These ‘last responders’ deal with the bodies as coronavirus deaths surge in the Rio Grande Valley

McALLEN, Texas – Reporting and writing by Shannon Najmabadi, photography by Miguel Gutierrez Jr.

Juan Lopez is in the ambulance bay of a McAllen hospital, zipping a gauzy blue jumpsuit over a Polo button-down and work slacks. Two well-worn stretchers are in the back of his Cadillac Escalade, a pack of Marlboros near the gear shift.

It’s Saturday morning in South Texas, and the corpse of a 60-something-year-old needs to get to a funeral home — specifically, a refrigerated truck behind a funeral home that’s run out of storage space. The deceased coronavirus patient goes in the back of the Escalade, and Lopez heads to retrieve a body from another hospital’s morgue.

These are the first jobs of the day — and far from the last. Lopez will pick up 16 bodies Saturday, wake up at 2 a.m. Sunday and transport 22 more, including a husband and wife both infected with the virus.

Lopez, 45, is a courier of the dead, contracting with funeral homes and the county to pick up and deliver bodies. In normal times, he handled around 10 jobs a week. But this isn’t a normal time.

A climbing death toll

More than 4,000 people with the coronavirus have died in Texas, an undercount because the figure includes only those who tested positive for COVID-19, not people who perished without being tested.

Few regions in Texas have been as ravaged by the virus as this border area, where more than 90% of the population is Hispanic, a demographic more likely than white people to end up hospitalized or die from the virus. Many have comorbidities like diabetes that could make them more likely to become severely ill if infected.

Deaths in one county here, Hidalgo (population 870,000), have reached 284 — or 33 per 100,000 versus the state’s 14. But deaths are a lagging indicator of the virus’ severity, trailing behind hospitalizations, which shot up in June and have started to level off.

“So actually, the worst is yet to come as we work our way through that massive increase in people testing positive,” Gov. Greg Abbott said in a television interview July 10.

The death toll in Texas is lower per capita than in more than 30 states and is a fraction of New York’s, where refrigerated trucks served as temporary morgues outside hospitals when the virus peaked this spring. There have been changes since then that could temper the death rate in Texas. Younger people, who tend to have lower death rates, are accounting for a larger share of the cases, and medical treatments are advancing.

But judging by the surge in hospitalizations, a wave of fatalities could be coming.

As the virus cleaves a devastating path through parts of Texas, straining hospitals in this border region, Lopez and other “last responders” are starting to see the increase.

Funeral homes are running out of storage space for the deceased or facing delays of more than a week to bury bodies. Crematories are backing up.

The federal government has dispatched mobile morgues. Refrigerated trucks are popping up behind hospital wards and funeral homes, bodies wrapped in plastic or sheets lined up on their floors.

Juan Lopez waits to pick up a body from a refrigerated trailer at Doctors Hospital at Renaissance in Edinburg. (Miguel Gutierrez Jr./The Texas Tribune)

The calls are constant

Around 11:30 a.m., Lopez pulls into the parking lot behind a hospital’s coronavirus ward in Edinburg to pick up his third body of the day.

He points to one of the two refrigerated trucks parked in the otherwise empty lot. “This one — they just brought it today,” he says.

Calls for his services started picking up this month and show no signs of abating. Lopez contracts with funeral homes, picking up the deceased from hospitals, nursing homes or private houses. He also works for Hidalgo County, charging $100 to transport someone who died of unnatural causes to the morgue.

Normally, that’s homicides, suicides or people who drowned in the Rio Grande. Now, it’s mainly COVID-19, he said. It felt like a relief — a bit of normalcy — when he was sent to the river last week to pick up a body.

A father of four, Lopez started working in funeral homes out of “necessity” when a limousine company he drove for moved away. He wanted to drive hearses. Instead, he was asked to pick up bodies — and ended up starting his own transportation business, which now comprises three Escalades. He wants families to feel like their loved ones travel to a final resting place in style.

Juan Lopez works in the early hours of the day to pick up and transport bodies from private homes and hospital morgues to funeral homes. Since the recent surge of COVID-19 cases in the Rio Grande Valley, Lopez has seen a dramatic increase in work. (Miguel Gutierrez Jr./The Texas Tribune)

Since the death counts began spiraling upward, Lopez has been sleeping three or four hours a night with his ringer on loud.

He’s transported young and old who died with the virus, most overweight; strangers and a deceased friend. He doesn’t visit his parents out of fear they’ll get sick, and he wears protective equipment no matter what the stated cause of death is. At each stop — a hospital bed, a morgue, a family home with multiple generations living inside — he zips into the jumpsuit, slips on layer upon layer of gloves and neatly arranges a black face mask — with his company’s name stitched in gold embroidery — over his N95 respirator.

After one stop, he showers Lysol over his steering wheel, his console, then his own head.

“It’s a total nightmare”

Lopez is one cog in an industry that handles the mechanics of death and gets bodies to a final resting place. The entire system is starting to strain.

A sales representative with Dodge, a supplier of embalming chemicals and other equipment to funeral homes in the region, says his phone has been ringing for 10 days with requests for body bags. There’s a weekslong wait to get gurneys from the main purveyor he works with, said Chris Aguilar.

Aaron Rivera, a third-generation funeral director in the region, bought a refrigerated trailer after he hit his storage capacity for six bodies earlier this month.

“We’ve all got coolers, but we don’t have enough space for what we’re going through right now,” he said. “I’ve been in the funeral business going on 40 years, and I’ve never seen anything close to this.”

Kimberly Foerster, whose father died in a Mission nursing home this month, learned his body wouldn’t be cremated for about a week because the ovens “overheated” from overuse and broke down.

“My dad often talked about his ‘dream’ for when he died: to be cremated, with his ashes left at the top of the Rio Grande river in Colorado so that they would flow back to his home in South Texas,” she said. “But COVID comes, and we’re not fulfilling my dad’s dream at all. It’s a total nightmare.”

The state funeral directors association solicited volunteers this week to help “with removals and transport” in “extremely hard hit” South Texas and said funeral homes elsewhere might become short-staffed if funeral directors have to quarantine.

Legacy Chapels in Edinburg has received 72 calls to pick up bodies in the last two weeks, far ahead of its normal pace of about 500 a year. Its refrigerated storage space is full. Lee Castro, the funeral director there, has had to stop accepting remains destined for the crematory.

The temperature gauges on an incinerator at a crematorium in Donna read above 2,000 degrees Fahrenheit. (Miguel Gutierrez Jr./The Texas Tribune)

“I can keep denying families and clear up what I have,” Castro said. “(But) then the minute I start accepting families, I get overwhelmed again.”

Some of the deceased in the cooler are headed for burials scheduled weeks out because family members are self-quarantining after being exposed to the virus. Others are there for 48 hours, the state-required waiting period before a body can be cremated.

On Friday, Castro drove through a Donna cemetery toward the black plume billowing from the onsite crematorium. It’s been burning bodies 12 hours a day, seven days a week.

The crematory now takes bodies by appointment only, keeping to a handwritten schedule listing time slots for when each funeral home will bring remains. Too many had been arriving at once.

Castro was scheduled to bring five bodies to the crematory Friday, including four coronavirus victims wrapped in black or white plastic. His funeral home will bring 15 more bodies for cremation before Tuesday.

Funeral directors beyond South Texas are also seeing an increase in calls or are eyeing limited storage space with trepidation.

It’s “scary” to think what will happen if the trend continues, said funeral director Greg Compean, chair of the Texas Funeral Service Commission.

“Everyone that I’m talking to — Rio Grande Valley, San Antonio, Dallas, Austin — everyone has seen a huge increase in the numbers,” he said. “The death rate and the people that are being labeled COVID has increased tremendously here at our facilities.”

Juan Lopez speaks to the family members of a recently deceased relative. The person tested positive for COVID-19, and Lopez reminded them of the importance of wearing masks to prevent the spread of the disease. Lopez said he had been working long hours and wasn’t sure how much more he could endure. (Miguel Gutierrez Jr./The Texas Tribune)

His funeral home in Houston has seen an increase in calls and requests for cremations because relatives of the deceased are quarantined.

Syd Waldman, who works at several funeral homes in Houston, said it can now take five to seven days to have a body cremated after the paperwork is finalized. He recently told a family it would take five days to bury their loved one because the synagogue-owned cemetery had no sooner time slot for a burial.

He primarily performs funerals for the area’s Jewish community, and the religious tradition is to bury as swiftly as possible and to wash but not embalm the body, he said.

“The crematories are running 24 hours a day, seven days a week. There’s a long wait time for crematories, and the cemeteries are the same way. They’re running as fast as they can, burning as many people as they can every day, and the wait is getting to be longer and longer,” he said.

Waldman’s cooler has been full twice in the last month. “When that happens, I’m sweating bullets,” he said. “I personally deal with unembalmed bodies, so they need to be refrigerated.”

It’s more than a job

Lopez drives to his fourth stop of the day, a body in the back, a cigarette in his hand. He’s reflecting on the virus and how the calls to pick up bodies started coming all of a sudden, one after the other.

He takes his job personally. “It could be one of my family members, it could be a friend of mine.”

Sometimes, it is. He picked up the mother of a friend last week — a woman who had cautioned him to be careful as the virus started spreading and prayed for him. He learned she had the virus two weeks ago.

Two hospital stretchers sit in the back of Juan Lopez’s Cadillac Escalade. Lopez uses the vehicle to pick up dead bodies and deliver them to funeral homes. (Miguel Gutierrez Jr./The Texas Tribune)

He sees a lot of families infecting one another.

The day before, he picked up a body from a home where several generations live under one roof. He implored them to wear masks. Take this seriously, he said. Do you know how busy I’ve been?

The physical and emotional burden

Funeral homes initially struggled to get protective equipment that was in short supply nationwide, especially as hospitals and front-line health workers desperately sought masks and gowns. Even Clorox and disinfectant products were hard to come by, and many items are still sold well above their pre-pandemic prices. Compean has paid thousands of dollars to have his facility disinfected since March, and “you can’t walk 10 feet” in the funeral home without hitting a bottle of hand sanitizer, he said.

Funeral homes have also moved many of their operations online to minimize the risk of infection and to comply with changing state and local directives about how occupied indoor venues can be. Caskets can be selected remotely. Dates chosen by phone. Waldman knows some funeral homes will have employees video conference a person washing a body to say ritual prayers, rather than having them gather in person.

Memorials dot the landscape at Val Verde Memorial Gardens in Donna. (Miguel Gutierrez Jr./The Texas Tribune)

The industry faces unique emotional challenges, too. It’s hard to comfort from afar or from behind a mask. Because hospitals and nursing homes have been largely closed off to visitors, there are grief-stricken families who didn’t see their deceased loved one for weeks before death.

And sometimes, funeral directors — who see their job as comforting the living as much as burying the dead — find themselves among the ranks of grieving friends and family.

A close friend of Compean’s, for example, died with coronavirus in a hospital earlier this month. He was a man Compean had barbecued and traveled with. Now, his funeral home was picking up the body and preparing it for an open-casket visitation and a burial.

“People talk so much about first responders, and I have the utmost respect for them. But once a death occurs, we get involved — and we have to not only care for the deceased, we have to care for the family members,” he said.

There are also concerns about their employees’ safety.

Castro has tried to minimize exposure to the virus in order to protect his kids and workers, going so as to bar families of the deceased from the funeral home if they might be infected. Instead, Castro will file the paperwork — the death certificate, cremation permit — and handhold the grieving family by phone or email.

He’ll transport remains to the crematory in body bags provided by the hospital. If a family wants a loved one buried, he’ll meet them graveside. There’s no embalming — or chemical treatment of the body to stave off decomposition — and no visitation. He’ll encourage families who want those facets of a traditional burial to look elsewhere, as other funeral homes are still embalming and cosmetizing the bodies of coronavirus victims while wearing protective equipment.

A relentless cycle

A little after noon, Lopez picks up his fourth body of the day. It’s in a small room holding six corpses, three stacked on two fold-out tables, partially on top of one another. The refrigeration isn’t on; he fiddles with the machine to try to cool the room down. The bodies will more quickly decompose in the heat.

In his Escalade, he fills out the paperwork certifying the time of pickup while FaceTiming his daughter and grandkids in a singsong voice — “What are you doing, baby?”

He has a dozen more bodies to pick up Saturday. It will start all over again Sunday.

He does take a break Monday: It’s his friend’s mother’s memorial service.

Juan Lopez drinks coffee during a break from his busy morning of picking up bodies and delivering them to funeral homes. From approximately 4:30 to 7:30 in the morning, Lopez delivered four cadavers to local funeral homes. They were all coronavirus-related deaths. (Miguel Gutierrez Jr./The Texas Tribune)