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.
“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?Live BriefingRead the latest updates on the coronavirus outbreak here.
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.
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.
“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.”
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.”
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.
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.”
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.”
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 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.
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.
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.
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.
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.
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.
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.