CENTRAL FALLS, R.I. (WPRI) – Central Falls shares a border with Lincoln, but the two Rhode Island communities are worlds apart when it comes to COVID-19.

Nearly 25 of every 1,000 residents have tested positive for the disease in Central Falls, a city of nearly 20,000 people. In Lincoln, the comparable figure is roughly five out of every 1,000 residents, in a town of about 17,000.

The disparity reflects a harsh reality in Rhode Island, where the pandemic has more negatively affected poorer, more densely populated neighborhoods with higher rates of racial and ethnic minorities, according to a Target 12 analysis of ZIP code data.

“Central Falls has a lot of poor and working people,” explained Dr. Michael Fine, Central Falls health policy adviser. “There’s also densely packed housing.”

While Central Falls and Lincoln have almost the same number of housing units – 7,500 and 7,000, respectively — about 16,000 people live in every square mile of Central Falls, compared to 1,000 in Lincoln. (Central Falls is technically 1.3 square miles in size.)

The dynamic is problematic, especially considering the coronavirus that causes COVID-19 spreads most quickly among people living in close quarters.

“We’re hearing about whole apartments of 10 and 12 people – everybody’s sick,” said Fine, who formerly served as the state’s health director.

‘Not an option’

Central Falls stands out with the most COVID-19 cases per capita in Rhode Island, but it’s hardly the only community getting slammed by the disease.

The Providence ZIP code of 02909 has the most cases overall, although slightly fewer per capita than Central Falls. The 02909 area covers several neighborhoods, including parts of Federal Hill, the West End, Olneyville, Silver Lake and Manton, and nearly 24 of every 1,000 residents have tested positive for COVID-19.

Like Central Falls, the neighborhoods in 02909 are densely populated with multifamily houses, making it almost impossible for people to keep distance from one another – even if someone is sick and needs to isolate or quarantine at home.

“It’s tough to tell anyone they have to use a different bathroom because that’s not an option,” City Council President Sabina Matos, who represents much of the area, told Target 12.

Matos said spread of the virus in her section of the city is exacerbated because many residents are so-called essential workers and have continued to work outside of their homes throughout the pandemic.

Essential workers are often employees in factories, hospitals, nursing homes and food suppliers, which are all places where the disease can spread easily, increasing the risk for people to carry the virus home to their densely populated apartments.

Despite the continued rise of cases in some of these densely populated areas, the experience in suburban and rural areas of the state have been relatively stagnant in recent weeks. In light of that fact, and as hospitalizations and new cases have plateaued, Gov. Gina Raimondo has announced her decision to let her stay-at-home order expire after Friday.

The announcement marks the first step toward what she says will be a gradual reopening of the economy that lets people out of their homes and back to work.

“My goal is to get everyone back to work as quickly as possible without jeopardizing our health and shutting down our economy,” Raimondo said during her daily briefing Thursday. “We need to go slow.”

The initial reopening comes as a welcome sign to many who have felt stuck inside for weeks, but Matos said she doubts many in her neighborhood will notice much of a difference, as so many have been going to work throughout the pandemic.

The sentiment was echoed earlier this week by Providence Mayor Jorge Elorza, who pointed out that the disease has disproportionately affected Hispanic and Latino communities in Rhode Island.

The Health Department currently estimates Hispanic and Latinos make up about 44% of known cases in Rhode Island, even though they represent only about 16% of the state’s overall population, according to the U.S. Census Bureau.

“We know people are getting infected at work,” Elorza said Tuesday during a WPRO radio interview. “Many Latinos work as [certified nursing assistants], many Latinos work in factories and then we come back into the neighborhood where there are double- and triple-deckers, so this is how it spreads when there’s a density of population.”  

Fred Ordoñez, a commissioner of the R.I. Commission on Health Advocacy and Equity, which advises the Health Department, was much more critical of what’s been happening, releasing a sharply worded critique on Thursday of how people of color have been treated during the crisis.

“This serious racial disparity with Covid-19 is not due to ignorance of safety suggestions and the need for their translations, but rather the structural racism which keeps black and brown people part of the working poor and struggling for safe housing and basic services,” Ordoñez wrote in a public letter. “They are the service, factory, restaurant, warehouse, food market, and low-wage employees, considered ‘essential’ — which is code for disposable.”

‘We’re all going to get it’

In addition to 02909, the rate of confirmed cases is likewise high in other parts of the capital city, including Smith Hill, Elmhurst and Upper and Lower South Providence.

The high rates largely drop off outside of the Providence area — with the exception of some communities with large numbers of cases in certain nursing homes, another close-quarters setting where people are disproportionately contracting the disease and oftentimes dying.

The exception in Providence is the more affluent downtown and East Side neighborhoods, largely made up of white residents living in high-end apartments or single-family homes.

Currently, nearly eight of every 1,000 residents in the East Side ZIP code of 02906 have contracted the disease compared to 24 in 02909, 19 in 02908, 16 in 02907 and 13 in 02905. In 02903, encompassing downtown and parts of the East Side, the rate is less than seven.

Asked Wednesday whether he’d consider setting different policies in different neighborhoods based on ZIP code data, Elorza said it’s not likely.

“We’re too small of a city and really too small of a state to really bisect in that way,” he said during a virtual press conference.

Raimondo has repeatedly said the state is monitoring how the disease is affecting different populations, saying protecting the most at-risk Rhode Islanders is paramount in her effort to reopen the economy.

And she hopes more robust testing will help the state respond to outbreaks more quickly, with a goal to test 10,000 people each day by July and 20,000 per day by September.

The state recently announced the opening of a new rapid testing site in Central Falls, and clinics in Matos’s neighborhood have received funding to provide more testing to people without insurance.

The ability to track cases by ZIP code will also help the state respond to areas where cases appear to be flaring up in the future, but Fine said reacting to data alone will not likely be enough to keep people safe, especially if they must continue to live with the disease in close quarters.

“As long as people are going to work, that’s going to be a real challenge in Central Falls,” he said.

As of Wednesday, the former health director noted the only place to isolate away from home for many people was in a hotel in Warwick, which is only about 13 miles from Central Falls — but too far for many to even consider.

“It seems close when you think of mileage, but it feels like 100 miles away for some,” he explained.

If the state doesn’t come up with more options to isolate away from home, Fine said he expects the disease will continue to spread throughout Central Falls, and start to flare up in other densely populated areas of the state, such as Woonsocket, especially as the economy starts to reopen.

“We’re not really talking about preventing disease, we’re all going to get it,” he said. “The question is: can we structure our medical environment so that the people who get it, if they get into trouble with it, do we have the capacity to take care of them, so they don’t have to suffer in silence in their own homes.”

Eli Sherman (esherman@wpri.com) is a Target 12 investigative reporter for 12 News. Connect with him on Twitter and on Facebook.

Steph Machado contributed to this story.