A Tale of Three Cities: COVID-19 in Florida's most vulnerable populations

With Cuban neighborhoods in Hialeah emptied due to COVID-19 lockdown, crowds turned to socialize over coffee at the pick-up service windows in South Florida known as “ventanitas” – forcing the city to ban the gatherings. 

An hour north in Lauderdale Lakes, the city with Florida’s highest concentration of black residents is bracing for an uptick in cases, with many of its sick already at higher-risk due to underlying issues like diabetes and hypertension. 

On the state’s Gulf coast, officials in the retirement community of Punta Gorda started ordering emergency supplies immediately after the first positive tests in Florida, knowing its elderly could be in jeopardy.

As coronavirus spreads across the nation, Hispanics, African-Americans and seniors are falling sick and dying in disproportionate numbers. The stakes are high in Florida, where one in five is aged over 65, and pockets of state are deeply rooted with Cubans, Haitians and other minorities.

Florida was also one of the states late to issue stay-at-home orders. With the numbers exploding in recent weeks – and nearly 17,000 cases confirmed as of early Friday – officials are scrambling to protect their vulnerable populations and convince them of the risk the virus poses.

“It’s a culture thing … a lot of folks here are just not taking it seriously,” Hialeah City Councilman Jesus Tundidor said. “When we regulate and enforce some of these policies, that’s when we’ll see a change.”

Hialeah has one of the highest concentrations of Hispanics in the country. The population of nearly 240,000 makes it the second largest city in Miami-Dade County, where more than a third of the state’s COVID-19 cases have originated.

Coupled with its large elderly community – many of whom are confined to public housing – city leaders say the demographics leave Hialeah especially susceptible to an outbreak.

As of early Friday, Hialeah’s 700 confirmed cases were the third-most among all Florida cities, more than areas with much larger populations, like Tampa, Orlando and Jacksonville.

In response, the city suspended senior activities, set new protocols for public housing to limit visitors and implemented a 10 p.m. curfew, while closing gyms, dining establishments and movie theaters.

But dozens still congregated at restaurants and cafeterias as they waited for takeout. Others socialized at walk-up “ventanitas” with their “cafecito” – Cuban espresso.

Understanding the cultural tendencies, Hialeah councilmembers have pushed for their mayor to take a more vigilant approach, pressing him for three weeks to close city hall. The city has a strong mayor who serves as the chief executive, and Tundidor said the mayor has mostly deferred to Gov. Ron DeSantis, who issued stay-at-home orders April 1 after weeks of criticism.

Hialeah Mayor Carlos Hernandez did not return calls and emails seeking comment.

“You have this demographic that’s highly susceptible, and they’re all living in very confined areas very close together,” Councilman Paul Hernandez said.

Hialeah officials also had to scramble after Florida’s online unemployment system crashed, leading the city to issue printed unemployment applications at the library. But the event drew hundreds, as throngs waited together in lines that wrapped around the street. Councilmembers called it a health disaster.

With the crowds getting out of hand, the city finally banned socializing at its popular coffee windows on Thursday and ordered face masks to be worn in public.  

“Our population just doesn’t want to take this to heart, but it’s here already,” Hialeah Councilwoman Monica Perez said. “At first, it was more denial. Now, it’s more shock. It’s a lifestyle change. These people like to be together, like to be in the streets and like to go to the store every day for fresh produce.”

'We’re going to get numbers larger than most'

Just up the shore from Miami, Lauderdale Lakes is ripe for an outbreak.

The city is four square miles in the heart of Broward County – a hotspot for the virus, with nearly 2,700 confirmed cases and 72 deaths as of Friday. 

Compounding the threat are its demographics. Nearly 90 percent of the residents in Lauderdale Lakes are black. No other Florida city has a higher percentage of black residents.

African Americans are contracting COVID-19 and dying at higher rates in almost every state where data is available, according to the Brookings Institution. 

Lauderdale Lakes has confirmed just six cases of coronavirus. But the lack of widespread testing means the actual number is certainly greater. 

“We know we’re going to get numbers larger than most,” Lauderdale Lakes Mayor Hazelle Rogers said. “Until you test a majority of this population, you don’t know for sure … Some folks just don’t want to know. We’re saying you should know, so you can protect your family.”

The virus already has battered the city’s economy, where most work in retail, restaurants, or at the county’s airport or seaport.

With testing numbers that lag behind neighboring cities, some worry the low case counts in Lauderdale Lakes downplays the threat. African Americans already carry more risk factors and pre-existing conditions and many in the minority neighborhood lack proper access to medicine. 

Experts also cited poverty as a contributor. The median household income in Lauderdale Lakes is about $36,000. Countywide it’s $20,000 higher.

“When you’re poorer, you’re more likely to be vulnerable to disease,” said José Szapocznik, professor of public health sciences at the University of Miami. “There are a lot more limitations.”

Early action in retirement community

In Punta Gorda, an almost all white retirement community in Southwest Florida, city leaders knew to expect the worst due to the average age of the population.

The city of about 20,000, where senior citizens account for 56% of the population, ordered supplies amid the state’s first confirmed cases in early March – nearly a month before the statewide stay-at-home orders. 

“We have this really at-risk community, so we took notice very early,” said Ray Briggs, Punta Gorda’s fire chief and emergency manager. “We understand the risk of our population – we really do.”

Briggs had some leftover protective equipment from the Ebola outbreak in 2016. And before the crisis took deep hold in Florida, he put in an order of N95 masks, eye protection, gowns and other supplies – beating out the statewide rush.

To limit exposure, Briggs also postponed all nonessential services and enforced a “no boots” rule in the fire station, which is cleaned with bleach solution three times daily. No visitors are allowed, not even families.

After a substantial outbreak at a Washington State nursing home claimed the lives of residents in February, Punta Gorda officials had meetings with assisted living facilities and local churches to get the message out to seniors. Officials also are trying to help elderly citizens who already suffered from isolation and depend on social services.

“It’s devastating everyone” Punta Gorda Mayor Nancy Prafke said. “Most seniors are watching, and paying attention, and doing what they can to weather this.”