Across the country, the novel coronavirus is infecting people of color at higher rates than the rest of the population.
The same is true in Maine. Black people and African Americans make up less than 2% of the population in the state, but they account for more than 20% of all COVID-19 cases.
It is a fact that's hitting the immigrant community in Lewiston especially hard. And some local leaders say the state needs to do more to support those who are sick and to prevent further spread of the disease.
Lewiston is the second largest city in the state. And the county it is in — Androscoggin — has the second highest percentage of Black people and African Americans, at more than 5%. Most are part of the immigrant community and live in dense housing in downtown Lewiston.
Some of the housing is just steps out the door from the office of the New Mainers Public Health Initiative, where Adulkerim Said is the founder and executive director.
"You see all of this is, I think 95%, is new Mainers,” Said says. “And this one, and this one too."
Said is joined by Abdikadir Negeye. They are both members of a local emergency response task force for new Mainers and COVID-19.
"If we cross the street — see those gray buildings?" Negeye points to several four-story structures a block away. These also contain apartments that are home to many new Mainers, and, Negeye says, a prime setting for the coronavirus to spread.
"That’s where a lot of big families live. It’s very congested,” Negeye says. “They all use the same rails, the same stairs. It’s only one door that they all use."
Advocates say if you combine this dense housing with the fact that many in the community work in essential jobs, such as cashiers, in health care and manufacturing, it is not a surprise that cases of COVID-19 have taken off here.
The interim CEO of the B Street Clinic in Lewiston, Coleen Elias, says the health center started offering walk-in testing about a month ago after local hospitals alerted them to an uptick in cases in the new Mainer community. Of the 90 people tested by the end of last week, nearly one-third were positive. And the vast majority of those who tested positive — 96%, says Elias — were new Mainers.
"That is alarming,” Elias says. “And I do know that those rates would be much higher if we had more people showing up to be tested."
But many are reluctant to test, says Elias, and that is not unique to the new Mainer community. "Regardless of the race or religion or background or any other factor, there seems to really be fear around what happens if I'm told I need to quarantine?"
That's because quarantining isn't really an option, says Abdikadir Negeye. He explains that new Mainers' families are often large, and there is not enough space in apartments to isolate individual members. The state Department of Health and Human Services says it has a contract with a space in Lewiston where people can go to quarantine, but Negeye says he is unaware of anyone being offered that choice. And even if there were, other problems can arise.
“For example, if the mom is positive, and you tell them to leave or isolate yourself from the children, and you don’t have any plan for those children — who’s going to take care of them and who's going to cook for them? That’s why the numbers are so high,” says Negeye. “They don’t have resources available. So there’s no choice but to have the interaction with someone who is positive or not."
Abdulkerim Said says there are also trust and language communication issues for members of the immigrant community with contact tracers, the people who follow the chain of transmission for infections.
"When a contact tracer calls a person to ask him his close contact, they don’t tell exactly the close contact because of fear,” Said says. “One person infected told me, ‘Why are they asking me the person I had contact with? Because if I mention their name, maybe those people are working. So they will be telling them to step down from their work and they will lose their income.' ”
To tamp down cases of coronavirus in their community, Said and Negeye say they need more collaboration from the state Center for Disease Control (CDC). They say members of the new Mainer community, who understand the language and the culture, are ready and willing to be trained as contact tracers. They would also like to establish door-to-door mobile testing to identify more cases.
That's an option that CDC Director Dr. Nirav Shah says his agency is exploring. In his press briefing Wednesday, Shah said that infection rates among racial and ethnic minorities are unacceptable and are one of the top priorities for his agency.
"We've made some progress, but I will be the first to acknowledge we're not there yet. We've got a lot more ahead of us."
Erin Guay, the executive director of Healthy Androscoggin, says the CDC is working with a public health system that has been weakened in recent years. Unlike Portland and Bangor, Lewiston does not have a public health department.
"What we've lost is time. We’re still building some of the systems that I wish we had had a couple of months back. We really need to figure this out quickly, and that's no easy task."
Reshid Shankol, another member of the new Mainers emergency response task force for COVID-19, says the virus has been described as the great equalizer because everyone is at risk. But he says it's clear that the risk for people of color is higher, and he acknowledges that that is a challenge for the public health system.
"I'm not blaming the CDC because we are caring for people with a new culture and a new disease that we have. We have two new things. So it's very difficult for them."
But, he says, he hopes that the state and the community can forge a strong partnership to find a solution.
Originally posted 5:32 p.m. June 18, 2020
