HIALEAH, Fla. — Of all the places in the country that are most vulnerable to the coronavirus, Hialeah is easy prey: a Hispanic blue-collar enclave outside Miami where households are packed, incomes are tight and work is essential.
The virus lurks in the South Florida city’s nursing homes, nestles in its densely crowded apartment buildings and multiplies among families whose breadwinners must go out each day to toil at construction sites, hospitals and factories.
Miami-Dade County has endured one of the nation’s worst coronavirus outbreaks, and on many days, no other ZIP code in the county has more new cases than downtown Hialeah. Only three cities in the state — Miami, Orlando and Jacksonville — have had more.
The Miami area has slowly begun to tame its rate of infection. But it is sometimes hard to be optimistic in Hialeah, Florida’s sixth-largest city, where prevalence has remained stubbornly high.
Paramedics have gotten sick. A father and son, both doctors who tended to local residents for decades, died. A funeral home brought in an extra cooler to store bodies, prompting worried neighbors to protest. Some hospitals in the city told ambulances at the peak of the summer surge to bypass their emergency rooms because they were too full of Covid-19 patients.
“The calls were back-to-back-to-back — at night, during the day, whenever,” said Eric Johnson, a firefighter paramedic in the city and president of the local firefighters’ union. He contracted the virus himself in March, probably at work, and then his wife got it.
“You would see a house with 11 or 12 people inside,” he said. “Many, many, many, many times you’d return to the same place for multiple patients out of the same house.”
Hialeah — pronounced hi-ah-LEE-ah — is prone to stereotypes, with its shabby motels, industrial roots and colorful history of corruption. (The sitting mayor has admitted to loan sharking and once tried to pay a $4,000 ethics fine in pennies.)
Hialeah Park, a casino and racetrack, appears as a backdrop in “The Godfather: Part II,” and the park’s flamingos were filmed for the opening credits of the TV show “Miami Vice.” A local Kentucky Fried Chicken is the only one in the country that sells flan for dessert. (It’s delicious.) The writer Jennine Capó Crucet, a city native, has said that readers outside of Florida often think that her first book, titled “How to Leave Hialeah,” is about a woman, not a place.
What Hialeah is at its core, however, is a city of families and workers, two demographics ravaged by the coronavirus.
Back in April, the city received national attention for the crush of people waiting at the public library to get applications for unemployment benefits. Now people line up in their cars — for three miles past pastel duplexes, auto repair shops and warehouses on a recent morning — to get weekly food aid at Amelia Earhart Park or San Lázaro Roman Catholic Church and Shrine.
Melissa Espinar, 26, works with her partner as a slot attendant at a Miami Gardens casino; both were temporarily laid off in March and then permanently in July. They have no health insurance.
Ms. Espinar is living off her savings and the $240 a week that she and her partner are each getting in unemployment compensation. They live in an apartment with his mother, who is self-employed cleaning houses.
“We keep telling her, ‘Don’t go,’” she said. “She’s cleaning other people’s houses, houses where we don’t know who’s sick or not. It hasn’t spared anybody.”
The swift spread of the virus through crowded apartments got so bad that elected officials began advising families to social distance among themselves and wear masks at home if any one of them had to regularly go out.
But enforcing even outdoor rules has proved difficult. When the city set up a hotline for people to report businesses violating mask and social distancing orders, some residents complained that neighbors were being asked to snitch on each other as people had been required to do years before in Communist Cuba. Hialeah, a reliably Republican city of more than 233,000, is 96 percent Hispanic and home to more Cubans and Cuban-Americans than anywhere else in the country.
“There’s been a lot of pandemic fatigue in this area,” said Dr. Jack Michel, president and chairman of Larkin Community Hospital in Hialeah. “A lot of people don’t understand that we’re going to live with this for another year — maybe longer.”
After the state shut down an assisted living facility in the city over its virus spread and big outbreak happened at a local nursing home, with 136 cases and 52 deaths, the city put together a task force and sent the Fire Department to visit each of the nearly 100 facilities in the city catering to older people, said Jesús Tundidor, a member of the City Council who leads the effort. About a fifth needed help securing protective equipment like masks and gloves.
Mr. Tundidor’s own family has been affected by the virus. His stepfather, who lives with Mr. Tundidor’s mother and 90-year-old grandmother, had to continue going to his maintenance job and tested positive for the virus, prompting a nerve-racking family conversation.
“‘What do we do with my grandmother?’” Mr. Tundidor recalled. “‘Do we bring her to my house?’ But I’m always out on the street as well, and my wife has to work as a physician assistant. And she’s pregnant.” (The grandmother stayed put but isolated in her bedroom until her son-in-law tested negative.)
Now that the prevalence of the virus has gone down, hospital administrators and public health experts worry that reopening too quickly could eventually lead to another spike.
In Miami-Dade County, the virus positivity rate is hovering at about 8 percent, less than half of what it used to be at its peak but higher than what it was in early June, when the county reopened the first time. There is concern about Labor Day because gatherings over past holidays, including Memorial Day and the Fourth of July, have led to measurable case hikes.
But the county mayor has said he will not close the beaches for the holiday. Restaurants let customers into their dining rooms again on Monday. Casinos opened, too. Soon there will be some fans at football games.
The Coronavirus Outbreak ›
Frequently Asked Questions
Updated September 1, 2020
Why is it safer to spend time together outside?
- Outdoor gatherings lower risk because wind disperses viral droplets, and sunlight can kill some of the virus. Open spaces prevent the virus from building up in concentrated amounts and being inhaled, which can happen when infected people exhale in a confined space for long stretches of time, said Dr. Julian W. Tang, a virologist at the University of Leicester.
What are the symptoms of coronavirus?
- In the beginning, the coronavirus seemed like it was primarily a respiratory illness — many patients had fever and chills, were weak and tired, and coughed a lot, though some people don’t show many symptoms at all. Those who seemed sickest had pneumonia or acute respiratory distress syndrome and received supplemental oxygen. By now, doctors have identified many more symptoms and syndromes. In April, the C.D.C. added to the list of early signs sore throat, fever, chills and muscle aches. Gastrointestinal upset, such as diarrhea and nausea, has also been observed. Another telltale sign of infection may be a sudden, profound diminution of one’s sense of smell and taste. Teenagers and young adults in some cases have developed painful red and purple lesions on their fingers and toes — nicknamed “Covid toe” — but few other serious symptoms.
Why does standing six feet away from others help?
- The coronavirus spreads primarily through droplets from your mouth and nose, especially when you cough or sneeze. The C.D.C., one of the organizations using that measure, bases its recommendation of six feet on the idea that most large droplets that people expel when they cough or sneeze will fall to the ground within six feet. But six feet has never been a magic number that guarantees complete protection. Sneezes, for instance, can launch droplets a lot farther than six feet, according to a recent study. It’s a rule of thumb: You should be safest standing six feet apart outside, especially when it’s windy. But keep a mask on at all times, even when you think you’re far enough apart.
I have antibodies. Am I now immune?
- As of right now, that seems likely, for at least several months. There have been frightening accounts of people suffering what seems to be a second bout of Covid-19. But experts say these patients may have a drawn-out course of infection, with the virus taking a slow toll weeks to months after initial exposure. People infected with the coronavirus typically produce immune molecules called antibodies, which are protective proteins made in response to an infection. These antibodies may last in the body only two to three months, which may seem worrisome, but that’s perfectly normal after an acute infection subsides, said Dr. Michael Mina, an immunologist at Harvard University. It may be possible to get the coronavirus again, but it’s highly unlikely that it would be possible in a short window of time from initial infection or make people sicker the second time.
What are my rights if I am worried about going back to work?
- Employers have to provide a safe workplace with policies that protect everyone equally. And if one of your co-workers tests positive for the coronavirus, the C.D.C. has said that employers should tell their employees — without giving you the sick employee’s name — that they may have been exposed to the virus.
“It just feels like nothing has changed around here,” said Ms. Espinar, the unemployed slot worker. “When things were shut down at the beginning, it was like people were actually staying home, not going out every day. But since June, I’ve been seeing parties — even my friends, on social media, going out. And I’m like, ‘I don’t feel safe! Why is everybody going out?’”
The virus has slowed, but it has left devastation in its wake across Hialeah. The list of victims now includes Dr. Carlos F. Vallejo, an internist who saw patients at Palmetto General Hospital’s rehab center in Hialeah, which is where his family thinks he got infected with the virus.
“We would tell him, ‘Be careful, Dad, try to keep your distance,’” said his son, Charles Vallejo. “‘Try not to walk into the rooms.’ But that’s just the type of man he was. He said, ‘No, no, I have to go in there, listen to their lungs. These patients are like family to me.’”
Dr. Vallejo, 57, was hospitalized on Father’s Day within three hours of his own father, Dr. Jorge A. Vallejo, an 89-year-old retired obstetrician and gynecologist who practiced medicine in Hialeah for 25 years. Jorge Vallejo died on June 27. Carlos Vallejo held on until Aug. 1.
“We always joked that Miami was a big city but a small community in Hialeah,” Charles Vallejo, who is a third-year medical student, said. “A lot of the people knew them.”
Among them was Ariel Cribeiro, 32, a high school football coach in neighboring Miami Lakes who inherited Dr. Carlos Vallejo as his internist because he had also been his parents’ doctor.
“Miami Lakes and Hialeah are just one big area, and it’s just an environment that is just different than anything else you see in Miami: You could go out to the street and you’re going to see people that you know,” Mr. Cribeiro said. “Everyone knows somebody that has been affected.”
A friend’s father died of Covid-19 in April. A member of his coaching staff got sick and recovered. Mr. Cribeiro’s fiancée got laid off from her banking job.
“A lot of people who live here just don’t have the means to say, ‘Hey, I’m not going to go to work to not get sick,’” he said. “It’s not like people are just running around freely coughing on people. There’s good people here. There’s good people struggling. Hopefully we can get through this.”