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| ‘We’re Petrified’: Immigrants Afraid to Seek Medical Care for Coronavirus | ‘We’re Petrified’: Immigrants Afraid to Seek Medical Care for Coronavirus |
| (about 4 hours later) | |
| LOS ANGELES — The coronavirus was not on the agenda when a legal-aid group two months ago invited farmworkers who toil in the date groves, lemon orchards and vineyards of California’s Coachella Valley to an information session about immigration issues. | LOS ANGELES — The coronavirus was not on the agenda when a legal-aid group two months ago invited farmworkers who toil in the date groves, lemon orchards and vineyards of California’s Coachella Valley to an information session about immigration issues. |
| But when Luz Gallegos and her team showed up over the weekend, they were cornered by people who peppered them with questions about the virus. On Monday, public health authorities announced the first two deaths from the virus in this part of Southern California, both in the Coachella Valley. | But when Luz Gallegos and her team showed up over the weekend, they were cornered by people who peppered them with questions about the virus. On Monday, public health authorities announced the first two deaths from the virus in this part of Southern California, both in the Coachella Valley. |
| “There’s a new layer of fear in the immigrant community right now created by Covid-19,” said Ms. Gallegos, a director of TODEC Legal Center, who stood with immigrants in the parking lot of the Hemet town library, which had abruptly closed as a result of the pandemic. “We believe that some members will be afraid to seek the care they need,” she said. | “There’s a new layer of fear in the immigrant community right now created by Covid-19,” said Ms. Gallegos, a director of TODEC Legal Center, who stood with immigrants in the parking lot of the Hemet town library, which had abruptly closed as a result of the pandemic. “We believe that some members will be afraid to seek the care they need,” she said. |
| Among the questions the farmworkers had: If I go to the hospital, is it going to hurt my chances of becoming a legal permanent resident? If I’m undocumented, could seeking treatment make me vulnerable to deportation? If I miss work as more people are forced to stay home, how will I feed my family and make the rent? | Among the questions the farmworkers had: If I go to the hospital, is it going to hurt my chances of becoming a legal permanent resident? If I’m undocumented, could seeking treatment make me vulnerable to deportation? If I miss work as more people are forced to stay home, how will I feed my family and make the rent? |
| As the coronavirus sweeps across the United States, immigrants may be among the least able to self-isolate and seek the medical care that is essential to protecting their health and slowing the spread of the disease. | As the coronavirus sweeps across the United States, immigrants may be among the least able to self-isolate and seek the medical care that is essential to protecting their health and slowing the spread of the disease. |
| The Trump administration on Wednesday closed the border with Canada to all but essential traffic and was also considering shutting the southern border to those without legal authorization, hoping to check the spread of the virus. But many of the unauthorized immigrants already in the United States face the same threat from the virus as everyone else — and are less equipped to protect themselves. | The Trump administration on Wednesday closed the border with Canada to all but essential traffic and was also considering shutting the southern border to those without legal authorization, hoping to check the spread of the virus. But many of the unauthorized immigrants already in the United States face the same threat from the virus as everyone else — and are less equipped to protect themselves. |
| Some of those without health insurance fear that going to a public hospital or clinic will ruin their chances of getting a green card under the Trump administration’s tough new public assistance regulations for immigrants. Other immigrants fear putting themselves in the cross-hairs of Immigration and Customs Enforcement if they step forward for help. | Some of those without health insurance fear that going to a public hospital or clinic will ruin their chances of getting a green card under the Trump administration’s tough new public assistance regulations for immigrants. Other immigrants fear putting themselves in the cross-hairs of Immigration and Customs Enforcement if they step forward for help. |
| ICE agents over the past week have continued to make arrests in some of the regions hardest hit by the virus, including California and New York. | ICE agents over the past week have continued to make arrests in some of the regions hardest hit by the virus, including California and New York. |
| “The fear that this administration has fueled in immigrant communities is thwarting efforts to protect the public health of everybody,” said Tanya Broder, an attorney who specializes in health care access for immigrants at the National Immigration Law Center. | “The fear that this administration has fueled in immigrant communities is thwarting efforts to protect the public health of everybody,” said Tanya Broder, an attorney who specializes in health care access for immigrants at the National Immigration Law Center. |
| Immigrants who are just scraping by often live cheek-by-jowl, making them vulnerable to the spread of illness, especially in cities where housing costs are high. In East Los Angeles, Latino immigrants often crowd an entire family into a single bedroom in a house. In the San Gabriel Valley, east of Los Angeles, thousands of Asian workers live in overcrowded apartments called “boarding houses.” | Immigrants who are just scraping by often live cheek-by-jowl, making them vulnerable to the spread of illness, especially in cities where housing costs are high. In East Los Angeles, Latino immigrants often crowd an entire family into a single bedroom in a house. In the San Gabriel Valley, east of Los Angeles, thousands of Asian workers live in overcrowded apartments called “boarding houses.” |
| They work at jobs that often do not offer paid sick leave, nor the luxury of being able to self-quarantine in the event that they are exposed to the virus. | They work at jobs that often do not offer paid sick leave, nor the luxury of being able to self-quarantine in the event that they are exposed to the virus. |
| “Unfortunately, these immigrants face a very tough choice during this crisis: risk exposure or risk homelessness,” said Louise McCarthy, president of the Community Clinic Association of Los Angeles. “A low-income worker can’t just take a day off — losing a day’s pay can mean losing your housing.” | “Unfortunately, these immigrants face a very tough choice during this crisis: risk exposure or risk homelessness,” said Louise McCarthy, president of the Community Clinic Association of Los Angeles. “A low-income worker can’t just take a day off — losing a day’s pay can mean losing your housing.” |
| Felix Aguilar, chief medical officer at Chinatown Service Center, which has four clinics in greater Los Angeles, said that it has stepped up screening for the coronavirus, in person and over the phone. “It’s a matter of time. We are getting ready. We know the onslaught is coming,” he said. | Felix Aguilar, chief medical officer at Chinatown Service Center, which has four clinics in greater Los Angeles, said that it has stepped up screening for the coronavirus, in person and over the phone. “It’s a matter of time. We are getting ready. We know the onslaught is coming,” he said. |
| Among all immigrants, 23 percent of those who are lawfully in the country and 45 percent of those who are undocumented lack health insurance, according to a report by the Kaiser Family Foundation. | Among all immigrants, 23 percent of those who are lawfully in the country and 45 percent of those who are undocumented lack health insurance, according to a report by the Kaiser Family Foundation. |
| In most states, community clinics serve people who require medical care, regardless of their status and ability to pay. And some states, such as California, Massachusetts, New York and Illinois, among others, cover medical care costs for undocumented children. | In most states, community clinics serve people who require medical care, regardless of their status and ability to pay. And some states, such as California, Massachusetts, New York and Illinois, among others, cover medical care costs for undocumented children. |
| But because of the Trump administration’s so-called public charge rule, Ms. Broder said, “Even when services are available, immigrants may be afraid to seek the care that they need.” | But because of the Trump administration’s so-called public charge rule, Ms. Broder said, “Even when services are available, immigrants may be afraid to seek the care that they need.” |
| The People’s Community Clinic in Austin, Texas, a city with a handful of confirmed coronavirus cases, had already been struggling to manage spikes in no-shows among undocumented patients intimidated by recent ICE arrest activity, as well as by the public charge rule, when the first cases began to appear. | The People’s Community Clinic in Austin, Texas, a city with a handful of confirmed coronavirus cases, had already been struggling to manage spikes in no-shows among undocumented patients intimidated by recent ICE arrest activity, as well as by the public charge rule, when the first cases began to appear. |
| “I know there are people reticent but what we’ve tried to do is reassure them,” said Regina Rogoff, the clinic’s chief executive officer, “We’re here to serve patients regardless of what their paperwork says. I’m hoping that’s how our patients continue to see us.” | “I know there are people reticent but what we’ve tried to do is reassure them,” said Regina Rogoff, the clinic’s chief executive officer, “We’re here to serve patients regardless of what their paperwork says. I’m hoping that’s how our patients continue to see us.” |
| Even before the coronavirus arrived in the United States, having a large population that feels disenfranchised from the mainstream medical community heightened the risk for transmission of infectious diseases, said Lawrence Gostin, a professor of global health law at Georgetown University and adviser to the World Health Organization. | Even before the coronavirus arrived in the United States, having a large population that feels disenfranchised from the mainstream medical community heightened the risk for transmission of infectious diseases, said Lawrence Gostin, a professor of global health law at Georgetown University and adviser to the World Health Organization. |
| “The first rule of public health is to gain people’s trust to come forward: People who don’t seek care cannot be tested or treated, and their contacts won’t be traced,” he said. | “The first rule of public health is to gain people’s trust to come forward: People who don’t seek care cannot be tested or treated, and their contacts won’t be traced,” he said. |
| “The last thing immigrants want to do in this political environment is tell health officials about their friends who are also unlawfully here,” Mr. Gostin said. | “The last thing immigrants want to do in this political environment is tell health officials about their friends who are also unlawfully here,” Mr. Gostin said. |
| Updated June 24, 2020 | |
| Scientists around the country have tried to identify everyday materials that do a good job of filtering microscopic particles. In recent tests, HEPA furnace filters scored high, as did vacuum cleaner bags, fabric similar to flannel pajamas and those of 600-count pillowcases. Other materials tested included layered coffee filters and scarves and bandannas. These scored lower, but still captured a small percentage of particles. | |
| A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. | A commentary published this month on the website of the British Journal of Sports Medicine points out that covering your face during exercise “comes with issues of potential breathing restriction and discomfort” and requires “balancing benefits versus possible adverse events.” Masks do alter exercise, says Cedric X. Bryant, the president and chief science officer of the American Council on Exercise, a nonprofit organization that funds exercise research and certifies fitness professionals. “In my personal experience,” he says, “heart rates are higher at the same relative intensity when you wear a mask.” Some people also could experience lightheadedness during familiar workouts while masked, says Len Kravitz, a professor of exercise science at the University of New Mexico. |
| The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. | The steroid, dexamethasone, is the first treatment shown to reduce mortality in severely ill patients, according to scientists in Britain. The drug appears to reduce inflammation caused by the immune system, protecting the tissues. In the study, dexamethasone reduced deaths of patients on ventilators by one-third, and deaths of patients on oxygen by one-fifth. |
| The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. | The coronavirus emergency relief package gives many American workers paid leave if they need to take time off because of the virus. It gives qualified workers two weeks of paid sick leave if they are ill, quarantined or seeking diagnosis or preventive care for coronavirus, or if they are caring for sick family members. It gives 12 weeks of paid leave to people caring for children whose schools are closed or whose child care provider is unavailable because of the coronavirus. It is the first time the United States has had widespread federally mandated paid leave, and includes people who don’t typically get such benefits, like part-time and gig economy workers. But the measure excludes at least half of private-sector workers, including those at the country’s largest employers, and gives small employers significant leeway to deny leave. |
| So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. | So far, the evidence seems to show it does. A widely cited paper published in April suggests that people are most infectious about two days before the onset of coronavirus symptoms and estimated that 44 percent of new infections were a result of transmission from people who were not yet showing symptoms. Recently, a top expert at the World Health Organization stated that transmission of the coronavirus by people who did not have symptoms was “very rare,” but she later walked back that statement. |
| Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. | Touching contaminated objects and then infecting ourselves with the germs is not typically how the virus spreads. But it can happen. A number of studies of flu, rhinovirus, coronavirus and other microbes have shown that respiratory illnesses, including the new coronavirus, can spread by touching contaminated surfaces, particularly in places like day care centers, offices and hospitals. But a long chain of events has to happen for the disease to spread that way. The best way to protect yourself from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing your hands, not touching your face and wearing masks. |
| A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. | A study by European scientists is the first to document a strong statistical link between genetic variations and Covid-19, the illness caused by the coronavirus. Having Type A blood was linked to a 50 percent increase in the likelihood that a patient would need to get oxygen or to go on a ventilator, according to the new study. |
| The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. | The unemployment rate fell to 13.3 percent in May, the Labor Department said on June 5, an unexpected improvement in the nation’s job market as hiring rebounded faster than economists expected. Economists had forecast the unemployment rate to increase to as much as 20 percent, after it hit 14.7 percent in April, which was the highest since the government began keeping official statistics after World War II. But the unemployment rate dipped instead, with employers adding 2.5 million jobs, after more than 20 million jobs were lost in April. |
| Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. | Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days. |
| If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) | If air travel is unavoidable, there are some steps you can take to protect yourself. Most important: Wash your hands often, and stop touching your face. If possible, choose a window seat. A study from Emory University found that during flu season, the safest place to sit on a plane is by a window, as people sitting in window seats had less contact with potentially sick people. Disinfect hard surfaces. When you get to your seat and your hands are clean, use disinfecting wipes to clean the hard surfaces at your seat like the head and arm rest, the seatbelt buckle, the remote, screen, seat back pocket and the tray table. If the seat is hard and nonporous or leather or pleather, you can wipe that down, too. (Using wipes on upholstered seats could lead to a wet seat and spreading of germs rather than killing them.) |
| If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. | If you’ve been exposed to the coronavirus or think you have, and have a fever or symptoms like a cough or difficulty breathing, call a doctor. They should give you advice on whether you should be tested, how to get tested, and how to seek medical treatment without potentially infecting or exposing others. |
| More than 450 public health and legal experts signed an open letter early this month to Vice President Mike Pence and other federal, state and local leaders demanding a “fair and effective” response to the virus, which would include a declaration that medical facilities are immigration enforcement-free zones, as occurred after recent hurricanes and the Sept. 11 terrorist attacks. | More than 450 public health and legal experts signed an open letter early this month to Vice President Mike Pence and other federal, state and local leaders demanding a “fair and effective” response to the virus, which would include a declaration that medical facilities are immigration enforcement-free zones, as occurred after recent hurricanes and the Sept. 11 terrorist attacks. |
| ICE classifies medical facilities as “sensitive locations” where enforcement is avoided, though exceptions can be made. | ICE classifies medical facilities as “sensitive locations” where enforcement is avoided, though exceptions can be made. |
| On Friday, after President Trump announced a national health emergency, the United States Citizenship and Immigration Services, which screens green-card applications, appeared to signal that it was suspending enforcement of the public charge rule. A statement posted on its website said that seeking treatment or preventive services for the virus would not adversely affect applicants applying for permanent residence. | On Friday, after President Trump announced a national health emergency, the United States Citizenship and Immigration Services, which screens green-card applications, appeared to signal that it was suspending enforcement of the public charge rule. A statement posted on its website said that seeking treatment or preventive services for the virus would not adversely affect applicants applying for permanent residence. |
| “If the alien is prevented from working or attending school, and must rely on public benefits for the duration of the Covid-19 outbreak and recovery phase, the alien can provide an explanation and relevant supporting documentation,” the agency said. | “If the alien is prevented from working or attending school, and must rely on public benefits for the duration of the Covid-19 outbreak and recovery phase, the alien can provide an explanation and relevant supporting documentation,” the agency said. |
| The administration has not publicized the change, and absent a clear shift in enforcement, many immigrants are likely to remain reluctant to seek government-subsidized medical care. | The administration has not publicized the change, and absent a clear shift in enforcement, many immigrants are likely to remain reluctant to seek government-subsidized medical care. |
| “People who are fearful are not going to be reading the fine print of policy, and if in doubt they will stay away from being tested and treated,” said Mr. Gostin of Georgetown University. | “People who are fearful are not going to be reading the fine print of policy, and if in doubt they will stay away from being tested and treated,” said Mr. Gostin of Georgetown University. |
| For more than 25 years, the better part of their lives, Maria and Francisco Garcia have worked as undocumented field workers, picking and packing cauliflower, peppers and dates in the low desert of the Coachella Valley. | For more than 25 years, the better part of their lives, Maria and Francisco Garcia have worked as undocumented field workers, picking and packing cauliflower, peppers and dates in the low desert of the Coachella Valley. |
| They recently became eligible to apply for a green card through an American-born child who turned 21. But with coronavirus cases on the rise in the area where they live, the couple have grown increasingly anxious about falling ill and jeopardizing their chance of become lawful residents. | They recently became eligible to apply for a green card through an American-born child who turned 21. But with coronavirus cases on the rise in the area where they live, the couple have grown increasingly anxious about falling ill and jeopardizing their chance of become lawful residents. |
| It was the reason their daughter, Mariana, attended the event in the parking lot in the Coachella Valley. “My mom is panicked about getting the Covid-19. If she goes to the hospital, she thinks that will make her a public charge,” said Ms. Garcia. | It was the reason their daughter, Mariana, attended the event in the parking lot in the Coachella Valley. “My mom is panicked about getting the Covid-19. If she goes to the hospital, she thinks that will make her a public charge,” said Ms. Garcia. |
| Ms. Garcia was relieved to learn about the exception but doubted it would assuage her mother’s concerns. | Ms. Garcia was relieved to learn about the exception but doubted it would assuage her mother’s concerns. |
| Her parents, who live paycheck to paycheck, also worry about not making the $500-monthly rent on their mobile home if they get sick. | Her parents, who live paycheck to paycheck, also worry about not making the $500-monthly rent on their mobile home if they get sick. |
| Sandy Cobarrubias, 46, another undocumented immigrant, said in an interview that, “We’re petrified.” Even after learning that seeking medical help for the virus would not jeopardize her chances of qualifying for a green card, she did not feel reassured. “This president says one thing one day and does another the next,” she said. | Sandy Cobarrubias, 46, another undocumented immigrant, said in an interview that, “We’re petrified.” Even after learning that seeking medical help for the virus would not jeopardize her chances of qualifying for a green card, she did not feel reassured. “This president says one thing one day and does another the next,” she said. |
| Caitlin Dickerson and Annie Correal contributed reporting from New York. | Caitlin Dickerson and Annie Correal contributed reporting from New York. |