Virus Erupts in Poor U.S. Cities Whose People Have Few Defenses

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The coronoavirus pandemic is burrowing into America’s battered industrial heartland and the South, bursting out in places like Detroit, Chicago and New Orleans that have legions of low-income residents with underlying medical conditions and few resources.

Michigan is fast becoming the next U.S. hotspot for the virus, registering new cases at more than triple the national rate; it was declared a federal disaster area late Friday night. The state had 3,657 Covid-19 cases as of March 27 — versus zero just over two weeks ago – ranking fifth in the nation. Of that, impoverishedDetroit and surrounding Wayne County made up half. At least 92 people have died.

“I’m not astonished that we are seeing such an explosive curve,” said Teena Chopra, a doctor who is an infectious disease specialist at Detroit Medical Center and a professor at Wayne State University. “What is happening in the rest of the world we are seeing in Detroit. And we should be more worried than anybody else, because our population is very vulnerable.”

Read More: What It’s Like on the Front Lines of America’s Battle With Coronavirus

The coronavirus made its first appearance in America in places where international travel is common, and where significant swaths of the population are affluent and have access to medical care. Despite those advantages, medical defenses arebuckling. The second wave of infection is striking cities far more vulnerable to begin with.

“We have been aggressive in terms of closing schools, bars and other gathering places,” Michigan Governor Gretchen Whitmer said in an interview. “Yet we continue to see Covid-19 spreading quickly, especially through Detroit and southeast Michigan.”

Detroit, which filed what was then the largest U.S. municipal bankruptcy in 2013, has almost 90,000 vacant parcels held by its municipal land bank. Despite a spruced-up and resurgent core, its 673,000 people are scattered over 139 square miles (360 square kilometers) after the former industrial giant lost more than half its population since the 1950s. It’s a landscape of vacant lots and vast tracts of boarded-up houses, many being reclaimed by nature.

About 36% of the populationlives in poverty. With diabetes and hypertension rampant, Detroiters are prey to the new virus, Chopra said. In a city built by and for the automobile, they often lack transportation to get to the hospital. Many ignore early signs of the disease.

That’s set the coronavirus racing through the state. Suburban Oakland County, the second-most populous and the affluent seat of thousands of white-collar auto jobs, represents 23% of cases.

Deep Need

Other Midwestern cities are following the same trajectory. Cook County, Illinois, which encompasses Chicago, saw cases rise from 413 at the end of last week to more than 1,900 Friday, according to data compiled by the University of Chicago. The county now accounts for three-quarters of the state’s total.

Outbreaks in Louisiana, Arkansas, and Tennesee also accelerated recently. Cases in Nashville’s Davidson County quadrupled in a week, as did those in Orleans Parish, Louisiana. Such numbers may not reflect the precise case counts as shortages have made it difficult for sick people to get tested.

New Orleans, like many Southern cities, has a deep well of need. Almost a quarter of its citizens fall below the federal poverty line.

Want breeds disease, said Joseph Eisenberg, chair of the epidemiology department at the University of Michigan’s School of Public Health in Ann Arbor.

“People will go a lot longer since they don’t have access to health care,” he said. “That both means they’ve been in the community more and been transmitting more, and when they get to the hospital their prognosis is going to be a lot worse.”

Whitmer’s Orders

Michigan identified its first two Covid-19 cases on March 10, both linked to either international or domestic travel.

Since then, Whitmer has issued a slew of executive orders to contain the virus: school closures, a ban on large assemblies, and last Monday evening a shelter-in-place order that shuttered businesses and triggered mass layoffs across the state.

To her dismay, the number of cases is still growing rapidly. What’s worse, Whitmer said, is that the state may not know for weeks whether the health-care system and her containment methods are working. That means it could take even longer for carmakers, the state’s economic lifeblood, to get going again.

Even though Detroit’s status as the world’s center of auto manufacturing has eroded, there are still multitudes of car companies and suppliers in the region. The headquarters of General Motors Co. is in Detroit, as is a Fiat Chrysler Automobiles NV plant that makes Jeep Grand Cherokees. In all, about 175,000 auto workers are employed in factories and a roughly equal number of white-collar workers in the industry, according to federal statistics.

Ford Motor Co. and Fiat Chrysler said this week they’re extending shutdowns of their North American plants to at least mid-April. At least four of Fiat’s U.S. factory workers have died from the virus.

Hospitals in southeast Michigan are already stretched. Beaumont Health, the largest health-care system in the state, warned Tuesday that its eight hospitals are “nearing capacity” on staffing, personal protective equipment, and ventilators. Henry Ford Health System circulated aninternal memo laying out guidelines for deciding which patients would get life-saving ventilators in the event of a shortage.

Whitmer said her biggest concern now is fighting with other states and the federal government for masks and medical supplies. There is no central purchasing. Michigan, Illinois, Wisconsin and Minnesota jointly buy some things, but for others she is competing and bidding against other governments.

“One thing that I think is a source of frustration and a lack of sleep frankly is that we were told as states to procure these supplies,” Whitmer said. “Right now, I’m focused on triaging.”

In Detroit, Mayor Mike Duggan was gearing up to start drive-through testing on Friday, grappling with an outbreak on the police force that has left 400 officers in quarantine — and managing the delivery of 40,000 free meals a week to out-of-school children who might not otherwise eat.

Chopra of the Detroit Medical Center said it feels like a “tornado” or a “tsunami” has hit her hospital, and that the window to contain the virus has closed for residents of her city.

“That population has low vaccination rates, low transportation rates, no access to clean water — the lack of resources and all the social determinants of health,” she said. “We need mobile hospitals, we need spaces, we need nurses, we need PPE. We need help.”

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