LYNN — As COVID-19 ravaged Massachusetts in the spring and summer, a blue-collar city north of Boston emerged as the state’s worst outbreak.
Today, Chelsea continues to contend with high rates of infection. But state statistics suggest another diverse, working class city to the north has surpassed it. By some measure, the city held most tightly in the clutches of COVID-19 is now Lynn.
Even as officials pour resources into preventing a further rise in infections, conclusive explanations for Lynn’s struggle to contain the virus remain out of reach. Some here blame lax attitudes toward the pandemic. But a familiar pattern is plainly at play: Once again, a city that is home to a large number of people of color, immigrants, and essential workers is bearing the brunt of COVID-19.
In the two weeks from August 5 to 19, 7.09 percent of COVID-19 tests in Lynn came back positive — a far higher rate than any other city with 25 or more total coronavirus cases. The average for such cities in that time period was 2.6 percent.
The uniquely high rate of positive tests in Lynn reflects a persistent rise in cases over the summer. In the two weeks leading up to July 15, Lynn saw an average of 5.1 new cases per 100,000 residents per day. For the two-week period ending August 19, that figure rose to 23.6 new cases per 100,000 people. The increase in new cases, which quadrupled over the course of a month, substantially outpaced the increase in testing, which merely doubled over the same period.
Epidemiologists often shy away from terms like hot spot or epicenter. But Dr. David Hamer, a physician at Boston Medical Center and disease expert at Boston University, called Lynn’s statistics concerning. “There’s evidence of increased activity in Lynn relative to other cities in the state, which is worrisome as a trend, if it is a trend,” Hamer said.
When Governor Charlie Baker first unveiled a map on Aug. 11 highlighting the COVID-19 risk in communities across the state, Lynn was one of four cities shaded in red, along with Chelsea, Everett, and Revere. Six additional cities have since joined that list of communities with high rates of infections.
Lynn and other high-risk cities have received state support to expand free testing, contact tracing, and business safety enforcement.
But even as they work with the state to ramp up public health resources, public officials in Lynn are pleading with residents to do their part, saying that a lack of caution about the pandemic has contributed to rising cases.
“People have to understand that we as our community have to continue to limit the spread,” Lynn Mayor Thomas McGee said in an interview. “We need to work together to get through this.”
“I know a lot of people who are not even worried about [the coronavirus] because they feel so healthy,” said Eva Charkowski, 58, a Lynn resident. Charkowski said that she felt relatively safe from the virus, given what she believes is her strong immune system, but she still worried about less healthy neighbors. “You’ve got to be careful anyway, just the same. That’s why we wear masks, to stay safe.”
Most new COVID-19 cases in Lynn have been in 18- to 40-year-olds, said McGee and Lynn public health director Michele Desmarais. They pointed to large gatherings — including barbecues, baby showers, and a birthday party with a bouncy house — as places where infection has spread.
“What we have found with contact tracing is that our residents have let their guard down,” Desmarais said.
Desmarais insisted that leisure activities, not work, have led to most people getting sick. “The businesses are doing great. Following compliance, wearing masks, social distancing. It’s not the businesses,” she said. “It’s definitely mostly house parties [where residents are getting COVID-19].”
But David Schaffner, medical director of the urgent care team and COVID-19 testing at Lynn Community Health Center, took a different view.
“I feel like I have to push back when I hear people talk about how it’s all personal responsibility,” he said. “Our patients are put in really challenging situations which put them at much, much higher risk.”
Schaffner said that over 50 percent of Lynn residents are essential workers and that many live in multigenerational, multifamily housing, which McGee also named as a risk factor. Schaffner did not dismiss the role of individual actions in spreading COVID-19 in Lynn, but he said, “In my mind, it’s a couple of factors that are probably more important.”
Lynn’s median household income falls nearly $23,000 below the state median. The population is 41.5 percent Hispanic or Latino compared to 12.4 percent for Massachusetts as a whole, according to 2019 census estimates. The city’s share of Black and multiracial residents also exceeds state figures. Just 36.5 percent of Lynn residents were listed as white alone, not Hispanic or Latino. Nearly the same share, 36.2 percent, are immigrants.
Seen through the lens of these data, the virus’s path through the state has hardly changed at all, even though the worst-off city may have changed. From the early days of the pandemic, it was working-class communities of color that saw their infections and death tolls quickly outpace the rest of Massachusetts.
Now, even as the pandemic appears to trail off in most of the state, several of the same communities are still battling higher-than-average transmission. On the state’s Aug. 19 report, Chelsea’s 14-day average of new cases barely topped Lynn’s, with 23.9 new cases per 100,000 residents per day compared to Lynn’s 23.6. Of the 10 cities the state identifies as highest risk for COVID-19 transmission, most are lower income, more heavily immigrant, and browner than the state as a whole.
These preexisting, macro-level inequalities mean we should be “cautious” of attributing public health outcomes in any city to individual choices alone, said Nancy Krieger, a professor of social epidemiology at Harvard T.H. Chan School of Public Health.
“If you have a background higher rate of infection, the ‘same’ behavior may carry more risk,” Krieger said. “If someone has a party in an area that has a high background rate of infection already, you will probably see more of a risk” than if someone hosts a similar party in a low-infection area.
“So then the question becomes why are there the higher rates of existing and persistent tolls of infection and death in the communities [the state] identified as high-risk. And that’s not parties,” Krieger said.
For Desa Simic, 59, public health disparities and her neighbors’ choices are both causes for concern. A nurse who has lived in the city for 24 years, Simic said that even as she, her family, and many other essential workers are taking every precaution to avoid transmitting or contracting COVID-19, other Lynn residents are hosting maskless gatherings, which she said she has seen “all over the city.”
Simic said the parties worry her all the more because she knows how high-risk her community already is. “The public behavior I don’t understand,” she said. “I see two different parts of the city.”
Dasia Moore is the Globe Magazine's staff writer. E-mail her at email@example.com. Follow her on Twitter @daijmoore.