CENTRAL FALLS, R.I. — Her fever spiked to 105 degrees and she thought she was going to die.
As an undocumented immigrant, she worried what questions she might face if she went for coronavirus testing. But eventually, she and her husband did get tested and were told they had COVID-19.
As her symptoms grew worse, the woman — who identified herself only as Lil — decided she would not go to the local hospital because she was alarmed by TV images of people dying in New York City hospitals.
“If I’m going to die, I’d rather die at home,” she said.
She resorted to a home remedy from her native Guatemala — a special type of tea — and eventually got a nebulizer from a local health clinic to help her breathe.
But soon, her whole family was sick — all eight people, including her husband, a nephew, and five children ages 2, 6, 9, 17, and 19 — all crammed into an apartment in Central Falls.
Her husband and nephew were unable to continue working at jobs installing air conditioners — cutting off the family’s only source of income. As undocumented immigrants, they could not turn to unemployment insurance or federal stimulus checks. So they ended up paying their rent late, and now their landlord has asked them to leave.
The ordeal that Lil’s family is going through reflects the disproportionate toll that the coronavirus is exacting on Rhode Island’s Latino population, including undocumented residents.
While Latinos make up 16 percent of the state, they account for 44 percent of Rhode Islanders who have tested positive for the coronavirus, according to the latest state Department of Health data. Those figures exclude cases where demographic information is unknown. But Latinos account for just 13 percent of the state’s coronavirus deaths because, experts say, the Latino population is younger than the general population in Rhode Island and the virus tends to hit younger people less hard.
Nowhere is the impact of those numbers more clear and severe than Central Falls. The smallest city in the smallest state is now among the hottest of the hot spots.
At 3,446 cases per 100,000 people, Central Falls has by far the highest coronavirus rate in Rhode Island — exceeding Providence’s rate of 2,181 per 100,000, according to Department of Health data. Central Falls even exceeds the rate of 2,852 per 100,000 in New York City’s hardest-hit borough, the Bronx — but it trails the astronomical rate of 6,404 cases per 100,000 in Chelsea, Mass.
At 1.29 square miles, Central Falls is a densely populated pocket of Rhode Island, with Latinos accounting for at least 66 percent of its 19,000 residents. Also, the city is home to thousands of the 29,000 undocumented immigrants that live in Rhode Island, according to Latino Policy Institute at Roger Williams University estimates.
Central Falls City Council President Maria Rivera said she gets calls every day from residents who are getting sick and losing their jobs, struggling to pay their bills, and scrambling to come up with next month’s rent.
“We are being hit real hard,” Rivera said. “Many of those impacted work in factories, and when one person tests positive, they work or live together. We are such a condensed community — it’s so hard to have our residents isolate themselves.”
Responding to the increasing need, she helped to organize the Central Falls Emergency Fund for Undocumented Families. With assistance from the Rhode Island Welcome Back Center and the Elisha Project and donations from Walmart, the drive raised more than $15,000, providing gift cards for 70 families.
Lil said she ended up getting a $250 gift card, using it to buy soap, toothpaste, and dish detergent for her family.
The story of Lil’s family “is completely emblematic of the fact that the pandemic has not abated in the Latino community and the immigrant community,” said Dr. Pablo Rodriguez, medical director for community affairs at the Care New England health system and host of the “Nuestra Salud” radio talk show.
“When we are about to open the economy again, we are very concerned the epidemic will continue raging and many more people will get infected and die,” Rodriguez said. “This should tell Rhode Island officials that the effort has to be in the hot spots, and the hot spots are where the Latino community resides.”
Rodriguez said Central Falls and Chelsea, Mass., are like “twin cities” — both tiny, densely populated municipalities with large Latino populations that are now being ravaged by the coronavirus.
The rates of infection are high in part because of the density but also because of “social determinants of health," he said. For example, while others can work from home with Zoom conferences, many Central Falls residents must go to work in low-wage jobs at factories and food processing plants, Rodriguez said. Also, many lack access to health care, and many live in crowded apartments, he said.
While all eight members of Lil’s family did end up getting tested, Rodriguez said many undocumented immigrants are too afraid to go to testing sites where Rhode Island National Guard members are working in uniform.
“Some don’t want to come out because they are concerned about Trump,” he said. “It’s a real fear. Government is Trump in their mind.”
Rodriguez said it has definitely helped that a walk-up COVID-19 rapid testing site has opened at 934 Dexter St. in Central Falls, providing free tests for Central Falls and Pawtucket residents.
But he said the state also should move its contact tracing operations into the community so that trusted people are tracking down residents who have been exposed to the virus and ensuring they remain isolated for 14 days.
Also, Rodriguez said Rhode Island should follow the lead of California, which has partnered with philanthropic groups to provide disaster relief to undocumented immigrants who are not eligible for unemployment insurance or aid through the federal stimulus package. The California fund provides undocumented workers affected by coronavirus with one-time payments of up to $500 per person or $1,000 per household.
“If we really are serious about stopping the epidemic, this is one way to support them and prevent people from going to work sick in order to put food on the table,” he said.
Residents of every city and town in Rhode Island have a stake in preventing the virus from spreading in Central Falls, Rodriguez said.
“The virus does not recognize borders or political parties,” he said. “As long as there are hot spots, you will have embers, and with embers, you can have a raging fire.”
Marcela Betancur, executive director of the Latino Policy Institute at Roger Williams University, said the pandemic exposes and exacerbates the problems and the inequities that Latinos faced before the outbreak — higher unemployment rates and higher poverty rates, lower rates of health insurance coverage, and lower high school and college graduation rates.
“The virus is showing the lack of investment and equity that we see in policies and programs in our state and in our nation,” said Betancur, who grew up in Central Falls.
On April 23, the state’s Latino elected officials wrote to the governor and top legislators, saying they want to help Rhode Island tackle the factors behind the outsized number of Latinos being infected with the coronavirus.
“It is critical that we take this unprecedented opportunity to evaluate and eliminate the long-standing systemic inequalities that have been brought to light by COVID-19," said the letter, signed by Secretary of State Nellie M. Gorbea, Providence Mayor Jorge O. Elorza, Central Falls Mayor James A. Diossa, and others.
Diossa, the city’s first Latino mayor, has called Central Falls the “Comeback City” as it has clawed its way back from bankruptcy and the conviction of his predecessor on corruption charges. But now, as he serves the final year of his final term, his city faces the daunting task of coming back from an unparalleled public health crisis.
To face this threat, Diossa said Central Falls and neighboring Pawtucket are partnering with local groups to create a team, known as Beat Covid-19, led by former state Department of Health director Dr. Michael Fine. The team set up a hotline (855-843-7620), and it’s reaching out to people in both cities, offering access to testing and helping them find ways to safely isolate.
Diossa said many Central Falls residents stock shelves and work in factories, providing the food and the products needed by other Rhode Islanders. But those jobs can expose them to the virus, and if they get sick, they might not have a way to avoid being near family members.
“Not everyone has the luxury of isolating,” he said, citing Lil’s family as an example.
Last week, Lil stood on a sidewalk in Central Falls, surrounded by her children, who were all wearing cloth face coverings, as City Council President Rivera translated for a reporter.
She said the coronavirus had been particularly virulent for her and her 17-year-old daughter. They were vomiting, fighting severe headaches, and high fevers.
Now, she said, all eight members of her family have recovered and completed a quarantine period, and her husband and nephew were able to return to their jobs, where they each make about $600 a week, or $15 per hour.
But Lil said she still panics when she thinks of COVID-19, and she is not sure they would survive if they contracted the virus again.
She said she knows a woman who traveled from Guatemala to visit family members in Providence and ended up getting the virus and dying.
“My 9-year-old prays to God a lot,” Lil said. “He wants the virus to go far away — so our life can go back to normal.”
Edward Fitzpatrick can be reached at firstname.lastname@example.org