A South Texas chaplain prayed with his hospice patients. Then the coronavirus came for him.
The hospital where he had previously ministered to terminally ill patients was full when Adolfo Alvarado Jr. neared death in his Mission home. He was finally admitted, and his daughter watched on her laptop as he died.
Need to stay updated on coronavirus news in Texas? Our evening roundup will help you stay on top of the day's latest updates. Sign up here.
The symptoms came quickly. Body aches. Fever. Cough.
On July 11, Adolfo “Fito” Alvarado Jr. wrote in his journal that he was “not doing well at all” and had taken to sleeping in the garage of his Mission home despite the boiling South Texas heat.
“I’m freezing and it relaxes me and I fall asleep… my breathing has been really getting to me and my cough is horrible,” he wrote.
“Scary feeling when you can’t breathe… eating very little…. I couldn’t even tell you what hurts; everything.”
His entry the next day was brief: “I feel horrible," he wrote in part. "My body is in great pain."
In swift succession, Alvarado, his wife and his daughter-in-law tested positive for COVID-19. Medics were called but hospitals in the Rio Grande Valley were so packed that there was a two-day wait to be admitted by ambulance, they said.
So on July 13, Alvarado’s son Aaron fashioned a makeshift pallet in the bedof his truck, helped his dad — who was barely able to walk — get in, and turned on his hazard lights. He made the 9-mile drive to Doctors Hospital at Renaissance, in Edinburg, hoping the staff could find a spare bed for one of their own colleagues.
A masked worker was standing outside the emergency room when Aaron drove up. He got out of the truck, Alvarado lying prone in the back. A nurse came out.
I have my dad, Aaron said. He’s an employee here — a chaplain.
For three years, Alvarado had worked for DHR Health Hospice, visiting families from Roma to Brownsville, comforting the living and praying with the dying. He was a healthy 70 year old who phoned his three kids every day and called his wife “La Beauty.”
Now, the coronavirus had come for him.
By the time Alvarado was hospitalized in July, the border region was a national COVID-19 hot spot. Infections tore through South Texas, leaving entire families sickened and prompting local officials to use descriptors like “tsunami” and “war zone." Ambulances idled 10 hours or more, waiting to deliver patients to packed emergency rooms.
In Hidalgo County, one health official said the “only way you get a ... bed is if somebody dies.” Neighboring Starr County began flying sick patients hundreds of miles away for care.
Throughout the spring, infections had been relatively under control in the region, where leaders took aggressive early steps to stall their spread. But after the governor let businesses begin reopening in May — overriding local officials’ ability to take a more cautious approach — the virus roared through a vulnerable population.
In Hidalgo County, where Alvarado lived, a third of residents live in poverty, and more than 90% are Hispanic, a demographic that’s seen disproportionate deaths from the virus. In the Valley’s four counties, there’s a high prevalence of underlying conditions, like diabetes, that bring a higher risk of serious illness from COVID-19 and a large number of uninsured residents.
By early August, the fatalities had mounted along the Texas-Mexico border. Statewide, the death rate from COVID-19 was 33 of every 100,000 residents. In Hidalgo County, the fatality rate reached 88 per 100,000.
Alvarado saw the ripple effects of the pandemic months before it sent him to the hospital. The hospice facility at Doctors Hospital at Renaissance where he worked was turned into a makeshift coronavirus ward in the spring, and the hospice patients were moved to another building. He observed in his journal that the virus was “gaining ground.”
By late June, he was told only to see patients who requested a visit and then only while wearing protective gear, he wrote in his journal. “Our hospital units,” he wrote on June 24, “are full with COVID patients.”
A few days later he wrote: “The building with the Covid patients is full and now they are using another building.”
His siblings and children cautioned him to be careful. He said he was, and diligently wore a mask. “Don’t live in fear, but use wisdom,”he told one daughter.
But by July, he was in one of DHR’s coronavirus units — this time, as a patient.
He video-called a colleague shortly after he was admitted.
“Hey, girl,” he said, turning the camera to show blue curtains, a bed, and a hallway that led to administrative offices. Do “you know where I’m at?”
Reborn, he found his calling
Alvarado, the eldest of eight children, grew up in a one-room house in Mission, a half-mile from his grandparents’ ranch, where there were horses, chickens, a pigpen and fields where they planted crops. Alvarado’s grandfather doted on him, taking him out on the tractor as a toddler.
His father, who had a sixth-grade education and worked for a paving company, instilled a strong work ethic in his children. The eldest spent their summers picking cotton and produce to help pay for school supplies, and on occasion the whole family piled into a truck camper for a long ride north to pick produce in the midwest. Their mom worked out a budget to send all eight kids to a private Catholic school. After class, they’d hang around the convenience store she ran, a neighborhood hangout they called La Tiendita.
The four youngest, far in age from their older siblings, looked to Alvarado as a second dad.
After graduating, he worked for 30 years as a technician for Southwestern Bell.He married and had two children, Amanda and Aaron, both now in their 40s. He was a jokester and a drinker who raced horses and dressed sharply, family members said — always starching his shirts.
But something changed in his early 30s, around the time he divorced. He told Amanda he went out on a service call and the client asked to pray with him. He started sobbing uncontrollably on the drive home and pulled over, unsure what was happening to him or how to articulate his feelings. It was “an encounter with God,” a “transformation,” family members said — and he was never the same again.
He started working with churches and remarried. With his second wife, Yolanda, eight years his junior, he worked as a youth pastor and made missionary trips to Mexico. He became an assistant pastor. They adopted their youngest daughter, Alexandra, or Lexy, from a friend’s acquaintance. (He and Yolanda remained close with his first wife.)
Alvarado was generous, “very caring, very compassionate” Yolanda said. Several times, he’d cut the grass of a neighbor whose husband was away working in the oilfields. He frequently took his grandsons to donate to a nonprofit providing care to the terminally ill and told his wife that if he had all the money in the world, he’d get them a new building.
“I learned a lot from him,” she said.
After retiring in 2001, Alvarado got a bachelor, master’s and doctorate in theology from Latin University of Theology and California Christian University. He started a church from his living room — its inaugural service announced by Lexy, who wrote “River of Life Church… Come join us!” on a sheet of paper and stuck it on the front door.
A few families came at first, she said. But it expanded, moving to a bail bonds office they rented Sundays and Wednesdays, then to a brick church and on to two other buildings. Lexy, then in junior high, was her dad’s “little right hand,” she said, working as an usher, with the kids ministry, cleaning the church.
Alvarado found his calling as a pastor. People would call him in the middle of the night seeking solace, and kids from his and Yolanda's youth group sometimes stayed overnight. Once, a family knocked on the door late — a single mom whose kids were acting out. “My dad would just let them come in and cry for hours and just talk to them and he would sit down and talk with the older son,” said Lexy, now 30. “He would give his all to people.”
The church closed around 2012 due to financial reasons and Alvarado went to work briefly as a driver for Hertz, then started working in hospice centers. He joined DHR in 2017.
He told one of his sisters that it was rewarding to lead someone to God — or just give them some peace — before they passed away.
Beatriz Ramirez, a social worker who worked closely with him, liked to visit patients’ families after Alvarado did. He had a way of setting people at ease, helping them find peace in a heart-rending situation, she said. He had the same effect on colleagues. When Ramirez went through a bad bout of postpartum depression, he sat and counseled her after work for weeks.
As spring turned to summer amid the pandemic, Alvarado wrote in his journal that he was grateful to be working and was looking forward to baptizing his grandsons on Padre Island in July. He’d already written the sermon he was planning to deliver.
On June 23, he got gifts from Barnes & Noble for his grandson, Justus, whose birthday was coming up.
On June 24, he wrote about the birthday celebration. “He is nine years old! Praise the LORD! We had a wonderful time at his party. Aaron cooked monster Mexican hamburgers and a lot of other things. It was great! Everybody had a good time and Justus got a lot of presents... I bought a scratch off ticket and got $100; praise the LORD.”
His journal entry for June 26 was less bright. “I was home all day while Yolanda went to the mall… The sand storm is here and so is the heavy rain. The baptisms for the boys in Padre Island was canceled due to the severe dust in the air.”
It was one of his last entries before he became sick.
"This is not good"
The chills began around the Fourth of July. Soon, Alvarado and Yolanda were feverish and coughing.
Their children brought soup and medicine. But both got worse. A day after Alvarado was hospitalized, Lexy came to the window, broke the screen and asked Yolanda to put her finger outside. She checked Yolanda’s oxygen levels using a pulse oximeter, consulted Amanda, who livesin the Houston area and was on the phone, and then drove Yolanda to the hospital. Yolanda sat in the back of the truck, a blanket over her masked face to try to prevent the virus from spreading. Lexy and her husband wore N95 respirators.
Yolanda asked to see her husband after she was admitted. But she was told he was in a different unit for sicker patients.
She glimpsed him once through a family video call, where he appeared as a small icon on the screen.
“Honey, how are you doing?” she asked.
He looked fatigued.
The chaplain who had prayed for everyone was now himself in need of prayers. He asked for them in a series of calls and texts from his hospital bed.
“This is not good. Please pray,” he told his mother, panting. Estoy entre verde y seco — “I am between green and dried,” he told her, not okay but not dead.
When he called a second time, his mother said: “I love you.”
Yo tambien, he responded — “Me too.”
He phoned his three children once in the middle of the night and said the prognosis was not good.
“If I don’t make it ... I’ll see you in heaven,” he said, his breathing labored, in a recording Amanda made.
“You’re going to make it,” she said.
On July 22, he texted a friend: “Need your prayers right away please.” Then later, “I need to get the right plasma from a prior COVID patient for the help I need. It’s coming and I thank God.”
By July 23, he was struggling to breathe. “Please please please pray for me,” he texted another acquaintance.
On July 24, he got a text from Yolanda. “I love and miss you. Stay strong. The best is yet to come.”
He never replied.
He was placed on a ventilator that day. It was clear to the family he was about to die.
They called in to say last goodbyes. They took turns saying their names and telling him they loved him. His mother told her firstborn son it was okay to let go and that she was “right behind you.”
“You and your dad wait for me,” she said.
Amanda, his eldest who'd been calling the hospital daily, said they “would take care of everything here and would make sure that mom would be good.”
“I told him he had done well — not just with us but with so many other people,” she told him, in her recollection.
Later that day, Amanda had a final video call with him.
Sitting on the floor of her bathroom, she watched on her laptop as healthcare workers extubated her dad, she said. She played music. She kept talking to him as a nurse told her it wouldn’t be long.
You’ll notice his breathing slow down, they told her. They called out his heart rate as it declined, she said.
The nurses stayed with him, touching his hands and shoulder. Amanda heard the song change, to one called "Welcome Home," and thought her dad looked exhausted; not like himself. A nurse said “I don’t have a pulse ... I'm so sorry sweetie,” according to Amanda's recollection.
Alvarado died July 25. He was 70.
Amanda sat and cried. Then she got a call from a funeral home offering to pick up her dad, saying it would be “an honor.” A storm was bearing down on South Texas, and she wanted his body out of the hospital before it hit.
An empty side of the bed
With the coronavirus still rampant in South Texas, Alvarado’s family couldn’t come together to mourn. They turned instead to a remembrance page on Facebook and sifted through their own recollections of him.
Mary David, his sister,remembered how he phoned her daily after her son suffered a devastating injury.
Another sister, Clare Rodriguez, lost her ex-husband several years ago. Alvarado had found the words to comfort her.
Lexy said her dad had driven her to ballet class three times a week as a kid — the only dad there — and was at every dance recital with roses.
The month of July, she said, felt like “a hurricane that just happened and came out of nowhere.”
“Boom, he’s not doing well. Boom, he’s sick. Boom, he has COVID, and then he’s just gone,” she said.
His youngest sister Teri noted the irony that her brother “was here for so many families for so many years … and he died by himself.”
The family tended to the logistics that quietly follow a death. Returning Alvarado’s laptop to his employer. Worrying about the grandkids and great grandson he’d adored, and his mom and her “shattered” heart.
Amanda turned to paperwork and closing his accounts. She's held off on coordinating a funeral.
Yolanda returned to their brick house in Mission after a stay in a rehabilitation facility. Lexy moved in to keep her company and help out. Aaron sent over yard workers to clear debris from a July storm. They made sure to disinfect the home and put away their father’s belongings.
Still, Yolanda felt his presence everywhere.
Their closet was organized, like he was, and full of his starched shirts. At night, she would instinctively reach out for him in bed, expecting to feel his warmth.
Even the front lawn evoked a memory of him. Soon after Yolanda’s return, she heard a lawnmower running and saw a shadow outside.
She looked through the window and saw a neighbor in her front yard, cutting the grass.
Disclosure: DHR Health has been a financial supporter of The Texas Tribune, a nonprofit, nonpartisan news organization that is funded in part by donations from members, foundations and corporate sponsors. Financial supporters play no role in the Tribune's journalism. Find a complete list of them here.
Perhaps it goes without saying — but producing quality journalism isn't cheap. At a time when newsroom resources and revenue across the country are declining, The Texas Tribune remains committed to sustaining our mission: creating a more engaged and informed Texas with every story we cover, every event we convene and every newsletter we send. As a nonprofit newsroom, we rely on members to help keep our stories free and our events open to the public. Do you value our journalism? Show us with your support.