PROVIDENCE, R.I. (WPRI) — When Clínica Esperanza started doing COVID-19 testing in Olneyville in mid-April, Dr. Annie De Groot says about half the people who came in the first week tested positive.
“A lot of them didn’t have cars,” said De Groot, a biotechnology CEO who is also founder and volunteer medical director at the health clinic, which serves mostly Spanish-speaking and uninsured patients. “So there was a pent-up demand for testing.”
In the weeks since then, the numbers have leveled out to a 30% positive rate, according to data provided to Target 12. As of Tuesday afternoon, 50% of tests at the clinic on Valley Street were negative, and 20% of tests were pending results.
As statewide testing numbers dip — only 8% of the test results reported Tuesday from all sites were positive, according to R.I. Health Department data — Gov. Gina Raimondo has sounded increasingly optimistic about her plans to cautiously reopen the state in phases. But the urban neighborhood testing sites, which serve lower-income and higher-risk patients, are seeing positive results that are more than double or triple the statewide percentage.
At the Bailey Elementary School testing site run by the Providence Community Health Centers, 34% of the 550 people in total tested as of late last week were positive for the virus, according to a spokesperson.
That’s nearly triple the rate of positive results at all Rhode Island testing sites combined, which is 12% since the start of the crisis, Health Department data shows.
The Health Department has not yet publicly released numbers for individual testing sites, so Target 12 went directly to the clinics. And they reported positive rates much higher than the aggregate totals presented by the state in its daily updates.
The Bailey Elementary site — the first in the state to accept walk-through patients, by appointment only — started out testing 40 people a day and now tests 100 a day, according to Providence Community Health Centers CEO Merrill Thomas. He said the center’s 60,000 patients are mostly lower-income — the vast majority are within 200% of the poverty rate — and Latino.
“We’re just dipping our toe in the water as far as testing,” Thomas said in an interview. “We are expecting more positive results and we don’t see this stopping … I don’t think the people have been tested enough.”
He said PCHC is working to open a second site in another part of the city, but the health center needs enough supplies to do so first.
“We just don’t have the behind-the-scene kits and PPE to do that many people,” Thomas said, adding that the health center has about two weeks worth of gowns left.
Thomas and De Groot both attributed the high positive rates partly to a delay in getting information to non-English speaking communities, including Spanish-speakers.
“There was a little bit of a lag in getting the information out in Spanish,” De Groot said. “It took a while for the announcements to be in Spanish, so I feel that as a city and as a state we weren’t really reaching about 14% of the population.”
She said she wrote a letter to Raimondo in April asking for more messaging in Spanish, though she also praised the job Raimondo and Health Department Dr. Nicole Alexander-Scott have done so far addressing the crisis.
De Groot said many of the clinic’s patients live in crowded multi-family homes, and are also still out working in the community providing cleaning or delivery services, potentially exposing them to the virus. She added that the clinic’s 30% positive rate might even be artificially low, since workers have sought testing there because their employer requires a negative test for them to go to work.
Providence City Council President Sabina Matos, who represents Olneyville, said the high positive numbers indicate there were many people — including the uninsured — who were unable to access testing before the clinic’s site opened.
“I think probably these are numbers that were going on all along,” Matos said. “Now we’re able to do the testing and be able to provide the support that those individuals need, and hopefully we’re going to be able to control the spread of the disease.”
Matos recently granted $100,000 to Clínica Esperanza (Hope Clinic, in English) from the City Council’s Neighborhood Services Account, allowing the clinic to double the its hours for testing.
“We are trying really hard to increase testing right in the community,” Matos said. According to the Health Department’s ZIP code data, last updated on May 4, the 02909 zip code — which includes Olneyville, Silver Lake and the West End — had the most coronavirus cases in the state at 964. Providence as a whole had 3,770 cases as of Monday.
Providence got another new testing site late last week, at the Rhode Island Free Clinic on Broad Street. The site is only serving patients who are uninsured, by appointment.
Other communities have started ramping up local testing, as well; Central Falls and Pawtucket now have multiple walk-through and drive-through sites after the two cities’ mayors spent weeks sounding the alarm about a lack of testing options in the Blackstone Valley.
The options include a walk-up site on Dexter Street in Central Falls that just opened last week, plus the former Memorial Hospital site, which started testing in late April. A Care New England spokesperson says the site is testing 175 to 200 people a week, and the positivity rate is 20%.
The Blackstone Valley Community Health Center has tested nearly 1,000 patients in Central Falls, Pawtucket and Cumberland in the past six weeks, with 24% testing positive, double the statewide rate.
“It is safe to state that the positivity rate is always positively correlated with population density,” said Ray Lavoie, the executive director. “Central Falls and Pawtucket, as two of the most densely populated cities in Rhode Island, are proof of this.”
Central Falls has the highest per-capita rate of positive cases in the state, followed by Providence and Pawtucket.
The city of Woonsocket also announced a new walk-through and drive-through site on Tuesday, run by Thundermist Health Center, which can test 170 people a day by appointment only on Clinton Street.
Health Department spokesperson Joseph Wendelken said in an email that the high positive rates at the community testing sites are not surprising, since the cities where they are located also have high numbers of cases.
Alexander-Scott said the Health Department is focused on getting more resources to those areas.
“We know that 80% of health outcomes are determined by factors at the community level,” she said in a statement. “They include things like the stability of our housing, the quality of someone’s education, and whether or not someone earns a living wage. These factors impact someone’s health and can make them either more vulnerable to, or more resilient in face of, something like COVID-19.”
She added, “We have to focus simultaneously on these broader factors while also working to get resources and COVID-19 support services into the communities where they are needed most.”
Calls for more testing
While Rhode Island has boasted some of the highest testing levels per capita in the country, the capacity has been stagnant for weeks, fluctuating between 2,000 to 3,000 tests a day.
Raimondo has said she wants to get to 10,000 tests a day by July in order to better identify and isolate people who are sick, while the state slowly reopens and restarts regular activities. The governor has already lifted her stay-at-home order, beginning Phase 1 of her reopening plan Saturday.
State Rep. Anastasia Williams, a Providence Democrat, said Tuesday she thinks Raimondo’s plan needs to include more specifics for testing and supporting minority communities.
“The numbers in our neighborhoods and in our communities are probably even higher than what was presented,” Williams said in an interview. “Realistically, when you talk about ‘let’s reopen the state’ … one size does not fit all.”
She listed a number of barriers to testing for marginalized communities: no doctor for a referral, no insurance, no transportation to the state-run sites in the suburbs. Plus, she says some people of color are not comfortable going to one of the large sites run by uniformed R.I. National Guard members, which evokes fear of police or immigration officials even though there is no such enforcement taking place there.
The neighborhood testing sites — some of which accept uninsured patients without a doctor’s referral — have therefore been extremely welcome, but Williams says there needs to be more of them.
“It’s not enough,” she said. “You’re telling us to be distant and I have to walk a mile?”
While some towns and cities are in a good place and have enough data to reopen, she said of her neighborhood, “We’re not ready.”
Mayor Jorge Elorza has diverged with Raimondo on some COVID-19 policies over the past two months, but is so far on board with her timeline for reopening, with the city starting to take permit applications Tuesday for restaurants to begin outdoor dining next week.
“As we begin to develop reopening plans, we are mindful of the increased rates of positive cases in our city and of the risk of a second wave,” Elorza said in a statement. “We appreciate the state’s thoughtfulness on each of these concerns and we will continue to work with them to make sure the reopening goes well.”
He said the city is working on launching two more sites with the Providence Community Health Centers, including one at Crossroads.
Raimondo acknowledged the need for more neighborhood testing at her daily news conference Tuesday, saying the underlying inequities in the health system contribute to the high rate of positive cases in communities of color.
“We are working very hard to make sure we beef up our access to health care for everybody,” Raimondo said.
She rattled off some of the towns and cities that now have local test sites, and pledged to add more walk-through sites “in communities that are the poorest and are the hardest hit.”
“We’re doing a lot,” Raimondo said. “We’re not doing enough.”