Manuel Caló, a 56-year-old Nashville construction worker from Guatemala, fell so ill so quickly that, although he took the test for COVID-19, he couldn’t wait for the results. Friends took him to Vanderbilt University Medical Center, where he was placed on oxygen and hospitalized for four days.
Even feeling so sick, Caló had to overcome his suspicion of hospitals. Trusted friends told him they don’t treat immigrants well.
On Friday, the day after he was discharged, Calo told Tennessee Lookout he doesn’t know how he contracted the virus, since his job working from 6 a.m. to 5 p.m. each day as a stone layer allows little time for extra activity. He lives with two roommates in an apartment complex near Murfreesboro Road and now takes extra precautions to keep his distance and keep them safe.
He has to return to work soon. Caló’s Hispanic coworkers have been vouching for him while he has been out sick, but he doesn’t want to have to ask any special favors from his boss, he said.
“I am a person that doesn’t like to take advantage of a situation,” Caló said. “There’s people who need more than I do. In any case there comes a moment where I do need help, well, of course I’ll ask and see if I can get a little help from somewhere, but I hope to God I that doesn’t happen.”
One in every three Tennessee residents who has tested positive for COVID-19 thus far is Hispanic — 35 percent of the state’s entire count of positive individuals. The figure doesn’t take into account pending positive cases in which ethnicity data is still being verified.
As of Sunday, 7,817 of the 22,291 positive individuals in Tennessee whose ethnicity is known are Hispanic.
In Nashville, one-third of all city residents who have tested positive for coronavirus are Hispanic — an alarming data point that some Nashville council members and community advocates said they did not learn until last week.
Latinos are a growing but still relatively small population in Tennessee, making up about 10 percent of Nashville’s population and 5 percent of the state’s, according to official census counts.
The disproportionate impact of the virus on Latinos has dismayed advocates, who are critical of the response by state and city leaders as lacking a sense of urgency, failing to collect or share critical data and and, in some instances, impeding efforts to instill trust among Latino residents in the public health system during a pandemic.
A controversial decision to share COVID-19 patient names and addresses with law enforcement by Dr. Michael Caldwell, the Nashville health department’s chief, was halted Friday after a public outcry over the privacy implications, amplified in many communities of color who have a troubled history with police and immigration authorities. Gov. Bill Lee ended the practice statewide on May 30.
“I think this should really be a wake up call, not only for the city but for the state,” said Sandra Sepulveda, a Metro Councilwoman who represents heavily Latino areas in southeast Nashville.
“You have a huge community who is getting sick at disproportionate rates and that’s due to the fact we don’t have access to healthcare, due to the fact we work essential jobs and due to the fact we don’t have the luxury of taking time off,” she said.
“And the fact of the matter is we still don’t have all the information to try and tackle this problem. It’s hard to come up with a game plan when you don’t have the data.”
Sepulveda is one of several Nashville council members who have been pressing the city’s public health department for more data in increasingly angry exchanges during conference calls and on email strings.
In response, Nashville public health officials issued new details late last week to councilmembers — a ZIP code breakdown of the city’s COVID-19 cases by race, ethnicity and by cases that are traced back to an outbreak cluster, rather than a result community spread.
The data, obtained by Tennessee Lookout, shows that in seven of Nashville’s 29 Zip codes, Hispanic infection rates are surpassing non-Hispanic rates, although there are a significant number of pending or unknown cases in many Zip codes
The data, dated June 4, shows:
- In Zip code 37013 in Antioch, 34 percent, 468 out of 1,351 COVID-positive individuals, are Hispanic, 551 are non-Hispanice and 332 cases are pending.
- In 37211, an adjacent Antioch neighborhood to 37013, 44 percent, 441 out of 1004 positive residents are Hispanic, 290 are non-Hispanic and 273 are pending.
- In Madison’s 37115 Zip code, 56 percent of residents who have tested positive for the virus, 382 in all, are Hispanic, 76 are non-Hispanic and 92 are pending.
This information has not been shared publicly, although Metro has released “heat maps” showing concentrations of the virus by Zip code without underlying numbers of positive cases. For weeks, the department has denied media requests to release underlying data that would reveal case numbers by Zip code.
Data on positive COVID-19 cases by Zip code has been made available in cities across the nation, including in Tennessee.
Chattanooga, as one example, began releasing COVID-positive data by race on March 30 and by ethnicity on April 8.
Weekly news releases from Nashville officials list COVID-19 deaths by ethnicity, but have not included the total breakdown of Hispanic COVID-19 cases in the city.
A more detailed data dashboard with that information was shared with Metro Councilmembers. The dashboard is not released in weekly COVID ethnicity updates to the media or public, although it has been posted to the Nashville health department’s 4,400 Twitter followers since May.
Katie Lentile, a spokeswoman for Mayor John Cooper, said Monday, after publication of this story, that a link to the data has been posted on Metro sites since April 27.
A link to the information routinely shared is: https://www.asafenashville.org/
“The reason we decided not to push it on its own to media directly is because sometimes things need context that can’t be given on there,” Lentile said via direct Twitter message on Monday.
A spokesman for Nashville’s health department did not respond to questions last week about the city’s total Hispanic rate of infection, the number of contact tracers hired by the city who speak Spanish or the reason the city has not provided data sought by councilmembers on COVID-19, including information on work sectors or sites of positive patients.
“It is frustrating to see a problem and see it persist for so long and not have it addressed,” said Delishia Porterfield, a Nashville council member who represents a southeast Nashville district.
“For me the most important thing is figuring out if we know it’s essential workers or something else. If it’s essential workers, how do we keep them safe? If it’s group gatherings, how do we address that. The more questions I asked, the more answers didn’t make sense and that’s why I doubled down on my requests for data.”
In Nashville, 89 percent of transmissions have occurred in in-home spread, Dr. Stephanie Bailey, interim deputy director at the Metro Public Health Department, told councilmembers in an email last week. That data point has not yet been publicly disseminated.
Bailey in her email rebuked councilmembers over media reports she said “cast the MDPH as overall unresponsiveness.”
The Nashville average for transmission rates is “1:5”, she said. But in Zip codes 37215, 37211, 37072 and 37115, those rates are edging higher, she said. That data has also not yet been disseminated publicly.
“Lots of transmission is due to communal living,” Bailey wrote councilmembers. Construction work is a key agent in transmission, “riding together, etc.” she said. “Whole apartment complexes may commune and visit each other.”
Porterfield said she has asked repeatedly to see data behind Metro’s assertions about communal living, or workforce sector spread, but has not yet received it.
“I feel like they are making a lot of assumptions but have nothing to back it up,” she said. “If we don’t know how transmission is really happening, how can we address this?”
Nashville officials last week hit the pause button on entering the next phase of reopening the city, a delay prompted by the spike in COVID-19 cases in southeast Nashville.
Half of all new cases are in southeast Nashville, areas with large Latino populations, Dr. Alex Jahangir, chair of the city’s coronavirus task force, said last week.
“It’s very tiring to see that it’s only getting worse,” said Yuri Cunza, president of the Nashville Area Hispanic Chamber of Commerce.
He believes the pandemic was a perfect storm for a vulnerable community that has lived for decades in the shadows of society. Hispanic residents, particularly those who are undocumented, have become accustomed to living on the margins, said Cunza, and they’re used to suffering.
Government efforts do not do much to quell the fears of questions about their legal status. And if they do become sick, what then? Cunza asks. Will employers give them a break or will they lose their jobs? Some will not tell their workplaces if they feel ill and will continue to work for fear of losing their job. Some were told to go back to work even if they were sick.
“Are there assurances in place that people will be safe if they seek help?” Cunza said. People have told him they’re afraid of the long-term consequences of sharing their family’s personal information with the government.
“Nashville went into Phase Two hoping for the best but it’s not turning out that way,” said Cunza.
“Let’s give them benefits, let’s do something,” he said. “But no one wants to touch that.”
In the meantime, Hispanic residents who have contracted the virus continue to struggle.
Maria, a stay-at-home mother to three children, believes she contracted the virus from her husband.
He came home from his construction job one day complaining of achy arms and legs, and by the third day Maria, who asked her family’s name be withheld because they are undocumented immigrants, started sneezing, but no one believed the virus had reached their home.
Day by day her symptoms became worse. She had a high fever and her whole body hurt badly.
Her sense of smell and taste went away as she started coughing, and the attacks would leave her breathless. She never believed the virus would reach her family, but when her 17-year-old daughter started feeling ill, the entire family went to get tested, Every member of the family was positive for COVID-19.
Three weeks went by with the family under quarantine. Maria became too weak to get up. Her daughter, whose symptoms were less severe, stepped in to care for her 6-year-old and 8-year-old siblings as their fevers spiked.
Maria’s extended family didn’t believe she had the virus. She was called a liar and told the virus was a government hoax, a sentiment echoed by the community due to their distrust in the government.
“You think I would play with my life? I had a close encounter with death,” she told her family.
Maria was eventually hospitalized for five days. She was told by doctors that if she had stayed home just one more day her lungs would have collapsed and she would have died. Her family now believes after seeing what she went through.
The family spent five weeks total under quarantine. Her friends and church members were often their only source of food. Her family’s only income was her husband’s job, which paid him for the weeks he was unable to work.
“Thank God they paid him,” said Maria. She doesn’t know what would have happened if they hadn’t. Many others from his construction job have also contracted the virus.
She believes God gave her another chance, but knows many others have not been so lucky.
Maria sees many people in the community not wearing PPE and she pleads with other families to take care of themselves.
“We are all human, even if we don’t have papers,” said Maria.
Her husband is already back at work because the family cannot afford to stop working. She has received her first bill from the hospital for $20,000. Maria still feels weak.
In Chattanooga, mobile health clinic vans operated by Cempa Community Care pull into largely immigrant neighborhoods once a week to provide primary care services and test for COVID-19.
Of the 300-400 tests conducted weekly on residents, nearly 30% or 40% have yielded positive results, said Paulo Hutson Solorzano, a Latinx outreach consultant for Cempa Community Care in Chattanooga:
“This is a state of emergency,” Solorzano said. “It’s remained a state of emergency. We are seeing people, symptomatic or asymptomatic, passing away week to week.”
“A lot of the Hispanic community have not stopped working,” he said. “They never stopped working and they had more exposure. We’re finding now that not only are a lot of people sick, a lot of folks are asymptomatic.”
Information from state and local health officials have been shared widely in mainstream media and through public health campaigns, but those messages have been slow in being translated into Spanish and reach Latino Tennesseans, he said.
“By the time it gets to the Hispanic community, the English-speaking community has been getting a lot of information already,” he said. “We’re now having to catch up on three months of community education.
A void in information is straightforward explanations about testing: What questions will be asked, whether sites have Spanish speakers, what will it cost and what happens to personal information given.
One person sticks out in Solorzano’s mind. A woman in her 40s who lived in the Auburn Hills area of Chattanooga hit hard by March tornados. The stay-at-home mom of two young children sprung into action to help neighbors impacted by the tornado, cleaning house, making lists of names of addresses of families with urgent needs to share with community organizations.
“She passed away last week,” Solorzano said. “She had COVID. Maybe if the education was there and PPE were made available, she would be alive.”
Solorzano stressed the virus isn’t more likely to infect someone of one race.
“It’s not that they are more vulnerable to COVID,” he said. “It’s a matter of humans experiencing health disparities that should be a wake up call.”