After a quiet summer, doctors at Rhode Island Hospital began seeing one or two patients with Covid-19 on each shift — and soon three. Then four.
Cases climbed steadily from September until early December, when Rhode Island earned the dubious distinction of having more cases and deaths per 100,000 people than any other state in the country. The case rate still puts it among the top five states.
Where did this tightly knit state go wrong? Former Gov. Gina Raimondo’s “pauses” on economic activity were short-lived and partial, leaving open indoor dining, shopping malls and bowling alleys. But the shutdowns were no patchier than those in many other states.
Until late summer, she was lauded for reining in the virus. Even now, few residents blame her for the bleak numbers.
Experts point instead to myriad other factors, all of which have played out elsewhere in the country but converged into a bigger crisis in Rhode Island.
The fall chill sent people indoors, where risk from the virus is highest, and the holidays brought people together. Rhode Island is tiny — you can traverse it in 45 minutes. But crammed into that smallish area are a million people — a population density second only to that of New Jersey.
Apart from its density, Rhode Island has a high percentage of older residents in nursing homes, accounting for the bulk of deaths. Packed into the state are multiple urban areas — Central Falls, Pawtucket, Providence — where language barriers, mistrust and jobs have left immigrant families in multigenerational homes particularly vulnerable. The state is also home to multiple colleges that set off chains of infection in the early fall.
As in most of the country, the Latino community has borne the brunt of the epidemic. In Rhode Island, Latinos have 6.7 times the risk for hospitalization and 2.5 times the risk of death, compared with white people.
The state’s epidemic has been disastrous for immigrant families in multigenerational households.
Workplace exposures have especially hurt the Latino and Cape Verdean community, many of whom hold jobs that cannot be done from home. But in state surveys, it also became obvious that people were still holding get-togethers of 15 to 20 people even as the virus spread, said Dr. James McDonald, medical director of the Covid-19 unit at the Rhode Island Department of Health.
“People weren’t willing to live differently during the pandemic,” he said.