It has not crashed our health care system, we do have capacity, but it has to be a continual monitoring because things could change at any moment."


Although the coronavirus pandemic has not had a significant impact on San Diego County's hospitals to date, that could change in the next couple of weeks if Tijuana indeed sees a spike in COVID-19 cases and fatalities.


Hospitals throughout Baja California are experiencing shortages in personal protective equipment, COVID-19 tests, ventilators and health care personnel.


Tijuana has three public hospitals. Between them, they have a total of 64 available beds and 25 ventilators as of April 27.


Baja California's COVID-19 designated hospitals are at or near capacity and some hospitals are unable to receive new patients because they don't have the staff or equipment to treat them, according to the county's report.


Experts at UCLA who study Mexico's health care system have described the situation in Tijuana "like a time bomb."


In Tijuana, there have been 737 confirmed cases and 123 fatalities. That's a death rate of 17 percent. San Diego County has a 4% rate with 3,927 confirmed cases and 139 deaths.


Experts believe the reason behind Tijuana's high rate is lack of testing.


Monday, officials noted that the coronavirus pandemic has not prompted large groups of people from Mexico to overwhelm San Diego's hospital system.


By some metrics, the number of people requesting medical assistance at the border has actually decreased since the coronavirus began to spread in San Diego.


For example, ambulances have noticed a decrease in emergency transport calls along San Diego's ports of entry.


Between October 2019 and the end of February, paramedics responded to 7.47 daily border transports. That number dropped to 5.76 daily border transports between March and April 26, according to data from San Diego Fire-Rescue.


Since the federal government implemented cross-border travel restrictions, the average number of pedestrians and vehicle border crossings has decreased from 140,000 a day to 50,000.


Since the middle of March, roughly 90% of the people crossing north from Tijuana to San Diego are either American citizens or permanent residents and "only a few" have crossed for COVID-19-related medical care, according to the county's report.


For now, San Diego County health officials believe that the region's hospital system has the capacity to support an increase in patients.


The daily average of beds available in local hospitals is about 2,700 and the average number of new cases is roughly 276.


However, those numbers are not distributed equally throughout the county.


Sharp HealthCare and Scripps Health have both said that their Chula Vista hospitals have long seen higher "conversion" rates in the South Bay than they have seen in their health care systems as a whole.


Sharp said that, throughout the county, about 12% of all patients have tested positive for coronavirus infection. That number has been about 20% in Chula Vista. Likewise, Scripps has said that about 17% of its Chula Vista tests are positive compared with about 7% for all Scripps facilities in the county.


Both hospitals reported that the number of new patients with possible COVID symptoms testing positive for novel coronavirus infection is several percentage points higher at their Chula Vista hospitals than they have been countywide.


While the facilities closest to the border have occasionally reported transferring COVID patients north to sister facilities in other parts of the county when their beds become too full, the reality is that widespread public adherence to social-distancing orders have kept the overall number of hospitalized patients with the disease below 400 on any given day.


Daily charts from the county clearly show that there are thousands of additional beds available as facilities move to resume elective surgeries and procedures that were set aside to keep the local hospital burden as low as possible.


But there do not appear to be any plans in the offing at the moment for San Diego-area medical facilities to assist their neighbors to the south. At least not directly anyway.


Asked Monday whether there was more that could be done to assist Baja, Wooten said that, for now, monitoring and encouraging donations to local charities and assistance funds is the only public health recommendation.


Sending needed personal protective equipment south, she said, is not presently doable.


"These supplies come from the federal government, and we cannot share that," Wooten said.