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The U.S.-Mexican border wall is seen on Feb. 10, 2019 in El Paso, Texas.Joe Raedle/Getty Images

Uninsured Texans cross the Rio Grande into the Mexican border town of Matamoros in search of cheap prescriptions and affordable medical care. Some of them go to see Dr. Antonio Alfaro, an internal medicine specialist who treats a steady stream of patients with diabetes, hypertension and obesity – COVID-19 comorbidities common on both sides of the border.

Entering Mexico for a medical appointment is considered essential travel under the pandemic border restrictions in place since March. But in recent weeks, U.S. border officials have started to carry out more checks on Americans returning from Mexico at land crossings – in a bid to limit non-essential travel and slow the spread of COVID-19.

It’s a move that rankles Dr. Alfaro, who oversees the COVID-19 response in Matamoros’s main public hospital, especially as he sees more pandemic precautions being taken on the Mexican side, in the city opposite Brownsville, Tex.

“You can’t blame your neighbour for what’s happening in your own home,” Dr. Alfaro said. “When the adjustment was made [at the border], they thought that the virus was being brought from here and it’s totally false. I think it’s both of us, but mainly them because they are much more open,” he said, referring to the quicker reopening of the U.S. economy.

Neither country has won many plaudits for its handling of the pandemic. The United States has the world’s worst death toll, while Mexico ranks fourth – after Brazil and India – with more than 70,000 deaths.

Mexico carries out few COVID-19 tests, doesn’t do contact-tracing and the country’s coronavirus czar has wavered on the value of wearing a mask – with President Andres Manuel Lopez Obrador refusing to wear a face-covering unless forced to while taking commercial flights. But measures were implemented such as sheltering-in-place recommendations, closing shopping centres and itinerant markets, and keeping children home from school. The country’s reopening has been gradual and based on an assessment of local hospital capacity.

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Frequent border crossings – for everything from shopping to working to visiting relatives – were a prepandemic way of life along the 3,145-kilometre U.S.-Mexico frontier, populated by close-knit, cross-border communities. But as the pandemic dragged on and tore through regions such as the Rio Grande Valley, politicians on both sides blamed irresponsible border-crossers for spreading the novel coronavirus.

U.S. President Donald Trump jumped in, too, claiming his oft-promoted border wall was keeping COVID-19 at bay and erroneously referring to Tijuana as the “the most heavily infected place anywhere in the world.”

Mexican state officials, meanwhile, pleaded for Americans to stay put, and residents of a Sonora state town on the border with Arizona resorted to blocking the highway to the beach on the July 4 weekend. Health officials in the state of Tamaulipas, which includes Matamoros, have established checkpoints on border bridges – taking the temperatures of motorists coming across and asking if they have a valid reason for entering Mexico.

In late August, U.S. Customs and Border Protection (CBP) toughened inspections “to limit the spread of COVID-19 & protect our border communities and ensure crossings were essential,” acting commissioner Mark Morgan tweeted.

U.S. ambassador to Mexico Christopher Landau, who previously lobbied for borderland maquiladoras (factories manufacturing for export) to reopen and keep continental supply chains operating, tried to soothe any hurt feelings by tweeting that the measures targeted U.S. citizens “in the border region [who] are not taking the restrictions seriously.”

The comments didn’t sit well in Matamoros, where locals insist Mexico has taken more preventive actions –such as limiting public transportation, ordering cars off the roads on certain days and keeping cinemas and shopping centres closed for longer – than nearby regions across the border.

“They’re much more irresponsible in Texas,” said Dr. Arturo Garza, a physician residing in Texas but working in Matamoros. “It really bothers me to see restaurant parking lots full and other activities occurring.”

Dr. Alfaro added: “They opened much more quickly there. They opened South Padre Island [a beach destination near the Mexican border] and cases started climbing. Here, the beach is closed and isn’t going to open.

“Stores closed here, businesses have closed, lots of things have closed and people are holding on. There, nothing has closed.”

Two Matamoros physicians working in COVID-19 wards say they saw a spike in cases in May after beaches reopened in Texas and Mexicans headed north to take vacations.

Carlos Sanchez, a spokesman for Texas’s Hidalgo County, which neighbours Tamaulipas, said nobody blames Mexico for problems in the U.S. But he said, “It’s likely the reporting [of COVID-19 cases] from Mexico isn’t as accurate” as it should be, “but, frankly, neither is it in the United States.”

He attributed the outbreak in south Texas – among the worst in the U.S. – to a slew of factors, including a premature reopening ordered by the governor, a population living in extended families and not avoiding social gatherings, and a region “historically underserved in terms of medical care.”

The pandemic has quieted somewhat on both sides of the border after an especially rough July – although Matamoros saw “40 to 50 new cases for five consecutive days” after Mr. Lopez Obrador came to town on Aug. 27 to inaugurate public-works projects, according to Tamaulipas Health Secretary Gloria Molina. Thousands of well-wishers turned out to see him, despite admonishments to stay away.

Erroneous perceptions still persist about the coronavirus and its impact, according to Mexican medical staff.

There’s the perception in Mexico that “if I go to the hospital, they’ll kill me,” said Francisco Ponce, head of paramedics for the Matamoros Red Cross. “People say: ‘They’re going to inject me with COVID,’ ‘They’re going to pull liquid from my knees and sell it,’ ‘It’s something from the government,’” Mr. Ponce said, recalling several of the myths he has heard from patients.

Many in Mexico only started taking the pandemic seriously after it touched friends or family, he said.

Sergio Ramirez recalls colleagues from a club of retired oil workers in Reynosa, 90 kilometres west of Matamoros, continuing to hold carne asada cookouts well into May. Few wore masks or took precautions. Then they started falling ill and five of his friends died.

“They’d say to you, ‘President Lopez Obrador said it’s no big deal’ and they believed him,” Mr. Ramirez said.

The politicization of the pandemic has played out on both sides of the border.

An American construction engineer living in Reynosa has crossed the border into Texas to work in the Rio Grande Valley throughout the pandemic.

“People keep saying: ‘It violates my rights to wear this mask,’” he said of U.S. attitudes. In Mexico, not wearing a mask “is sheer ignorance,” said the man, whom The Globe and Mail is not identifying because of possible repercussions for his frequent border crossings.

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