Marco Bosquet, the outpatient clinic administrator for El Centro Regional Medical Center
Marco Bosquet, the outpatient clinic administrator for El Centro Regional Medical Center in Imperial County, lives in Mexicali, Mexico. REUTERS/Ariana Drehsler

Hundreds of Mexicans and Americans who live south of the border enter southern California’s hospitals every day.

But these are not the patients — they are medical workers and support staff keeping a saturated healthcare system running amid the coronavirus pandemic.

Over a thousand nurses, medical technicians, and support workers who live in the Mexican border towns of Tijuana, Tecate and Mexicali work in the United States, Mexican census data shows. They staff emergency rooms, COVID-19 testing sites, dialysis centers and pharmacies.

Well over a thousand more clean contaminated hospital rooms and biotech labs; wash doctors’ scrubs and patients’ bed sheets; and provide in-home care to the elderly and others vulnerable to the virus.

“From the receptionist to nurses, doctors, surgeons, and pharmacists, there’s cross-border workers in every single stage,” said Paola Avila, vice president of international business affairs at the San Diego Regional Chamber of Commerce.

In recent weeks, U.S. officials and California hospitals raised alarms about U.S. citizens living in Mexico crossing the border for treatment as COVID-19 cases surged in Tijuana and Mexicali.

At El Centro Regional Medical Center, the largest hospital in California’s Imperial Valley, which employs dozens of cross-border workers, a wave of such patients helped saturate the intensive care unit and forced the hospital to begin airlifting people to hospitals over 100 miles away.

The healthcare workers are a reminder that in the interconnected region the state also benefits from cross-border travel, at a time when President Trump has warned that infections in Mexico are a risk for the United States and senior Department of Homeland Security officials have expressed concerns about dual nationals living in Mexico.

“This is a workforce that is needed in the hospital,” said Dr. Andres Smith, medical director of emergency services at Sharp Chula Vista in San Diego.

Angel Esquivel, El Centro’s base hospital trauma manager, who coordinates the flow of patients with ambulance and helicopter services, said living in Mexico enabled him to prepare better for the recent rise in patients crossing the border.

It gave him first-hand knowledge of how that outbreak was unfolding, he said, “so we can have a picture of how that emergency can impact our emergency room.”

Emerald Textiles, the largest health care laundry service in San Diego, said more than half its employees live in Tijuana.

“Without my people being able to cross the border it would be very, very difficult for us,” said president Jaye Park.

That concern was echoed by representatives of two hospital systems in the San Diego area — Scripps Health and Sharp HealthCare — who sent a letter to Trump administration officials in April warning of a brewing public health crisis at the border, yet acknowledging the health care system’s dependence on cross-border workers.

“It is critical that our healthcare personnel be able to move freely,” the letter stated.

Hundreds are U.S.-born workers who reside in Mexico for personal or financial reasons, Mexican data shows. Melody Thomas, a registered nurse and director of clinical services for Scripps Mercy Hospital, said she lives in Mexico because of her husband’s immigration status.

The majority of this workforce were born in Mexico and have dual citizenship or U.S. work documents.

“The president says we Mexicans who live in Tijuana are carriers (of the virus),” said Ada Loera, a janitor in a San Diego biotech company researching a COVID-19 vaccine.

“But when the pandemic started, (our bosses) sent us email after email saying we were essential personnel and that we were required to come,” she said.