CHELSEA – As the coronavirus pandemic has shaken Massachusetts over the past few months, it has highlighted the effects of inequality in the Boston area – including in the city of Chelsea, which has the state’s highest rate of COVID-19 infection, according to the city’s website.
Dr. Adriana Cohen-Hausmann, a Mass General Hospital pediatrician working in Chelsea, has had firsthand experience of the situation. Cohen-Hausmann works with infants and young adults at the Respiratory Illness Clinic that MGH set up on April 14 at its Chelsea facility due to the need for a greater response to the coronavirus in the city. The clinic is open seven days a week, providing testing to individuals with COVID-19 symptoms, and offering services without regard to health insurance or immigration status, according to MGH.
While she said that young patients at the clinic generally have not been affected by the coronavirus to the extent that adult patients have, she noted that socioeconomic factors have made Chelsea as a whole particularly hard-hit.
The situation in Chelsea has made local and national headlines due to its high population density, low income and significant minority population, including Latin American immigrants who might need an interpreter when accessing medical care. Cohen-Hausmann herself is a Latin American immigrant. She is a Venezuelan Jew who grew up in the capital of Caracas, the daughter of a Sephardic father and an Ashkenazi mother. She notes that the majority of patients at MGH Chelsea speak Spanish, as do most of the health care providers. She has been working as a pediatrician-in-training since graduating from Tufts Medical School in 2016.
In Chelsea, she finds that the pandemic has highlighted income inequality.
“A lot of our families in Chelsea are low-income, so they’re very dependent on salaries,” Cohen-Hausmann said. “Families often need several jobs in order to provide for their children. Those jobs have been lost, or if the parents got sick, they’re not able to work as a result.” She said that “families often cannot access unemployment benefits in terms of rent support, which is very difficult to provide at this time.” She also noted that undocumented immigrants are not eligible to receive unemployment benefits.
Children in struggling families face age-specific difficulties. Cohen-Hausmann said that one of the main needs has been diapers, and the community has responded with diaper drives. The children that Cohen-Hausmann cares for as a pediatrician often need access to school lunch programs. Although area schools are closed, they have continued to provide lunches. But families worry about going out in public and risking infection, she said.
“Chelsea is a hot zone,” said Cohen-Hausmann. “People do not want to leave their houses. There are entire families and children who have not left in months. It might have complicated [results] on their overall well-being. It’s very challenging for a child and an adult to be at home 24 hours a day for a few months, very challenging for a family.”
Many living conditions in Chelsea have resulted in cramped quarters that may contribute to the spread of COVID-19, Cohen-Hausmann said.
“We know a lot of patients whose family lives in small or shared apartments,” she said. “Lots of families live in an apartment where they each rent one room … For a lot of patients, it’s very difficult to be in quarantine. If even one family member gets sick, it’s easy to expose other families.”
One response was the establishment of a coronavirus hotel for residents of Chelsea and Revere who needed to be quarantined because of COVID-19. Although Cohen-Hausmann has not visited patients in a quarantine hotel, she has treated individuals there through telemedicine.
“We’re hearing from families who had been sick in March,” she reflected. “At the time, we did not have hotels to provide quarantine for families. It would have been helpful.”
This is not to diminish the care that was provided, she explained. “We did as much as we could,” she said, adding that the front-line medical professionals at the respiratory clinic were “able to provide much-needed care.”
“The pandemic itself is a challenge,” she said. “It’s shown the weak spots in our system … It’s put a lot of stress on low-income communities.”