Every Monday, Wednesday, and Friday morning, Carmen Zuniga leaves her house in McAllen before dawn to go to the dialysis center about four miles away. Zuniga has had diabetes for nearly three decades; the disease has left her mostly blind and reliant on dialysis, each session lasting several hours, to stay alive. At the center, she waits in a wheelchair and quietly listens to other patients chatter about family members, meals they’ve eaten, and—more recently—coronavirus and just how seriously to take it. This has been her routine since starting the treatment about three years ago. But her trips to the dialysis center have become far more dangerous as coronavirus spreads rapidly around the country. Now, she worries that the very thing keeping her alive may be what kills her.
Health clinics in the Rio Grande Valley have reduced in-person visits, urging patients to stay home if possible and call in their prescriptions. For many diabetics, who are at higher risk for coronavirus complications, not seeing a medical professional regularly to manage their disease can be risky. For those on dialysis, it’s impossible. Missing even one session can have disastrous consequences. So Zuniga’s only excursions from home these days are to the dialysis center, where she sits in a room with about 20 other people for 12 hours every week. She worries that others aren’t taking the pandemic very seriously, but there’s not much she can do. “Mentally I’m scared, I get anxious,” Zuniga says. “I think I’m gonna die.”
I first met Zuniga, 62, a year and a half ago, when I was writing a magazine story on the crisis of diabetic amputations in the Valley. About one-third of residents have diabetes, triple the national rate, and the region is one of the poorest and least insured in the United States. Many don’t have access to preventive health care, so their diabetes often becomes uncontrolled, leading to complications like blindness, amputations, heart problems, and severe kidney disease that requires dialysis. The lack of access compounds: Uninsured people are more likely to skip medical care, exacerbating underlying health issues. Now, those conditions make COVID-19 more dangerous—but being uninsured means facing even more barriers to treatment if they do get the virus.
