From left, Mohamed Yarrow, Hassan Guedi, Siad Saleh, Abdi Abdalla, Fowsia Musse and Sadik Lag, who formed the Lewiston-based coronavirus response group Barefoot Community Health Outreach Workers, gather at the Maine Community Integration office in Lewiston. Credit: Jessica Piper / BDN

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Immigrant leaders in Maine’s largest cities say the state has failed them as the nation’s whitest state sees some of the biggest racial disparities in coronavirus cases.

Most states have seen some racial disparities, according to data compiled by the Covid Tracking Project. But nowhere is it greater than in Maine for Black and African American people. They are 24 times more likely to have tested positive for the virus than whites are here.

While the virus has waned in Maine over the past month, transmission has continued in the most populated and diverse parts of the state. Last week, there were more new confirmed cases among Black and African American Mainers — who make up 1.6 percent of the state’s population — than white Mainers, who make up nearly 95 percent.

Nirav Shah, director of the Maine Center for Disease Control and Prevention, has called the disparities “completely unacceptable.” His agency has worked to add testing in minority communities in recent weeks and provide isolation options for individuals who test positive.

So far, the racial disparities in case counts have not extended to deaths, though the relatively few coronavirus deaths in Maine mean that the ratio is subject to significant swings.

But immigrant leaders in Lewiston, which has one of Maine’s largest Black and immigrant populations, feel the government has been too reactive in addressing the crisis, focusing more on responding to outbreaks than prevention. They say they are under-resourced and their communities could be left behind during the state’s economic reopening.

Community leaders and public health advocates say the virus has magnified long standing structural issues in three key areas: workplaces, housing and access to health care. Many low-income Mainers struggle with inequities in these systems, but the effects are acute for immigrants and people of color.

“We can’t reduce these disparities only by responding after someone gets sick, or gets exposed,” said Kathy Kilrain del Rio, director of campaigns and health care at Maine Equal Justice. “We need to actually look at what is making people more vulnerable in the first place.”

Black Mainers are starkly overrepresented among frontline workers, including health care workers, according to an April report from the left-leaning Center for Economic and Policy Research. One of the largest coronavirus outbreaks in Maine occurred in early May at a Tyson Foods plant in Portland, where many immigrants work.

Testing and treatment are less accessible to immigrants and people of color. Low-wage workers, regardless of race, are less likely to have paid leave. Low-income families are less likely to have health insurance and those without it are more likely to skip preventative care, according to the Kaiser Family Foundation.

Earlier this year, the Trump administration finalized changes to a “public charge” rule, potentially making immigrants who used public benefits, including Medicaid, ineligible for green cards. The change should not affect immigrants seeking treatment for coronavirus because the federal government carved out an exemption for the virus.

But Hassan Guedi, program coordinator for the Djiboutian American Community Empowerment Project in Lewiston, said the change shook many immigrants’ trust in the system. Undocumented immigrants, he said, had concerns about seeking testing or treatment if they got sick. Virus testing is free regardless of insurance, but treatment is not.

The third issue, housing, is where immigrant leaders in Lewiston see the biggest problem. Maine’s second-largest city struggled to provide affordable, quality housing long before the coronavirus pandemic, with a child lead poisoning rate double the state’s average. Many immigrant families occupy poorly ventilated multifamily units, where distancing is difficult.

“The number one factor that made the coronavirus worse is the housing issue,” said Sadik Lag, who works for a Lewiston nonprofit aimed at helping people with disabilities. “On Knox Street, a three or four story building has hundreds of people, and they’re using one rail, one staircase, one hallway.”

The Maine CDC has improved access to testing and working with hotels to provide rooms for individuals who contract the virus so they are less likely to infect others. Asked about preventing transmission in immigrant communities on Friday, Shah reiterated those changes.

But Fowsia Musse, the executive director of the Lewiston nonprofit Maine Community Integration, described the move as “too little, too late.” She said the virus spread significantly in the city before hotels were an option.

Immigrant leaders have been active, distributing masks, translating educational materials and otherwise assisting families. But they wish they had more say over the policies that affect their communities, so they could proactively advocate for the resources they need.

The Maine Legislature established an office for minority health under the state CDC in the mid-2000s, tasking it with using data to identify racial disparities in health outcomes and addressing cultural and linguistic barriers to access to health care. But the office was quietly eliminated under former Gov. Paul LePage and has not been reinstated.

The racial disparities in coronavirus cases in Maine come at a time when the United States is already reckoning with systemic racism in law enforcement and health care. They also come as the state has been gradually resuming economic activities due to overall declining case counts.

The push to reopen while coronavirus is prevalent in immigrant communities has many feeling “left behind,” said Mufalo Chitam, executive director of the Maine Immigrants’ Rights Coalition.

Musse used to be more hopeful that the state represented Mainers like her. She and her children canvassed for Gov. Janet Mills in 2018, excited to have a female governor after growing up in a country where violence against women was common. But now she feels the state has ignored immigrants’ concerns and failed to protect her community.

“If the state can come up with a plan for how to get tourists here, why isn’t the state coming up with a plan for how to reduce the racial disparities?” Chitam said.

But the immigrant community in Maine is resilient, said Siad Shaleh, the program director for the Lewiston-Auburn Youth and Family Enrichment Services. Many came to the country as refugees or asylees after enduring war or famine.

“No matter whether we get resources or not, we will do our work,” Shaleh said.