Brockton, Randolph stand out with coronavirus infection rates among the state’s highest

Number of nursing homes, challenges facing low-income and immigrant groups may be factors

Main Street in downtown Brockton, where coronavirus rates are high.Barry Chin/Globe Staff

BROCKTON — Earlier this year, the biggest news in Brockton was Mayor Robert Sullivan’s inauguration, and speculation about how the newly minted executive would reshape city government.

Now the city is grappling with a fast-moving pandemic, and the alarming distinction of being second only to Chelsea in having the state’s highest rate of infections — and second only to Boston in overall cases.

A flashing digital marquee posted near the downtown bus depot tells of its latest priorities: Brockton’s curfew is 9 p.m. Essential employees only. Wear a mask.

Good Samaritan Medical Center hopes the surge is over

Brockton has the second-highest rate in Massachusetts for COVID-19. Good Samaritan Medical Center is hoping the surge is over. (Shelby Lum|Globe Staff)

In the past month, the number of coronavirus-related deaths in Brockton surged from the single digits to 138. More than 1,800 residents are being treated for the virus. The nearby municipality of Randolph, where 29 people have died of coronavirus complications, also has one of the state’s highest rates.

Both communities face similar challenges in containing a highly contagious virus among their populations — many of whom are part of immigrant or low-income families that live in close quarters and work in blue-collar and social services industries that require continued interaction with the public.

A walk-in COVID-19 testing tent outside the downtown Brockton Neighborhood Health Center.Barry Chin/Globe Staff

Brockton and Randolph are among the most diverse places in the state: Census data show about 40 percent of their residents are Black, roughly 10 percent Hispanic, and about 33 percent foreign born.

In the region south of Boston, Brockton’s coronavirus numbers remain the highest — probably fueled by its five nursing homes, each with more than 30 residents who have tested positive for COVID-19.

Many in this city — it’s about 19 miles from downtown Brockton to the State House — say they worry that the numbers of infections and deaths will continue to surge as testing becomes more available. But they remain hopeful that new data will show intensified efforts to isolate those who’ve been exposed and to expand testing are flattening the trend lines.

“Certainly from a wishful-thinking perspective, we’re hoping we’re past peak,” said Sue Joss, chief executive of the Brockton Neighborhood Health Clinic.

No one is sure the main reason Brockton, with a population of about 95,000, has emerged as a hot spot. Some point to outreach efforts to the immigrant community, where a lack of English fluency can complicate efforts to communicate the dangers of the virus.

Others say racial and economic inequality are driving the outbreak, leading to higher infection rates among low-income and “essential workers" who can’t work from home, issues mirroring those in Chelsea. Yet these can’t be the only reasons, some say, as many of these same demographic factors exist in so-called gateway cities like New Bedford and Fall River, which show relatively low levels of coronavirus cases.

At Good Samaritan Hospital in Brockton, officials say a specific local factor is the concentration of nursing homes, each of which has recorded more than 30 infected residents, according to recent state data.

For example, more than 80 employees and residents at the Brockton Health Center tested positive for the virus, and 12 have died. Across town at Alliance Health at West Acres, the tally of coronavirus-related deaths stood at 22, a spokeswoman said.

Local leaders say they worry about what is to come, and that more testing will only reveal a bigger problem that could overwhelm a city already struggling to cope with the outbreak.

Still, medical officials hesitate to draw premature conclusions about the reasons for the number of cases. Testing has been uneven between cities, and demographic data on those who are infected is scarce, they say.

"We just don’t know what sets Brockton apart from other gateway cities,” Joss said.

Still, some other factors stand out, painting a grim picture of the city’s struggle.

More than 30 percent of the people tested at the city’s main shelter for the homeless tested positive for the virus, reinforcing the idea that it can spread rapidly among those living on the streets and in shelters.

Homeless people congregate on the steps of the former Keys Of The Kingdom Tabernacle Of Prayer on Main Street in Brockton. Barry Chin/Globe Staff

Many of the city’s workers are employed in front-line jobs at medical and long-term care facilities, where the chance of being exposed to the virus runs high. The Census Bureau estimates that nearly a quarter of Brockton’s workers are employed in health care and personal assistance roles.

In Brockton, there can be a ripple effect of challenges that makes coping difficult. Good Samaritan Hospital treats up to 100 coronavirus patients each day, many of them transferred from local nursing homes. But for those who recover, discharge is not always an easy proposition.

“There’s always a concern about putting someone back into another nursing home after they’ve already recovered from the virus,” said the hospital’s chief of medicine, Dr. Kenneth Lawson. “So if you don’t have family, where do you go?"

For immigrants, language barriers also can pose a problem. Brockton health authorities said they do not have tracking data on the races of those who’ve tested positive for the coronavirus. But new immigrants, especially of Haitian and Cape Verdean descent, have been deeply affected.

State and local officials have intensified efforts to translate their messages into the Creole languages spoken by these immigrants, but they don’t always break through.

The language barrier only heightens the danger for immigrant communities, in which cultural customs and limited incomes make group living a necessity, said a former Brockton city councilman, Jean Bradley Derenoncourt.

Sullivan, the mayor, said a host of factors are behind the city’s coronavirus outbreak, but he also believes some residents initially ignored warnings to take precautions. He has declared a local emergency and imposed a mandatory curfew, but said some residents are not taking them seriously and treat the situation "like an extended vacation.''

He said he has asked police to disperse groups from playgrounds and a golf course.

Officials at the state Department of Public Health said they are working hard with the Brockton and Randolph health departments to address the issues with social-media campaigns and contact-tracing programs.

With about 34,000 residents, Randolph is about one-third the size of Brockton. And while it has more middle-class sections, it also has substantial immigrant and low-income enclaves that face similar challenges in preventing the virus’s spread.

A cyclist wears a mask in Randolph.Barry Chin/Globe Staff

Randolph town officials said information about the coronavirus threat and guidance for residents on the pandemic has been provided in multiple languages “whenever possible."

Randolph has one nursing home, where more than 30 residents are infected with coronavirus, state data show.

Officials in both municipalities said they’re working hard to secure more funding to combat the outbreak and promote testing and educational outreach.

“In the beginning there was a disconnect between what we like to do and what we have to do,” said Iva Andrade, of Brockton’s Cape Verdean community. “I don’t think that’s happening anymore, because it’s hitting us so hard."

Liz Kowalczyk of the Globe staff contributed to this report.