Inside crowded courtyard buildings, where blue-collar Latino families share apartments meant for one, the sick are multiplying.
But their apartment complex in Herndon has become a coronavirus magnet. Soon, others were coughing and wheezing.
Latinos, who make up about 10 percent of the population in the District, Maryland and Virginia, make up about a third of the coronavirus cases in the region, according to a Washington Post analysis of jurisdictions that track the race and ethnicity of patients with covid-19, the disease the virus causes.
The disparity is not unique to the capital area. Latinos young and old are contracting the virus at alarmingly high rates in places such as New York, Chicago and Los Angeles, although the fatality rate for their community is significantly lower than that of African Americans. In an ABC News-Ipsos poll released Friday, 26 percent of Latino adults in the country said they know someone who has died of the virus or from complications related to it.
Experts cite many explanations: Latinos are a dominant presence in service industry jobs, leaving them unable to ride out the pandemic from home. Many have struggled to get protective equipment, while others ignored shutdown orders to take risky jobs in exchange for much-needed cash.
Outside of work, avoiding the virus can be nearly impossible, either because Latino families are more likely to live in multigenerational homes or because many take on multiple roommates to manage the Washington region’s high housing costs.
Efforts to slow the virus’s spread are tangled with complications, public health experts say, including language barriers, economic stressors, limited resources and, in some cases, a slow response from local governments.
“There is a lot of fear,” said Yukmila Soriano, a primary care doctor at Virginia Hospital Center in Arlington County, where a majority of the patients she sees with positive tests for covid-19 are Latino. “We are asking everybody to stay home, but the idea of staying home is very different depending on who you are and what your role in society is.”
In Northern Virginia, Latinos make up 16.8 percent of Fairfax County’s population but nearly 64 percent of its coronavirus cases where ethnicity is known, records show. In Prince William County, Latinos represent 24 percent of the population and nearly 77 percent of infections where ethnicity is known. In the Maryland suburbs and the District, predominantly Latino neighborhoods also have some of the highest rates of contracting the coronavirus.
As it spreads, the virus has gnawed through the region’s economic backbone, sidelining thousands of cooks, custodians, landscapers and other front-line workers.
Fredys Medina, a diabetic construction worker from Arlington County, waved off his wife’s suggestion that he had the virus after he developed a cough and fever in late April, and he continued to work.
Two weeks later, he collapsed on the living room floor. By the time paramedics arrived, Medina, 56, was gone. His wife, Leonor Medina, an unemployed hotel housekeeper, was left with an $8,000 funeral bill she couldn’t pay until neighbors and members of their church chipped in.
At the funeral, the couple’s middle child, Alberto, 14, flung himself onto his father’s body, holding tight as he wept. He has since tested positive for the virus. So did his mother and 11-year-old brother, Freddy. Leonor Medina seeks comfort in her Pentecostal Christian faith, grateful that her symptoms — and those of her children — have been mild.
“This is a demon that wants to kill everyone,” she said. “I was spared, and so were my sons.”
Jeff C. McKay, chairman of the Fairfax County Board of Supervisors, said the number of Latinos who work in hotels, restaurants and stores was one reason he asked Gov. Ralph Northam (D) to delay relaxing restrictions on nonessential businesses in Northern Virginia until at least Thursday.
“Some of them are eager to work again because they’re not getting income, but there is a whole lot of them also scared to go back to work,” said McKay (D-At Large). “That’s a really bad position for anyone to be in.”
'Desperate state of affairs'
In the District’s historically Latino Columbia Heights neighborhood, the virus ripped through Flor Morales’s home like a tornado. They still don’t know how it got in.
Morales, 23, lost her job as an office custodian when the pandemic began. But her husband continued to work in construction, and her twin sister, Rosa Morales, kept her job at McDonald’s, despite her growing unease over maskless customers and the cramped restaurant kitchen.
In early April, their mother, Maria Elena Velasquez, got sick and died of covid-19. Soon, Rosa was coughing. She quarantined in the only vacant room: the one her mother had used. Within days, her father’s temperature spiked. Both tested positive for the coronavirus.
The family heard about sick friends and neighbors — a pastor and his wife, the owner of a pupuseria down the block, co-workers, street vendors, supermarket employees.
One of the boarders who rented a room from the Morales family also fell ill.
Flor Morales spends her days taking care of everyone else — delivering food to her father, leaving hot soup and tea outside the basement door for her sister, caring for her three children and four nieces and nephews, the youngest one just 6 months old.
When Morales’s 8-year-old niece developed a fever, she carried the girl to her car and took off toward the hospital, passing groups gathered on corners, neighbors talking without masks. One night, she shut herself in the bathroom she shares with her husband and their kids, threw herself onto the tile floor and screamed.
“God!” she shouted. “Why did you take her away from me?”
Downstairs, her sister Rosa leaned up against the closed basement door and cried.
Ivan Torres, a language access coordinator for the District, said quarantining Latino patients who live in crowded multigenerational homes is rarely effective. Instead, Torres said, local governments must provide lodging and support to allow individuals to quarantine safely away from their families.
“We know not everyone can say, ‘Okay, I’ll just stay in my room’ or ‘I have my own bathroom,’ ” Torres said. “We understand what the reality is.”
The District and parts of Maryland and Virginia have worked to provide individuals with a place to isolate. But advocates say most rooms go to homeless people, and many Latino residents don’t know about the option.
In the predominantly Central American immigrant neighborhood of Langley Park, Md., an entire family of six came down with the virus, said Prince George’s County Council member Deni Taveras (D-District 2). When the parents were hospitalized, the four children were taken in by relatives — adding another layer of potential exposure.
“It is a desperate, desperate state of affairs,” said Taveras, who lost four family members to covid-19 in New York.
Prince George’s recently opened a quarantine site seven miles from Langley Park that can hold 100 people, but officials declined to say how many rooms are in use. In Virginia, Fairfax County has rented 221 hotel rooms, and Prince William County has rented 40. The District has designated 864 hotel isolation rooms, which officials said primarily are used by people who otherwise would be in shelters or on the street. D.C. data shows just 38 people have used the hotel rooms because they were unable to quarantine at home.
Public health advocates and doctors said government agencies need to do more. James Lamberti, a pulmonary care doctor whose practice in heavily Latino Annandale treats as many as 30 patients per day, called the lack of quarantine sites in Fairfax County “an embarrassment.”
“There’s a history for this with public health with tuberculosis,” he said. “If people were not able to go back to a home, they got put up in a hotel. A lot of this ongoing community spread over the last month could have been prevented by better public health, by figuring out where the problem was at a local level.”
Fairfax County, which has 1.1 million people, had reported 9,482 infections and 331 deaths as of Monday. Officials say they plan to rent an additional 160 hotel rooms for quarantining, on top of the 221 that are mostly occupied.
Local governments also have struggled to get Spanish-speaking residents information about the coronavirus and to track its spread in the community.
Spanish-language text alerts recently launched by Fairfax reach fewer than 200 residents, despite a population of about 53,000 who speak mostly Spanish. About 39,000 residents of Prince William County primarily speak Spanish, but only 53 have signed up for their alerts.
Steven Woolf, director emeritus of Virginia Commonwealth University School of Medicine’s Center on Society and Health, said increased testing and the ability to track people potentially exposed to an infected person are crucial to control community spread of the disease. But, Woolf said, many contact-tracing efforts do not include interpreters.
Another obstacle local governments and health-care providers must contend with is fear.
Jair Carrasco, an organizer with D.C. street-vendor advocacy group Vendadores Unidos, has heard from immigrant families afraid to take sick relatives to a hospital that they are concerned immigration agents could be lurking there.
“On top of the virus and people not wanting to go outside due to safety concerns, you’re also dealing with immigrant communities with a long history of police abuse and discrimination,” said Carrasco, 29, who began to feel ill in early May after his girlfriend came home from her supermarket job feeling feverish and dizzy. She later tested positive for the coronavirus.
While he waited to be seen by a doctor, he decided to try out the District’s Spanish-language coronavirus hotline. He was transferred three times, he said, and given a new number to call. He never found the food-delivery service he was seeking.
“What if I was only a Spanish speaker and they’re giving me this go-round?” he said. “That can make the difference between someone getting help and people suffering.”
D.C. officials said they consulted with a wide range of organizations that work in the Latino community before launching robocalls in Spanish and attempting to streamline the District’s complex web of bureaucracy for non-English speakers.
“Something we saw at the [outset] that was really devastating is, we had residents dying in their homes because they had not sought care,” said Tomás Talamante, the deputy chief of staff for D.C. Mayor Muriel E. Bowser (D). “That’s the message we’ve been trying to get out: Regardless of immigration status, regardless of socioeconomic situation, we want our residents to seek care.”
Tip of an iceberg
On a recent morning, a line of patients stretched down the block outside the Upper Cardozo Health Center in Columbia Heights.
The clinic — which tests more than 80 people daily, about half of them Latino — opens its doors at 8 a.m. Patients have been known to arrive as early as 6.
Medical director Blanca Toso worries that they are just the tip of a much larger iceberg. She spends her weekends making calls to patients, reminding those who have tested positive to treat the symptoms, isolate and call for help if conditions get worse.
Though the respiratory effects of the coronavirus are well known, she said, many of her patients are unaware of the disease’s other manifestations. Often, if a patient is ill but does not have a hacking cough, Toso said, they don’t think it’s possible that they could have the virus. Some try home remedies as a cure: herbal teas or roots mailed from relatives outside the United States.
“A lot of these people still have to go to work every day, so they’re not able to keep up with the news or every new symptom that we’re discovering about this virus,” Toso said. “They may not think they have the virus, but many of them do.”
Others have tried to get tested but, amid an initial shortage of test kits and supplies, were turned away.
Edith Morejon rarely ventures outside her apartment in Hyattsville, Md., anymore. Still, she said, it feels as if the virus is closing in.
Her husband, who works during the week in Pennsylvania and shares an apartment with four other men, recently came home with a fever and a cough.
Within days, he was diagnosed with covid-19. Morejon, 40, was not able to get tested, despite having a low fever. Her doctor advised her to try again if her symptoms got worse, she said.
To protect their three children — ages 12, 10 and 6 — Morejon kept her husband isolated inside the bedroom. When the children ran to hug her, she waved them off, unsure whether it was safe.
Morejon has done everything officials have asked. She keeps up to date on covid-19 news and signed up for text alerts from Prince George’s County. Even though Maryland recently expanded its testing options, as of Thursday, she had not been able to secure a test.
“I’m just waiting here in my house, passing my quarantine so as not to infect anyone else,” Morejon said. “I don’t know what else to do.”
The virus can dissolve what little economic stability some families have.
Before the pandemic struck, Danilo and Isabela Rivera relied mostly on her income as a hotel housekeeper near Dulles International Airport. He lost his job as a house painter last year.
Now, with Isabela bedridden, Danilo puts on a cloth mask every morning to stand outside a 7-Eleven with other day laborers.
He leaves food donated by a neighborhood church by his wife’s bedroom door and checks in by phone with their son, Alan, who doesn’t understand why he can’t just come home.
“He cried a lot the first three days,” Danilo said. “We’ve wanted to give him a hug and kiss him but haven’t been able.”
In Northeast Washington, Jose Mardoqueo Reyes was hospitalized with covid-19 in late April, the day his wife, Blanca Bonilla, was discharged from a hospital after her symptoms subsided. He died three weeks later.
The family isn’t sure how the virus entered their household of six, though it had several possible avenues.
Bonilla worked at a McDonald’s before the pandemic took hold in March. Mardoqueo Reyes, a well-known Spanish-language sportscaster in the region, also worked in construction. His eldest son, Mardo Reyes, 28, drove a delivery truck.
Mardo’s wife, Emmy, who has been on leave from her job as a nurse, was the first to experience symptoms and was briefly hospitalized last month.
Ingrid Reyes, 26, Mardo’s sister, lives elsewhere in the neighborhood and so far has stayed healthy. After her father spent three weeks on a ventilator, she asked for two weeks off from her job as a construction site traffic controller to help care for her family.
Instead, she said, her boss fired her.
Mardoqueo Reyes died on May 12. The family is now seeking help with the $14,000 burial costs.
“Everything just hit us at once,” his daughter said.
Rachel Chason contributed to this report.