The perfect storm: Why Sussex County has seen a drastic increase in coronavirus cases
A perfect storm has settled over rural Sussex County, where issues that have defined the area for decades have helped lead to an alarming increase of coronavirus cases in recent weeks.
Small Delaware towns – like Seaford and Georgetown – are now reporting some of the highest numbers of cases statewide, poising Sussex to push past more urban and populated New Castle County for the most confirmed cases.
With the large presence of Hispanic and Haitian immigrant communities, health care workers, advocates and elected officials say those residents face many challenges, including language barriers, when trying to access emergency resources and learn what safety precautions they need to take.
Many of those residents work in the county’s largest industry – chicken processing plants – where to complete their jobs, workers must stand close together, not adhering to social distancing guidelines.
Low-income workers in the heart of Sussex County can't afford to lose a paycheck during this pandemic, causing hesitation about whether to get tested – even if they have potentially been exposed to the infection. Others are concerned that seeking treatment could jeopardize their immigration status.
And, on top of all of this, Delaware's limited testing capability in the early weeks made it difficult to identify COVID-19 patients and further stop the spread.
“Because of this crisis, everything that hasn’t been addressed before is exacerbating,” said Erika Gutierrez, the Latino outreach coordinator for the Delaware Campaign for Achievement Now, a nonprofit that advocates for student achievement.
Delaware Online/The News Journal found that the growth rate of COVID-19 cases in Sussex County is more than double New Castle County's, once adjusted for population size. The number of cases in Sussex County is also doubling faster than it is in New Castle County.
As of Saturday, April 25, health officials have confirmed 1,490 cases in Delaware’s most rural county, making up more than 40% of the state total. The Georgetown area is seeing the highest number of cases of any Delaware ZIP code, state officials said.
Dr. Karyl Rattay, director of the Division of Public Health, said the state doesn’t have “one great explanation” for why there’s been a rise in Sussex County cases. But she said those who are unable to social distance, live in crowded homes and are essential employees have a high risk for the chance of infection.
It’s why the state has drastically increased testing in the area, both at poultry plants and at community sites, and will now provide no-cost housing to some of those who are sick and unable to self-quarantine.
The reality is that the poultry plants are just a symptom of a much larger problem in Sussex County, where million-dollar homes line the beaches, but socioeconomic and racial issues saturate the county west of the waterfront.
“We are very focused on Sussex County right now,” she said. “For us, this is an all-hands-on-deck approach.”
'This is the moment of truth'
When the results finally came in early April, nurse practitioner Emanie Dorival was not surprised.
Her patient – a Haitian immigrant, who works in a chicken processing plant and lives in the Seaford area – had tested positive for the coronavirus, adding to the almost two dozen patients of Dorival’s who have been confirmed with the virus. She said all of her COVID-19 positive patients work at a chicken processing plant.
This man lives with his pregnant wife, his brother and sister-in-law, who is also expecting. They all have since tested positive for the coronavirus, according to the nurse practitioner.
"I am really worried,” said Dorival, whose practice primarily serves the Haitian community in Seaford. “I am really worried for the Haitian and Hispanic community, and I don’t feel like there are protections in place.
“I am feeling helpless.”
The Haitian community makes up about 8% of Seaford’s population. Census data shows more than one-third of Georgetown residents are Hispanic, pointing to southern Delaware’s need for resources and health information to be provided in languages like Haitian Creole and Spanish.
According to the Delaware Community Foundation, 80% of Latinos in Sussex County live in poverty.
State data released Saturday revealed that the Hispanic population statewide is leading Delaware in the rates of infection, with 66.5 people per 10,000 having confirmed COVID-19. For comparison, Delaware's white communities reported an infection rate of 14.3 per 10,000 people.
Dorival said she has done outreach with local churches and hosts information sessions through conference calls every Saturday. But she worries it won’t be enough.
Her patients are afraid to get tested, she said. They fear they could be separated from their families due to their immigration status or not be able to return to work. Many of her patients, she said, are the breadwinners for their family.
“All they are thinking,” Dorival said, “is ‘Am I going to lose this paycheck?’”
In Georgetown, Dr. Rama Peri hears the same concerns.
The family medicine physician, who primarily cares for the Hispanic community, has been holding drive-thru clinics at local churches in the past month.
Oftentimes, her biggest battle is making sure her patients are properly informed about how dangerous the coronavirus is. Some, she said, have incorrectly likened it to the flu. Like Dorival, the physician said many of her patients are afraid to seek help.
“We’re trying to do outreach of ‘You don’t need to be afraid. And no one is out there to try and get you.’”
Peri believes testing has played a large role in why the state is now seeing an increase in cases. And though testing capacity has improved, Peri said she is still limited in testing those who are demonstrating symptoms of the virus.
“Four weeks ago, when I first started, I couldn’t get enough tests,” she said. “It just wasn’t available. That’s what this is.”
Gutierrez, the outreach coordinator, helped pen a recent letter to Gov. John Carney, urging the state to protect immigrant workers’ rights and not exclude them from COVID-19 relief efforts. Gutierrez said she and other advocates are working with Carney to provide better communication for those workers and ensure companies like the ones that run chicken plants comply with safety measures.
State Sen. Brian Pettyjohn, R-Georgetown, said he has done more constituent outreach in the past month than the last seven years in office combined. He wonders if more “blanket communication” should have been done earlier in the outbreak, particularly with the Hispanic community in his area.
“Everyone could Monday morning quarterback this till the cows come home,” he said. “I’m sure once this was done there will be a look at what actions the state took … and try to learn from some of the difficulties of what happened this time.”
The state announced this week that, in addition to increased testing at chicken processing plants, it will also have rapid test kits available at various community testing sites in Sussex.
The state will also be providing “care kits,” which will include hand sanitizer, bandanas, thermometers and educational materials. The informational materials will be translated into Spanish and Haitian Creole.
Rattay, the director of the Division of Public Health, said the state is working with a hotel in Sussex County to provide no-cost temporary housing for those who have tested positive and are unable to properly quarantine because they live in a crowded home.
Right now, about 100 people can be accommodated, health officials said. But the state is looking for other hotel groups to partner with.
Rattay said the state does have concerns for black and brown communities in Delaware, which already experience disparities in health outcomes.
Across the country, people of color – particularly black Americans – are being infected and dying from coronavirus-related complications at a disproportionate rate.
This includes immigrant employees who work for wages to keep America – and their families – fed, said Gutierrez, the outreach coordinator.
"This is the moment of truth,” she said. “This is the moment to change the way our state functions.”
'I'm trying to stay safe'
Much of the chicken that adorns American dinner tables comes from poultry processing plants like those in southern Delaware, where employees stand side by side to debone, gut and strip each bird of feathers, then cut and package the meat.
The work is demanding, low-paying and essential, meaning employees have to come into the plant to do their work.
Though plants have taken some preventative steps, some employees say they still fear they are at high risk for infection when they go to work every day.
These workers have told Delaware Online/The News Journal that the lack of both social distancing and information about which of their colleagues has been infected makes the job more dangerous than it already is.
These employees also said fewer people are showing up to work either because they are sick or fear they will be infected. The recent preventative measures, including temperature checks, that have been put in place since the pandemic, however, have eased some concerns.
Across the country, more than 150 of the largest meat processing plants are in counties where the rate of coronavirus infection is already among the nation’s highest, based on an analysis by USA TODAY and the Midwest Center for Investigative Reporting of slaughterhouse locations and county-level COVID-19 infection rates.
Rates of infection around these beef, pork and poultry plants are higher than those of 75% of other U.S. counties, the analysis found.
USA TODAY INVESTIGATION:Coronavirus at meatpacking plants worse than first thought
Only two companies in Delaware, Mountaire Farms and Perdue Farms, have publicly confirmed cases: two at Perdue’s Milford plant and one at Mountaire’s Selbyville plant.
The United Food and Commercial Workers International Union Local 27 previously told The News Journal that officials at Mountaire’s Selbyville plant informed the union there have been 16 confirmed cases.
Additional cases at these plants have not been announced publicly.
"Unless these employees are a close contact of the individual infected with COVID-19, the employer is not required to notify other employees," a state spokesperson said in an email.
Videos and photos shared with The News Journal from inside one Delaware plant in early April show workers standing and walking closely together, nowhere near 6 feet apart.
Those photographs and videos are not being shared publicly to protect the identity of the source who took them.
“We have a lot of people talking very close in a place that’s not ventilated,” an employee told The News Journal. “I’m trying to stay safe, be safe for my family.”
This week, the state began rapid coronavirus testing at Delaware chicken processing plants, Rattay said.
Though not mandatory, the tests are free for workers at the chicken plants, which employ more than 6,000 people and offer contract work to hundreds of local farmers in southern Delaware.
Testing employees will help the state better understand how common asymptomatic spread is in Sussex County, she said.
Since Delaware had confirmed its first case at a plant one month ago, the poultry industry has worked on creating social distancing, screening employees and having workers wear masks while working, she said.
“Any large employer with a large number of essential employees is going to see an increase in the risk of infection,” Rattay said.
Gov. John Carney said Friday that the state could not publicly provide the specific number of confirmed cases associated with the processing plants at this time, but he indicated he might do so in the future.
He said the number of confirmed cases to come from testing at the plants, which on Friday was not included in the state's total count, is "very high."
Perdue Farms plant employees practice social distancing on the production lines “where possible,” according to the company’s website.
A Perdue Farms spokesperson said there have been a “limited number of cases” throughout the poultry company’s facilities.
“We’ve decided not to specify every individual case moving forward out of respect for our associates’ privacy under applicable confidentiality guidelines,” the spokesperson said when asked for specific numbers of cases.
Mountaire Farms said it has its facilities disinfected every night and has “redoubled” efforts to clean and disinfect common areas and cafeterias.
Gutierrez, the advocate for the Hispanic community in Delaware, has heard from families about how scared they are to go to work.
“While businesses are telling the governor they are complying and doing everything possible,” she said, “our families are not agreeing with that.”
Environmental reporter Maddy Lauria contributed reporting to this article.
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