By Perla Trevizo, Ren Larson, Lexi Churchill, ProPublica and The Texas Tribune; Mike Hixenbaugh and Suzy Khimm, NBC News
*
HOUSTON - When Shalemu Bekele woke up on the morning of February 15, the house he shared with his wife and two children was so cold that his fingers felt numb.
After bundling up with more clothes, Bekele looked out of a frosted window:
a winter storm had hit Texas, knocking out millions of homes,
including his own, and covering Houston in a thin layer of icy snow.
"It was beautiful," recalls Bekele, 51, thinking as she went out to take photos of her two sons, ages 7 and 8, playing in the snow for the first time.
After a few minutes, he had them come inside to warm up under the covers while he cleaned the ice off his car, in case he had to drive to work.
Millions face power outages amid Texas cold snap
Feb. 16, 202103: 11
At the same time, Bekele's wife, Etenesh Mersha, 46, made a fateful decision, echoed by countless Texans who were without power that week.
Desperate to warm up, she went into the garage and started the car.
With the engine running, she could turn on the car's heater and charge her phone while talking to a friend in Colorado, but at the same time, her garage and home were being filled with poisonous gas.
The home did not have a carbon monoxide alarm to warn the family of the invisible danger.
Neither state or local law required one.
When Bekele returned to the house 30 minutes later, he found Mersha slumped in the driver's seat, intoxicated by fumes from the car's tailpipe.
Confused, he shook her and called her name.
Still on the line, the friend from Colorado was pleading over the car speaker for someone to explain what was happening.
Not knowing what else to do, Bekele, a devout Christian, ran and took holy water from inside and poured it on his wife's face, while his children cried and screamed, “What's wrong with Mom?
What's going on?".
[A woman and a girl die in Texas trying to heat their home with the car running in the garage: avoid carbon monoxide poisoning]
At that moment, Mersha vomited.
Suddenly, he began to feel bad himself, and he wondered if everyone had gotten sick from the eggs he had prepared for breakfast.
In a panic, he sent the children inside to fetch towels to clean up their mother.
Before they could return, both children collapsed inside the house.
Bekele passed out next.
His body fell, making a thud as it hit the concrete of the garage, as the car kept moving.
After millions of Texas homes were without power during February's historic frost, families like Bekele's faced an impossible choice: risk hypothermia or improvise to keep warm.
Many lit charcoal grills inside their homes or started their vehicle engines indoors,
unaware of the danger or when it was too cold to think rationally.
In desperation, thousands of Texans unknowingly released deadly gases into homes and apartments that, in many cases, weren't equipped with life-saving carbon monoxide alarms. Which resulted in the
nation's
"largest CO poisoning epidemic in recent history,"
according to Neil Hampson, a retired physician who has spent more than 30 years researching carbon monoxide poisoning and its prevention. Two other experts agree.
After the unprecedented wave of poisonings two months ago, Texas lawmakers have taken little action to
protect residents from future carbon monoxide-related catastrophes.
That decision comes at the end of more than a decade of ignored warnings and inaction that have made Texas one of six states where the state government does not require homes to have carbon monoxide alarms, according to research by ProPublica, The Texas. Tribune and NBC News.
What Texas does have is a confusing patchwork of local codes and regulations, with varying levels of protection for residents and limited enforcement, which health policy experts say likely contributes to unnecessary deaths.
At least
11 people
have been confirmed to have
died and more than 1,400 sought emergency room care
for carbon monoxide poisoning during the week-long blackout, just 400 fewer than the total for all of 2020. Children accounted for 42% of the cases. These figures do not include residents who were intoxicated but were not taken to a hospital or those who sought medical care at hospitals and emergency clinics who do not voluntarily report data to the state.
Blacks, Hispanics and Asians suffered a disproportionate share of carbon monoxide poisoning, according to a review of state hospital data by ProPublica, The Texas Tribune and NBC News.
These groups accounted for 72% of the poisonings, much more than the 57% they represent of the total population of the state.
Over the past two decades,
the vast majority of states have implemented laws or regulations requiring the use of carbon monoxide alarms
in private residences, often after high-profile deaths or mass poisonings during storms.
Freezing Temperatures Increase Cases of Carbon Monoxide Poisoning in Texas
Feb. 18, 202101: 46
[Three little brothers and their grandmother died while sheltering from the cold without electricity in Texas. His house caught fire]
But in Texas, where many legislators often place personal responsibility above state mandates, efforts to pass similar carbon monoxide requirements have failed time and again.
Lawmakers introduced a series of bills aimed at revamping the state's power grid after the storm, the strongest impact felt between February 14-17.
Temperatures dropped to single digits, nearly 4.5 million Texas homes and businesses lost power at their peak, and more than 150 people died, many of them frozen in their homes.
Demands for a change prompted a series of resignations but, with virtually all media and legislators focused on the regulatory failures that caused the blackout, little attention was paid to the carbon monoxide alarms. This resulted in
the loss of an important opportunity for “a totally preventable public health crisis,”
said Emily Benfer, a visiting professor at Wake Forest University School of Law in North Carolina, who specializes in health risks. in homes.
This year, lawmakers are considering a broader modernization of state building codes that is unrelated to the February storm.
If the measure passes, it would require the installation of carbon monoxide alarms in some new homes and apartments, but not in those built before 2022. In addition, it would allow local governments the opportunity to opt out.
"It's completely shocking," Benfer noted.
"In a single week
we have concrete evidence of a state government's deliberate disregard for the health
and safety of the state's most vulnerable residents."
[A mayor of Texas calls his citizens "lazy" for complaining of the cold due to the lack of electricity during the storm]
"Public health disaster"
Bekele and Mersha came to Houston from Ethiopia a decade ago with the dream of a better life for their family.
For years, they lived in a small apartment and saved from their wages as gas station clerks until they were able to buy a house.
In 2017, they bought a three-bedroom in southwest Houston, where they planned to see their son Beimnet and daughter Rakeb grow up.
Shalemu Bekele with his wife, Mersha, their daughter, Rakeb, and their son, Beimnet.Courtesy of the Bekele family
Bekele doesn't recall if anyone notified them that the home did not have carbon monoxide alarms.
State law requires that such information be disclosed when single-family homes are sold, but there is no policy in Houston, or in all of Texas, requiring previous owners to install one.
"I've never been told about carbon monoxide before,
" Bekele said, through an interpreter from Amharic, her native language.
The first thing he remembers after fainting on the morning of February 15 was waking up inside an ambulance.
He thought he had only passed out for a few minutes, not realizing that it was already past midnight.
He and his family had spent more than 12 hours unconscious while his wife's friend in Colorado, without knowing her address, frantically searched social media for family members who could send first responders to her home.
Two days without electricity or gas in the middle of the freezing storm in Texas
Feb. 16, 202101: 51
Bekele began asking paramedics what happened to his wife and children, but before he could finish speaking the words he fainted again.
Bekele was eventually transferred to Memorial Hermann Hospital at the Texas Medical Center, after the driver had to navigate ice-covered roads.
The hospital was packed with patients like Bekele.
Medical personnel were treating so many people for carbon monoxide poisoning that they were running out of beds
and oxygen tanks, said Samuel Prater, medical director of the emergency department.
"We've never seen anything like this," Prater said.
NBC News
Each year, Memorial Hermann Health System treats about 50 patients for carbon monoxide poisoning in its 20 emergency rooms in Houston and surrounding counties.
But that Monday, Prater emergency room personnel alone treated more than 60. Throughout the Memorial Hermann system, one of the largest hospital chains in the Houston region,
224 patients sought medical attention for monoxide poisoning. of carbon during frost
and power outages, more than four times what they see in a whole year, according to data provided by the hospital.
["A disaster within a disaster": Hundreds of cases of carbon monoxide poisoning in Texas as millions search for heat sources]
Quickly, Prater secured more oxygen tanks for the emergency room and established triage protocols to prioritize the hospital's limited hyperbaric chambers.
The chambers, which deliver high-pressure oxygen to more quickly remove carbon monoxide from the bloodstream of patients, are a standard treatment to stop the damage caused by severe cases of CO poisoning.
As the power outage continued in millions of Texas homes and temperatures continued to drop, Prater asked communications officers at Memorial Hermann and UTHealth's McGovern School of Medicine, where he is a professor, to speak to the media to warn to residents about the dangers of carbon monoxide.
"In no uncertain terms, this is a public health disaster,
" Prater said at a televised news conference a day later, urging people who had lost power not to put charcoal grills or portable generators inside their homes.
"Also, never start the vehicle inside your garage and then go inside to try to warm up."
Later in an interview, Prater explained what was at stake: Carbon monoxide is a colorless, odorless gas that, in high concentrations, can kill in minutes.
In severe cases, those who survive can suffer permanent brain damage
and other long-term health problems, such as memory loss, blindness, and hearing damage.
Nearly 80% of the patients treated that week at the Memorial Hermann facility for carbon monoxide poisoning were Hispanic or Black, although those groups only represent 55% of the population in the greater Houston region. Most of the patients came from neighborhoods the hospital identified as home to "vulnerable populations."
Part of this disparity is the result of where the power outages occurred. Across the state, areas with a high proportion of residents of color were four times more likely to be without power compared to predominantly white areas, according to an analysis of U.S. census and satellite data released by the Initiative of Growth and Use of Electricity in Developing Economies, a non-profit collaboration between five universities.
When power was cut off, families in low-income communities faced greater challenges.
Few had relatives they could stay with.
Some did not have vehicles that could drive on icy roads and others were unaware of local shelters where they could go to warm up.
This left many trapped in frozen homes and at increased risk of carbon
monoxide poisoning, said Melissa DuPont-Reyes, an assistant professor at Texas A&M who studies health care disparities.
"They have no other option to keep warm," he said.
"They are going to use all possible means and, unfortunately, it is toxic."
Benfer, the Wake Forest professor, agrees: "The most marginalized communities are also marginalized in access to information, resources and a safety net that they can turn to in times of crisis."
More than 24 hours after passing out, Bekele finally regained consciousness inside one of Memorial Hermann's hyperbaric chambers.
He immediately asked about his wife and children, but a nurse told him that he was very ill and needed to rest.
Bekele kept asking, until finally a doctor sat by his bed.
He cried when she broke the news.
Her son, Beimnet, was on a ventilator in the intensive care unit, the doctor told her.
As for his wife and daughter, the doctor informed him that they had died
before the paramedics arrived, poisoned by a gas that, until that moment, Bekele had never heard of.
A young Latino dies while trying to heat his home with a portable generator in Texas
Feb. 18, 202102: 02
Begging for help
As Bekele recovered in the hospital, 911 calls continued to flood emergency lines across the state.
In Austin, the capital, Franklin Peña felt increasingly helpless as he watched his 3-year-old son shiver from the brutal cold that gripped his apartment.
On the night of February 16, after two days without electricity, Peña brought a charcoal grill to burn wood and warm himself.
"My despair was so great that I lost my fear or lost my mind,
" Peña said during an interview.
"The only thing I thought about was putting the grill in."
Shortly after 6 p.m., Peña's wife and their two children began vomiting.
With her own legs shaking, Peña dialed 911.
"Please help me," he pleaded with the operator, according to a recording obtained through a request for public information.
His wife was crying in the background as he told the 911 operator that his oldest son, a 12-year-old with a developmental disability, had passed out.
Due to their high metabolic rates, experts say,
children may be more vulnerable to the effects of carbon monoxide.
[No heat, no electricity, and now no water: crisis worsens due to winter storm in Texas]
"Is everyone out of harm's way?"
the operator asked, while Peña explained that they had fled their apartment and were out in the cold.
"They are breathing but they are not well," he replied.
For 30 intense minutes, the 37-year-old Mexican tried to answer the operator's questions while his wife and son continued to faint over and over again.
"
Please
, get your strength, mommy," he repeated between sobs, begging his wife to resist.
A
later report of the incident cited "extreme levels" of carbon monoxide
in the family's apartment, which Peña said had no alarms to detect this gas.
They were not required.
Texas has given local governments the discretion to set their own carbon monoxide rules.
As a result, the requirements vary widely and are tracked by no agency statewide.
Fort Worth and Dallas require the devices in newly built homes and existing multi-family units, but not in most single-family homes.
Houston only requires them for new or remodeled homes, although it is currently considering a broader requirement that will include existing homes.
Most rural communities have even less supervision.
Millions of Texans run out of clean water, some melting snow and boiling it to drink
Feb. 18, 202101: 48
Even in cities with stricter regulations, many homes lack the devices.
In 2017, Austin voted to become the first major city in Texas to require carbon monoxide alarms in many new and existing residences where fuel-burning appliances or garages are attached to the home.
The change was due, in part, to an incident that occurred years earlier in which two residents were killed.
Peña's home only had appliances, which excluded his apartment from the requirement.
When first responders finally arrived at Peña's home, they took him, his wife, and their 12-year-old son to the hospital for carbon monoxide poisoning.
Your 3-year-old was given oxygen but was not transported to the hospital.
Peña, who works painting and remodeling houses, said everyone has recovered since then but occasionally suffers from headaches and the trauma of what they went through that night.
"If we see that it is cold, we are afraid," he
said.
"If we see that something is smoking on the stove, we feel fear, and everything we went through comes back to us."
State emergency room data does not reflect the number of residents by city or county who visited hospitals for carbon monoxide poisoning. But 911 call logs obtained and analyzed by ProPublica, The Texas Tribune, and NBC News show that, in Austin and around Travis County,
the majority of the 60 carbon monoxide emergency calls come from vulnerable neighborhoods,
where residents have incomes equal to two-thirds of the average in Travis County.
The vulnerabilities were most severe around Rundberg Lane in north Austin, where Peña lives. A third of the city's carbon monoxide emergency calls came from this community, with more than double the county's share of immigrants and refugees.
About 4 in 5 residents in the area are people of color, and nearly 2 in 5 are not fluent in English,
according to an analysis of 911 calls and US Census data by the media that conducted this research.
Three miles from Peña's house, Lucila Montoya's family brought a portable gas stove inside the house to cook lunch and a charcoal grill to help heat the house.
They did not know that the embers continue to emit toxic gases, even after the flames go out.
Within an hour, Montoya began to feel weak but thought it was her pregnancy.
She was scheduled to give birth in March.
But then her 7-year-old daughter Tifany started crying and losing consciousness.
Montoya picked up the phone as her husband, José, rolled the girl onto his back and pulled her out into the storm.
"My girl got sick, she started vomiting and my girl doesn't respond, please," Montoya said, crying, to the 911 operator through a Spanish interpreter.
"I need them to come quickly ... she is barely breathing."
The 28-year-old mother, a native of Honduras, was hospitalized one day along with her daughter.
He remembered Tifany saying that she couldn't breathe.
"I felt like I was going to die," said Montoya, whose home also didn't have a carbon monoxide alarm.
"Innocent us, we were going to end her life and mine by the way,"
added Montoya, who last month gave birth to a healthy girl.
"As a mother, I don't wish this on anyone."
Latinos in Texas line up for water after days without service
Feb. 18, 202103: 17
Failed attempts at reform
In the weeks and months after power outages, Texas lawmakers scrambled to introduce and pass bills aimed at revamping the state's power grid, with the goal of preventing future disasters.
"When I see people dying of hypothermia or carbon monoxide poisoning, when I see disruptions in the business community, people who cannot get hot food, who cannot get water ... this cannot be tolerated," he declared in February the Texas Lieutenant Governor Dan Patrick, a Republican who sets legislative priorities in the state Senate.
But while lawmakers demanded a wave of complex reforms, they did little to address one of the simplest changes: establishing a state requirement for carbon monoxide alarms in homes.
The state's top three Republicans - Governor Greg Abbott, House Speaker Dade Phelan, and Patrick - did not respond to questions about why carbon monoxide safety was not a legislative priority.
State Representative Donna Howard, a Democrat from Austin and a member of the legislative committee where the energy reforms were discussed, said carbon monoxide was not on her radar.
But he admitted that it should have been based on the findings of ProPublica, The Texas Tribune and NBC News.
"Clearly
throughout this discussion we had to be reminded about the fact that there were people who died,
" he said.
"We all know how tragic it is, but we get caught up in politics, and sometimes we lose sight of the end result."
["I lost all my savings": Texas residents recount the nightmare of receiving thousands of dollars of electricity bills after the storm]
In Texas, legislative proposals seeking to create state regulations for carbon monoxide alarms have repeatedly failed, even after major storms that led to an increase in CO poisonings and deaths.
A bill introduced in 2019 that would have required the devices in rental housing did not get a hearing.
Former state senator Leticia Van de Putte, a Democrat from San Antonio, co-authored a failed measure in 2007, a year after former state senator Frank Madla and his mother-in-law died in a fire at their home.
His 5-year-old granddaughter, who was also in the house, died of carbon monoxide poisoning.
La medida habría requerido detectores de humo y alarmas de monóxido de carbono en las nuevas construcciones y casas antiguas a la venta, si las residencias tenían electrodomésticos que usaran combustible.
Pero el proyecto de ley no avanzó a pesar de la estrecha conexión que muchos legisladores tenían con Madla y el testimonio de apoyo de jefes de bomberos, un médico de la sala de emergencias y un representante del centro de control de intoxicaciones.
Grupos de la industria —como la Asociación de Constructores de Texas— se opusieron firmemente en ese momento, criticando las alarmas de monóxido de carbono como una “tecnología no probada” que haría más daño que bien, si se exigía su implementación.
“Creemos que exigir esto crearía una falsa sensación de seguridad para los propietarios y abriría la responsabilidad de los constructores en caso de que fallen”, dijo en 2007 Ned Muñoz, vicepresidente de asuntos regulatorios y asesor general del grupo, durante una audiencia en la Cámara de Representantes. Muñoz también señaló que los dispositivos aún no estaban incluidos en los códigos de construcción internacionales que son ampliamente adoptados por los gobiernos estatales y locales.
[Biden declara el desastre mayor en Texas tras el temporal que ha afectado a millones de personas: habrá más ayuda federal]
Para Van de Putte no queda duda de que el hecho de que el estado no haya aprobado una política sobre el monóxido de carbono costó vidas en febrero.
“Tenemos tantas cosas que protegen lo físico, lo tangible, la propiedad”, dijo Van de Putte, una farmacéutica, sobre las regulaciones actuales. “Al no poner alarmas de monóxido de carbono, eso es lo que estamos valorando. Estamos valorando la propiedad por encima de la vida”.
Desde el fracaso del proyecto de ley de 2007, las alarmas de monóxido de carbono se han vuelto más confiables y ahora son requeridas por la mayoría de los gobiernos estatales y recomendadas por las principales organizaciones de salud y seguridad. El Consejo Internacional de Códigos las recomendó por primera vez en 2009 para nuevas construcciones y viviendas unifamiliares remodeladas, y para complejos de apartamentos en 2012.
NBC News
A raíz de los nuevos estándares, la Asociación de Constructores de Texas ha cambiado su posición, dijo Scott Norman, director ejecutivo del grupo. Ahora, la organización apoya los requisitos para las alarmas de monóxido de carbono en las residencias recién construidas o remodeladas, señaló Norman.
“Hace décadas, había dudas sobre la confiabilidad”, dijo. “Pero los códigos evolucionan”.
Los defensores de la seguridad contra incendios y los expertos en salud pública dicen que un requisito estatal de alarmas de monóxido de carbono protegería mejor a los residentes y ayudaría a transmitir el mensaje sobre el peligro mortal.
[¿Cómo funciona el sistema eléctrico en Texas y por qué está fallando?]
“No sabes si vas a estar expuesto hasta que es demasiado tarde y estás enfermo o muerto”, dijo John Riddle, presidente de la Asociación de Bomberos del Estado de Texas, que representa a los socorristas. “Una ley o requisito a nivel estatal facilitaría mucho las cosas”.
En algunos de los estados que han aprobado reglas sólidas ha habido una reducción significativa de las intoxicaciones, según los expertos en seguridad contra incendios.
“Cuando el estado llega y lo exige, hay continuidad en todo el territorio: hay un mensaje”, dijo Jim Smith, jefe de bomberos del estado en Minnesota, donde las visitas al departamento de emergencias por intoxicación con monóxido de carbono disminuyeron en un 45%, de 411 a 226, en los siete años posteriores a que ese estado aprobara una ley general que requería alarmas en la mayoría de las residencias privadas. “No es diferente a un cinturón de seguridad”.
A principios de abril, la Cámara de Representantes de Texas aprobó un proyecto de ley que requeriría que las ciudades se adhirieran a los códigos de salud y seguridad más recientes para las residencias recién construidas y remodeladas. Según la medida, aún no aprobada por el Senado estatal, se requerirán alarmas de monóxido de carbono en las casas construidas después de 2022 que tengan electrodomésticos que funcionen con combustible o garajes adjuntos. El requisito no se aplicaría en zonas no incorporadas a menos que los condados decidan adoptar los códigos, y las ciudades pueden optar por no participar.
La legislación, tal como está redactada, no protegería a millones de texanos que viven en casas y apartamentos ya construidos.
[Tormenta invernal: ¿cómo prepararse y mantenerse a salvo?]
Volver a empezar
En Houston, luego de pasar cuatro días en el hospital, Bekele estaba lo suficientemente bien como para ser dado de alta, pero no regresó a su casa. Durante días, se mantuvo al lado de la cama de su hijo, saliendo solo para ducharse en la casa de un familiar, mientras una máquina bombeaba oxígeno dentro y fuera de los pulmones del niño.
Bekele estuvo allí, al lado de Beimnet, unos días después, para conmemorar su noveno cumpleaños.
Inicialmente, los médicos le dijeron que su hijo tenía “una probabilidad muy baja de sobrevivir”, dijo Bekele. Incluso si lo hiciera, advirtieron que probablemente sufriría daño cerebral permanente. La exposición prolongada al monóxido de carbono había impedido que el oxígeno llegara a su cerebro.
Día tras día, Bekele tomaba la mano de su hijo y le rogaba a Dios que lo salvara.
A casi dos semanas de ser hospitalizado, Beimnet recuperó el conocimiento. En cuestión de días, dejó de recibir soporte vital y se levantó y comenzó a caminar por el hospital, fortaleciéndose lentamente hasta que estuvo lo suficientemente bien para ser dado de alta.
Dos meses después del accidente, Beimnet toma pastillas para prevenir una recaída con convulsiones como las que sufrió por su exposición al monóxido de carbono pero, por lo demás, hasta el momento, no muestra síntomas de daño permanente.
“Ahora asiste a la escuela y le va bien”, dijo Bekele, quien desde entonces regresó a trabajar en la gasolinera.
Shalemu Bekele y su hijo, Beimnet, el 14 de abril de 2021. Annie Mulligan / for NBC News / ProPublica / The Texas Tribune
Este mes, Bekele demandó a casi una docena de empresas que suministran energía a la red eléctrica del estado, una de las decenas de demandas que buscan responsabilizar a las empresas de Texas por lesiones graves y muertes causadas durante los cortes de energía del invierno. Las compañías eléctricas aún no han presentado una respuesta a la demanda de Bekele en el Tribunal de Distrito del condado de Harris, pero en casos similares presentados en otras partes de Texas, niegan su responsabilidad por muertes relacionadas con los apagones.
Bekele no sabe qué pasará con el caso, pero dijo que ninguna cantidad de dinero puede compensar lo que perdió.
Todavía no ha tenido fuerzas para regresar al lugar que él y su familia llamaban hogar antes de que muriera su esposa y su hija. Con la esperanza de un nuevo comienzo, tomó el dinero recaudado por sus seres queridos en GoFundMe y lo destinó al depósito de seguridad y al alquiler de un apartamento cercano. Es más pequeño que su antigua casa en la ciudad, pero con suficiente espacio para los dos.
No mucho después de mudarse, Bekele descubrió un problema, uno que planea solucionar lo antes posible: el apartamento no tiene alarmas de monóxido de carbono.
Acerca de los datos:
Los datos de las salas de emergencias estatales son del 13 al 20 de febrero y provienen del Texas Syndromic Surveillance System. Los pacientes informaron voluntariamente sobre su raza y etnia. Se eliminó del análisis un total de 11% de las personas que no informaron sobre su raza o etnia.
Otro análisis sobre la edad de los pacientes eliminó menos del 5% de las personas cuya edad faltaba. Los datos económicos y demográficos provienen de la Encuesta de la Comunidad Estadounidense realizada durante cinco años y publicada en 2019 y se analizaron a nivel de tramo censal. A menos de que se indique lo contrario, las áreas con llamadas de EMS se compararon con toda el área de servicio de EMS de la ciudad de Austin y el condado de Travis.
*ProPublica es un medio independiente y sin ánimo de lucro que produce periodismo de investigación en pro del interés público. Suscríbase para recibir sus historias en español por correo electrónico.
Este artículo se publica en conjunto con The Texas Tribune y NBC News. Traducción por Noticias Telemundo.