A surge in coronavirus cases in rural Texas has forced one hospital to set up “death panels” to decide which patients it can save and which ones will be sent home to die.

Doctors at Starr County Memorial Hospital, the only hospital in Starr County, have been issued with critical care guidelines to decide which Covid-19 patients it will treat and which ones will be sent home because they are likely to die. The committee is being formed to alleviate the hospital’s limited medical resources so doctors can focus on patients with higher survival rates.

Starr county began experiencing increases in coronavirus cases in early July, with 1,769 confirmed cases reported as of 24July, 17 confirmed fatalities and 33 fatalities pending confirmation from the state. The county had gone several weeks in the early months of the coronavirus pandemic without reporting any cases. Starr county, along the US-Mexico border, has a population of aaround 64,000 people.

Officials blamed social gatherings for the surge in cases.

“We are seeing the results of socialization during the 4th of July, vacations, and other social opportunities,” wrote Starr county Judge Elroy Vera on the county’s Facebook page. “Unfortunately, Starr County Memorial Hospital has limited resources and our doctors are going to have to decide who receives treatment, and who is sent home to die by their loved ones.”

The county issued a shelter in place order on 24 July, and enacted curfews and mandatory face coverings. The first hurricane of 2020 to make landfall in the US, category one Hurricane Hanna, travelled through Starr county over the weekend, forcing some drive-through testing centers to temporarily close down.

“I have been a nurse for almost 30 years and I had never seen a time like this in our community,” said Corando Rios, a nurse at Starr County Memorial Hospital’s Covid-19 unit. He tested positive for coronavirus a few days ago and is recovering at home in quarantine.

“We are not ICU [intensive care unit] capable, but we are doing ICU work. We now have a state emergency response team of nurses, medics, respiratory therapists, and nurse assistants, and last week two doctors, nurses, and respiratory therapists came from the US Navy,” added Rios. “We are doing the best we can with the resources available.”

The guidelines have been referred to as “death panels” by critics of the Trump administration. The phrase was first popularized by Republican critics of Barack Obama’s healthcare reforms when they falsely claimed “death panels” would be used to decide who received critical treatment.

Starr county is not the first place to be forced to draw up guidelines for which Covid 19 patients it will treat. Critical care standards were first enacted in the US in Arizona on 3 July in response to requests from health service providers around the state. In early July, Arizona became a global coronavirus hot spot, though rates of positive cases have decreased since then.

“The standards have been activated by the state but I don’t think hospitals are using them right now,” said Will Humble, executive director of the Arizona Public Health Association. At present hospitals transfer coronavirus patients to different facilities to avoid capacity issues. “That may change this fall as demand for non-covid hospitalization begins to increase.”



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