CENTRAL FALLS, R.I. — After managing to beat back a massive coronavirus outbreak, the tiny city of Central Falls is facing a midsummer spike in cases, threatening to undo hard-won progress in the hottest of Rhode Island’s COVID-19 hot spots.
With school buildings scheduled to reopen next month, and a positive test rate of up to 17 percent, officials are worried about their ability to contain the spread of infection.
A month ago, a testing site devoted to the residents of Central Falls and neighboring Pawtucket was testing only about a dozen people a day and detecting less than two new cases of coronavirus per day. Some days, there were none.
“It was basically under control in the beginning to middle of June,” said Dr. Michael Fine, the former state Department of Health director who is now chief health strategist for the city of Central Falls.
But two weeks ago, the number of cases began to rise again. More people started showing up to be tested at the Dexter Street site in Central Falls, especially after the Twin River casino testing site closed. By last week, health workers were testing 130 to 140 people a day — 10 times more than a month ago. And by late last week, the number of positive cases hit 24 in a day.
The surge prompted Central Falls officials to issue a statement, warning of a “sudden spike of cases in the city.”
“You have to be worried that we have a bounce-back from one of many possible sources,” Fine said. “My fear is it may be getting worse, not better.”
The vexing news comes just as officials are focusing on the possibility of students returning to classrooms in the fall.
And it adds to the suffering that has seen Central Falls emerge as one of the hottest spots for COVID-19 in the Northeast — with a rate of 5,020 cases per 100,000 people, far exceeding Providence’s rate of 3,453 per 100,000, according to state Department of Health data released Wednesday.
Central Falls, a majority-Latinx city of nearly 20,000 people packed into 1.29 square miles, reflects the disproportionate toll that COVID-19 is taking on Rhode Island’s Latinx population: While Latinx make up 16 percent of residents, they account for 46 percent of those who have tested positive, according to Department of Health data that exclude cases with unknown demographic information.
And what happens in Rhode Island’s smallest city can have a big impact here in the smallest state. Fine noted that people are heading to beaches, going to restaurants, and working in other communities. “You cannot keep a virus like this in one place if you let it out of control,” he said.
Real progress had been evident in combating the outbreak in Central Falls.
The city joined Pawtucket in launching a BEAT COVID-19 hotline. The rapid testing site opened on Dexter Street May 6, and eventually the numbers of new cases identified there began to drop.
“I was looking at data from both cities every day, and there just was not that much disease,” Fine said. “Most of the spread was asymptomatic.”
He said he began looking for the resources to launch targeted testing of people without symptoms — hoping to go block by block to identify those with the virus and get them into isolation to contain the spread.
“But now we have a spike,” Fine said.
The Dexter Street site saw the following results over the past week:
- 22 positive tests out of 130 tests conducted on Thursday, July 16
- 24 positives out of 142 tests on Friday
- 10 positives out of 97 tests on Saturday
- No testing was done on Sunday
- 22 positives out of 144 tests on Monday
- 14 positives out of 109 tests on Tuesday
- 10 positives out of 108 tests on Wednesday
- 17 positives out of 139 tests on Thursday
Fine noted that the Centers for Disease Control director has estimated that for every case of COVID-19 reported, there could be 10 other infections. So, he said, the 17 new cases detected on Thursday might indicate 170 cases in Central Falls and Pawtucket.
Why the sudden increase?
City officials said the spike appears to stem from celebrations marking the Fourth of July and Cape Verdean Independence Day on July 5, and some cases involved people who had traveled to Florida, which is seeing a surge in COVID-19 cases.
With warm weather drawing people out to the beaches, celebrations, and restaurants, people can become complacent and fail to wear masks or keep the proper distance from others, Fine said.
So city officials are reminding residents to remain vigilant.
Central Falls will continue having police cruisers drive around the city playing messages in English and Spanish that remind residents that COVID-19 is still prevalent in the city. Residents are urged to wear masks, to wash their hands frequently, and if they feel ill, to call their doctor or the hotline at 855-843-7620 immediately.
City workers and police will enforce a face mask requirement and give out masks to those who don’t have one.
Last week, the state Department of Health determined that Georgia’s Family Restaurant in Central Falls was not following state regulations requiring that waitresses and cooks wear face masks and provide disposable menus. The restaurant has since complied.
Central Falls Councilman Franklin A. Solano said some people remain skeptical of the threat posed by the coronavirus. But given his own experience, he can attest: “This is not a joke. This is real.”
In mid-March, he attended a gathering for his daughter’s 34th birthday, and soon afterward all seven people there had fallen ill. Five of them, including his daughter and his ex-wife, tested positive for the coronavirus. Although his test came back negative, he remains certain he had COVID-19.
“I had all the symptoms,” Solano said. “I couldn’t taste or smell. I had conjunctivitis. I had chills. I have never felt so cold in my life.”
Gripped by fever and shaken by chills, he headed to the basement of his four-family home on Hunt Street, remaining in isolation for 14 days.
Solano, 56, a machine operator who grew up in the Dominican Republic, noted that Central Falls contains many triple-decker homes, and as a result, he said, the virus can spread quickly because people are often unable to isolate themselves from families in other apartments.
Also, Central Falls is home to thousands of the 29,000 undocumented immigrants that live in Rhode Island, according to estimates by the Latino Policy Institute at Roger Williams University. Solano said some undocumented residents remain wary of going to hospitals or other institutions when they get sick, for fear that they will be asked about their immigration status.
Solano implored people to stay home as much as possible, wear face masks, and take social distancing rules seriously.
“We have to do the right thing to protect our families, our friends, and our community,” he said.
On Monday, Solano joined Central Falls Mayor James A. Diossa outside City Hall for a flag-raising ceremony marking Colombian Independence Day, and reminders of the COVID-19 outbreak were apparent.
The event program contained a “COVID-19 Notice,” printed in English and Spanish, urging people to remain 6 feet apart and wear face masks.
A table outside City Hall contained hand sanitizer, face masks, and Department of Health handouts with information about how residents can protect themselves and get help if they become infected. Organizers tried to ensure the crowd would be smaller than normal for the annual event. And all the participants wore face masks.
“These are difficult times,” Diossa said during the ceremony. “I can’t believe we are celebrating this anniversary, or this independence day, with the circumstances not only here in Rhode Island but throughout the world.”
He noted that in Colombia, a spike in coronavirus cases has forced many towns and cities that had been reopening — including Bogotá and Medellín — to issue new lockdown orders.
“So I pray for them and the people there,” Diossa said. “My mom still lives in Colombia, so I’m always in constant communication with her.”
Diossa urged Congress to pass another round of coronavirus aid. He praised Governor Gina M. Raimondo’s handling of the health crisis, but he said he remains concerned about the prospect of schools reopening in the fall amid the pandemic.
“Being in a hot spot, I look at the world a little differently,” Diossa said. “Especially in densely populated communities, if the kids get it, they are likely to go home to a very full house where there are parents and grandparents, and that concerns me.”
Fine said other countries have done a much better job of containing the coronavirus. For example, China brought 42,000 health care workers to Wuhan, a city of 11 million, to stem the outbreak there, and Israel brought 2,000 health care workers to Bnei Brak, a city of 200,000, he said.
While Central Falls is a much smaller city, there are some 50,000 people in Pawtucket and Central Falls who lack access to a primary care physician, Fine said. The cities have two of the four highest COVID-19 infection rates in Rhode Island, and Central Falls has one of the highest infection rates in the nation, he said.
“You would have thought we would have brought the world’s resources to stomp this out,” Fine said. “We are a little behind the eight ball now.”
The spike in cases is coming just as communities are focusing on whether to bring students back to school buildings in the fall, and Fine said such decisions should be based on how much disease is circulating in each community.
In Central Falls and Pawtucket, the rate of positive tests is now ranging between 13 percent and 17 percent, Fine said. Most communities would be reluctant to open schools if the positive test rate is higher than 5 percent, or even 2 percent in some cases, he said.
“What we need to do is bring all these resources in to shut the transmission down — and then talk about schools,” Fine said.
Dr. Pablo Rodriguez, medical director for community affairs at Care New England and host of the “Nuestra Salud” radio talk show, agreed. “Any time the positivity rate is above 5 percent, you have community spread,” he said. “And if it’s above 10 percent, you are in a crisis.”
Rodriguez noted that Central Falls public schools, which are controlled by the state, were facing budget trouble before the coronavirus struck because of an unexpected spike in students, and in early June the school board voted to lay off 36 employees.
So, he asked: How can Central Falls hope to keep the virus at bay if it opens schools with more students, fewer staff, and infection rates rising in the community? “I am worried about an even further acceleration of the epidemic,” he said.
Rodriguez said Rhode Island won’t succeed in getting COVID-19 fully under control until it does more to deal with outbreaks in hot spots like Central Falls.
On Wednesday, Solano took stock of the toll the virus has taken on the city. “It’s killing a lot of people, it’s keeping a lot of people out of work, it’s doing a lot of damage,” he said. “We have to be careful. We need to be safe.”
But Solano maintains hope. “We will be back to normal,” he said. “When? That’s a question mark.”