Santa Cruz Atizapán does not even have a unique name.
In the State of Mexico, where this municipality of about 13,000 registered inhabitants is located, there is another that is called almost the same, Atizapán de Zaragoza, which is fifty times larger than the first.
Both are informally called Atizapán.
That is why, when bad news is titled with Atizapán, they say, fame spreads to the boy.
And for the same reason, the mayor of Santa Cruz was incredulous at news like the one that came to him this week from the federal government.
In Santa Cruz Atizapán, more people have died from covid-19 (in proportion to the number of inhabitants) than in any other municipality in the country.
His confirmed deaths to date are 151, according to figures from the Ministry of Health.
This number of deaths compared to the size of the town has placed it at the top of the map of tragedy, when Atizapán only appeared in the national press by mistake.
The size of this municipality and the impact of the pandemic make the gap between it and the following locations on the list even more striking: it multiplies by three the incidence of deaths confirmed by covid-19 with respect to San Miguel Ixitlán and Cohetzala, in Puebla , despite the fact that these are much less populated, and therefore a handful of deaths could produce a higher incidence.
But Santa Cruz Atizapán remains the only municipality in Mexico with more than 1% of its total population killed by the virus.
This week, in addition, the estimate of the National Institute of Statistics (Inegi) of excess mortality was known: around 40% over previous years until the end of August, when the first great wave in the country closed.
The figures suggest a number of deaths well above the official ones, particularly in large urban centers.
But in no case so many as to unseat this municipality from its position on the list.
From the window of his office in the Municipal Palace, the mayor observes the church square and the town limits at a glance.
On his desk and while he speaks, a large photo of him with the president of Mexico, Andrés Manuel López Obrador, presides over the room.
José Guadalupe Ramírez insists that the impact of the pandemic on his people has been overstated: "Not as many have died here as they say," he insists.
"Surely some of those deaths correspond to the other Atizapán."
The mayor, surprised by the news that has shaken the daily life of his town, shows through his communication officer, the death figures through his Civil Registry records: 127 from January 1, 2020, to December 27 January 2021. But local authorities maintain that the majority are not due to coronavirus, but those related to the pandemic only add up to 65. Even with this number, the death rate would be unusually high: 5 per 1,000, leaving it still in the first place in the country.
Without sufficient means
The town does not have its own PCR tests - although Ramírez has announced a purchase of rapid tests for next month - nor a hospital with the capacity to treat coronavirus cases, only a small one that focuses mainly on family medicine, childbirth and some emergencies.
The situation in this municipality is an example, on a small scale, of the usual conflict that the central government maintains with the entities to establish a diagnosis of the scale of the pandemic in the country.
Santa Cruz Atizapán is located on the slopes of the source of the Lerma River, one of the longest in the country that irrigates the entire State of Mexico and embraces the capital.
Its inhabitants are mostly merchants, they travel daily to nearby markets such as Santiago Tianguistenco to sell food and crafts.
Although the main source of income is focused on the maquila, clothing workshops where hundreds of women sew the pants and bags that are sold in the country's department stores, such as Suburbia.
According to the latest figures from Inegi, in this municipality almost 10% of its population is over 60 years old.
In Mexico, the average age of deaths from coronavirus is 64. Of the total population, almost half do not have any affiliation to public health services (4,779) and around 30% of their neighbors do not have a job.
At the gates of the City Hall, two Civil Protection ambulances have been waiting for a call since dawn.
A couple of paramedics disinfect one of the vehicles that has operated these months as the only transport for the population between this town and available hospitals.
Inside the ambulance is practically empty: only a stretcher and a first aid kit.
“We don't have the capacity for anything else.
We try to make the transfer as fast as possible.
But the hospitals in the area are saturated, we call before we go so we are not waiting.
Sometimes relatives take it upon themselves to send their sick person with an oxygen tank.
We can only facilitate the trip ”, says Dania Ruiz, one of the paramedics.
The trips are 40 minutes or up to an hour, to Toluca (the capital of the State of Mexico) or Mexico City, about 65 kilometers away.
And they say that many do not make it.
“We have had a lot of work.
Especially after Christmas.
Fortunately none have died here.
But we always have problems with family members because it is not easy to get a hospital bed these days and we do not take them until we are sure, ”adds Roberto Pueblas, an ambulance driver.
About a 15-minute walk from the center of town, amid unpaved streets and packs of sick and abandoned dogs roaming the outskirts, a small hospital stands on the corner.
The center has only six beds, according to the state Health Secretariat.
Four of them destined for labor, two for postoperative and one (which is not registered) for emergencies.
The hospital concierge, Santiago Chávez, who is a member of the state police forces, is in charge of selecting patients.
"I have seen five people arriving in a [Nissan] Tsuru with a very sick man, sure of the virus, and from here they have gone to Toluca because nothing could be done to him," says Chávez.
This morning the general practitioner who usually treats the most obvious cases of coronavirus is not there.
The care consists of taking vital signs, oxygen saturation and referring him, if necessary, to a large hospital.
This doctor, says Chávez, is also an epidemiologist and he has been charged with the task of being on the front line these days.
Today he has missed his work for the first time because one of his relatives has died from coronavirus.
On the way to the cemetery, a 28-year-old woman sets up a shoe stand at the entrance of her house with the help of her children.
Azuzena Medina explains that many people have died in her town, but not from what the news says.
“Here people died of flu, some from lung infections, others already had diabetes, hypertension.
But what they say about the pandemic has only affected us for our business, "he denounces.
"We are collapsed"
The skepticism of some neighbors about the pandemic that has officially claimed the lives of more than 150,000 people in Mexico and that has been primed with this small town, comes face to face with the cemetery.
At the gates of a little house in gray work, where Fredy González, 28, lives, some masons parade with shovels and a bottle of tequila to dig the hole in the land of the dead of the day.
"Here the relatives are in charge of paying for the work so that the deceased is buried," says González, in charge of the municipal cemetery for six years.
"Note that I don't know why, they are dying more at night and everything has to be fast," he adds.
I have never had so much work until now.
“The usual thing is that we bury six or seven a year.
Now we have come to bury 2 and 3 in one day, ”he explains from the cemetery gates that restrict entry to more than six family members - those necessary to carry the coffin and the closest ones - and prohibit wakes and other funeral ceremonies.
The sign that hangs at the entrance is one of the few notices in the town that the pandemic is still alive in Santa Cruz Atizapán.
Back in the center of town, the chicken shops, butchers, taco and cake stands continue their activity without restrictions.
The use of masks, as is common in poor parts of the country, is intermittent.
Some decide not to wear it;
others by the chin.
But in one of the busiest places these days, the Renacimiento Funeral Home, its owner Antonio Briseño, opens a drawer and puts on an N95 mask.
"We are collapsed," Briseño sums up among a handful of coffins.
The owner of the only funeral home in town explains that the most dramatic thing these days is keeping prices low due to the shortage of cheap caskets due to high demand.
To his right there are still those that cost more than 30,000 pesos (with funeral services included), about 1,500 dollars.
“But it has happened to us that four members of a family have died.
Dad, mom and two children.
The children died first and the others a week later.
We cannot demand these costs from you.
We are looking to buy the cheapest options, but the market is also collapsing, ”he says.
In addition, Briseño explains that there is a worrying shortage of official medical death certificates - which are issued by the state Health Secretariat by jurisdiction - which forces the body to remain in a house for up to four days before being buried.
Faced with the risk that this posed, Briseño works hand in hand with the local authority to speed up the process and that the local Civil Registry allows the burial even though the certificate is presented a few days later.
The pandemic has not given truce to this municipality of the State of Mexico.
It is also the town in the country whose deaths from coronavirus (in proportion to its inhabitants) have increased the most between the first wave - from March to June - and the one that began in October and is not yet over.
The rest of the municipalities most affected by this peak are found in Sonora and Oaxaca, although with minimal increases.
Santa Cruz Atizapán remains under the scrutiny of the Ministry of Health these days.
The wave of deaths that is shaking Mexico these months is cruel to small isolated municipalities without resources to face a crisis of this size, sometimes with added pressure from the capital: in the first wave, for example, the towns of Oaxaca (the federal entity with the most municipalities in the country) had comparatively good results, and they were chosen to start the reopening in June, July and August.
Between October and January, however, many of them have been painted red.
The chaotic management of the figures between the federal and municipal authorities continues.
Its true impact will only be known once the pandemic ends.
Then it will be possible to have definitive data on excess mortality by state, municipality and even neighborhood or neighborhood.
And the thickness of the scars that the covid-19 will have left on the country will be marked.