SAN FRANCISCO – Mandy Rong was terrified her 12-year-old daughter had COVID-19. It was 2 a.m. and the younger lady was hours right into a fierce fever and a racking cough. She was weak and didn’t wish to eat. What few medicines have been available had expired. She sipped heat water as an alternative.

“Mommy, why are my eyes on fire?” requested Amy Rong.

The mom and daughter, together with Rong’s dad and mom, dwell in an 80-square-foot windowless single-room-occupancy Chinatown constructing that may be a house of final resort for a lot of impoverished Asian immigrants. Hallways are cramped, loos and kitchens are communal. A ripe setting for the unfold of the extremely contagious novel coronavirus

That early March night time felt infinite. Rong, 42, repeatedly touched Amy’s brow, questioning if her baby would die in the small loft that the 2 shared. Down under, her father slept on the ground whereas her mom took the lone sofabed. The grandparents have been anticipating updates on Amy’s fever, however they apprehensive their whispers would wake her. 

In the morning, the fever had vanished, solely to return every week later. Once once more, the household endured a stressed night time. Rong made soup, however Amy wouldn’t eat it. She cooked porridge and spoon-fed it to her daughter. 

Getting examined for COVID-19 didn’t seem to be an choice for the Rongs. The rumor was that the exams have been costly. Rong additionally feared the response from neighbors.

“If you test positive, everyone would be scared of you,” mentioned Rong. “Everyone would think you are the devil.”

It is simple to mistake San Francisco for a thriving Asian American haven. The metropolis, which is its personal county, boasts a bustling Chinatown in addition to a preferred Japantown. Native Hawaiians, Pacific Islanders, Vietnamese, Indians and Filipinos even have made their properties right here, representing greater than 20 totally different international locations. 

But many Asian American immigrants in the county lead a fragile existence rendered much more precarious with the arrival of COVID-19. So far, 38% of the 123 COVID-19 deaths reported by the San Francisco Department of Public Health are Asian American residents, probably the most of any ethnicity.

COVID-19 has taken a toll on Asian American communities in San Francisco

Lack of presidency help and data has induced COVID-19 circumstances to rise in Asian American communities in San Francisco.

Harrison Hill, USA TODAY

Experts are also involved that positivity charges amongst Asian Americans in San Francisco could possibly be far greater than the 12% reported, a by-product of the decades-in-the-making mannequin minority delusion, which characterizes this ethnic group as financially profitable, bodily wholesome and upwardly cellular. This perception has induced segments of the Asian American neighborhood to lengthy be neglected in relation to social companies for housing, employment and well being. 

San Francisco is among the few locations in the nation monitoring information on Asian Americans and COVID-19 deaths at a time when officers don’t know the ethnicity of the individual affected in practically half of the nation’s 7.8 million coronavirus circumstances. Around 17 million Americans are of Asian descent, or 5.6% of the inhabitants.

In many circumstances, Asian Americans in this metropolis have obtained imprecise or no data in their native language about testing, security ideas, housing and different important care companies throughout the pandemic. At the identical time, the neighborhood is scuffling with insufficient entry to complete well being care, the necessity to maintain front-line employment and rising incidents of anti-Asian hate crimes.

“This model minority thing, that’s not us,” mentioned Judy Young, govt director of the Southeast Asian Development Center, a San Francisco nonprofit that helps space residents from Vietnam, Laos and Cambodia. She mentioned 80% of her purchasers have misplaced their principally service trade jobs throughout the pandemic. 

“There is the language barrier and our community is small,” Young mentioned. “So the city doesn’t think we have any problems when we do.”

Judy Young, govt director of the Southeast Asian Development Center
There is the language barrier and our neighborhood is small. So the town doesn’t suppose we now have any issues after we do.

That threat of invisibility is simply heightened by the pandemic. Since metropolis well being officers don’t break down COVID-19 statistics past “Asian American,” many advocates for the town’s varied teams mentioned they’re left to invest about coronavirus an infection and death charges inside their particular person communities. How many individuals are dying, and are these individuals Japanese Americans? Vietnamese? Korean? Filipino? No one is aware of. 

“There’s this feeling that there’s excess death out there,” mentioned Jeffrey Caballero, govt director of the nonprofit Association of Asian Pacific Community Health Organizations. “That high mortality rate among Asian Americans means either there isn’t enough testing or people are waiting far too long to get care.”

Entered , State


Deaths per 10,000:

National deaths per 10,000: 5.6


Population breakdown by race:

Asian: %
Black: %
Hawaiian: %
Hispanic: %
Native American: %
White: %
Multi-race: %
Other: %

Select your location to match with Featured County, State

Note: some areas of the United States are unincorporated or unbiased from a county or parish. In just a few choose circumstances, reminiscent of New York City and Denali Borough, Alaska, these areas is probably not out there for comparability in this interactive graphic as a result of the scope of the information just isn’t universally out there.

Cases and deaths

While your had ##### COVID-19 circumstances, County, , had ######. In San Francisco County, the COVID-19 death rate is about in comparison with in your location.

Foreign-born inhabitants

Were you born in the United States? In San Francisco County, have been born outdoors the U.S., whereas in have been born outdoors the U.S.

Asian American inhabitants

San Francisco County’s COVID-19 death rate is about in comparison with in . San Francisco County can be house to one of many largest Asian populations in the nation, the place of the inhabitants is Asian, in comparison with in your location.

English as second language

Is English your first language? In San Francisco County, of residents communicate English as a second language in comparison with in .

Median family revenue

Think about your revenue stage. In San Francisco County, the median family revenue is whereas that quantity is in .

Rate of uninsured

Consider your medical insurance standing. In San Francisco County, of the inhabitants is uninsured whereas in your space that rate is .

Sources: COVID-19 Data Repository by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University and the U.S. Census Bureau’s 2018 U.S. American Community Survey. Milken Institute Research Department COVID-19 Community Explorer. Data final up to date: Sept. 1, 2020.

Xing Tam’s mom examined constructive for COVID-19 in March. Her signs have been gentle. Medical officers advised her to quarantine at house and keep away from others. 

Suddenly, the working class Bayview district house the place Tam, his mom and 17 different kin and associates dwell collectively turned uncomfortably crowded. Tam’s mom was given one of many three-story house’s 12 rooms. For weeks, everybody in the two-story home feared they’d be subsequent. 

As his mom recovered, Tam, 39, fretted about the price of well being care if he acquired sick. He apprehensive the docs wouldn’t have the ability to communicate to him in phrases he may perceive. 

Before the pandemic, life had began to enhance for Tam. Five years in the past, San Francisco kin urged him to go away China’s Guangdong Province and check out his luck in the U.S. He discovered some English and landed a job at a resort in catering. But when COVID-19 hit, his job vanished. 

The price of housing in San Francisco is so costly, his household has no choice however to dwell collectively.

“Even if I test positive, I feel there is nothing the government will do to help me more,” he mentioned. “I can see why some people look at Asians here and feel we are all well-off because we work hard and save whenever we can. But for many of us, it’s very challenging.”

Xing Tam
Even if I check constructive, I really feel there may be nothing the federal government will do to assist me extra. I can see why some individuals take a look at Asians right here and really feel we’re all well-off, as a result of we work exhausting and save every time we will. But for many people, it’s very difficult.

For many Asian Americans in San Francisco, the high rate of COVID-19 deaths is straight linked to the corrosive and distorting results of the mannequin minority delusion, mentioned Dr. Tung Nguyen, a University of California at San Francisco professor of medication.

Nguyen co-authored a report in May by the Asian American Research Center on Health that referred to as consideration to the truth that 50% of San Francisco’s 31 COVID-19 deaths at the moment have been amongst Asian Americans, disproportionately high contemplating they make up simply over a 3rd of the inhabitants.

Although that proportion has since dropped, Nguyen mentioned a scarcity of detailed information about Asian Americans typically signifies that metropolis funds aren’t allotted to this group.  

“The truth is we are the ones who lose out as a result of this stereotype,” he added.

To be certain, the fortunes and contributions of many Asian Americans have skyrocketed in previous a long time. The median annual revenue of households headed by the nation’s 22 million Asian Americans is $73,060, in contrast with $53,600 for all U.S. households, in accordance with the Pew Research Center.

But these success tales obscure the troubling actuality going through many Asian Americans.

“You simply cannot look at Asian Americans as a monolithic group because if you do that, you’re going to miss how different communities experience the pandemic,” mentioned Jarvis Chen, a lecturer in social and behavioral sciences at Harvard University’s T.H. Chan School of Public Health in Massachusetts.

A better take a look at San Francisco’s two dozen Asian ethnicities reveals many teams inside this broad categorization are struggling financially and stay outdoors the mainstream. About 43% are non-English audio system, in accordance with a USA TODAY evaluation of U.S. Census information. About a 3rd of San Franciscans are foreign-born, and 13% will not be U.S. residents. 

“With Asian Americans, the average always is pulled way up by those doing very well, which means you miss the groups who clearly are not,” mentioned Margaret Simms, a non-resident fellow with The Urban Institute in Washington, D.C., who specializes in race and labor economics. The suppose tank discovered practically 13% of Asian American senior residents dwell in poverty in comparison with a 9% nationwide common.

Margaret Simms, non-resident fellow with The Urban Institute in Washington, D.C.
With Asian Americans, the typical all the time is pulled method up by these doing very nicely, which implies you miss the teams who clearly will not be.

Discrimination is also conserving some Asian Americans from getting examined for COVID-19. The web site Stop AAPI Hate, the acronym for Asian American Pacific Islander, has logged greater than 2,500 incidents of discrimination throughout the U.S. since mid-March. The assaults have ranged from verbal assaults to acts of bodily violence.

When Asian Americans hear President Donald Trump, who contracted COVID-19 in October, repeatedly name the virus the “China virus” and “Kung Flu,” “it makes them less likely to seek help, a bit like early in the AIDS epidemic when the gay community was stigmatized,” mentioned Karthick Ramakrishnan, professor of public coverage on the University of California at Riverside and chair of the California Commission on Asian and Pacific Islander American Affairs. “We fear many Asian American families have gone underground.”

Chinese residents started passing by San Francisco’s then bridgeless Golden Gate en masse throughout the Gold Rush of 1849. By 1851, some 25,000 had arrived, lured by the hope of riches in a land referred to as Gum Saan in Cantonese, or “gold mountain.” 

By the late 1800s, the Chinese weren’t simply vilified however outright barred from coming into the nation, with few exceptions, by the Chinese Exclusion Act of 1882. White officers charged they have been taking jobs from different Americans, regardless of having been integral to the Gold Rush’s growth and the development of the Transcontinental Railroad.

At the peak of World War II, Japanese Americans across the nation have been rounded up and despatched to internment camps, feared because the traitorous “yellow peril” after years of citizenship. Despite painful and humiliating therapy by the hands of the U.S. authorities, many Asians resolved to engrain themselves in the society at giant with a picture of themselves as patriotic, hardworking Americans. Japanese Americans have been among the many most embellished U.S. troopers throughout the conflict, and others excelled in teachers and commerce.

The mannequin minority picture gained momentum throughout the civil rights motion of the Sixties. Asian American success tales have been highlighted by white U.S. officers each as a method of signaling to different nations, specifically the Soviet Union, that America was not racist, but in addition to disgrace different ethnic teams, notably Black Americans.

The logic went that if Asian Americans have been doing so nicely, certainly failure on the a part of different ethnic teams was their very own fault.

Then got here the Vietnam War, a quagmire that resulted in a U.S.-sponsored evacuation of 125,000 refugees adopted by numerous others who escaped Southeast Asia in rickety boats. Many landed in San Francisco.

“The stereotype about us is broad and includes the notion that we’re all studious, we don’t get into trouble and commit crimes, and even the poor don’t have health care issues,” mentioned Ellen Wu, creator of “The Color of Success: Asian Americans and the Origins of the Model Minority” and historical past professor at Indiana University in Bloomington. “That’s quite the change from before World War II when many of us were seen as unclean and prone to diseases.”

California Assemblymember David Chiu, a Democrat who represents the jap half of San Francisco and chairs the California Asian & Pacific Islander Legislative Caucus, mentioned lawmakers should acknowledge that Asian Americans are a loosely linked group of immigrants with distinct challenges and wishes.  

David Chiu, California Assemblymember
The consideration being paid to the disparities endured throughout the pandemic by Black and Latinos is necessary, however our subject hasn’t gotten the eye it deserves.

“The attention being paid to the disparities endured during the pandemic by Black and Latinos is important, but our issue hasn’t gotten the attention it deserves,” he mentioned. 

One small demographic victory for Asian Americans got here in 1997 when President Bill Clinton directed the Office of Management and Budget to increase its information classification system to interrupt out “Native Hawaiian or Other Pacific Islanders” from the Asian American group. That geographic record contains international locations reminiscent of Micronesia, Tonga, Vanuatu, Guam, the Marshall Islands and Fiji.

As a outcome, we all know right now that Pacific Islanders rank third in phrases of COVID-19 deaths, behind Native Americans and Black Americans. 

But many different Asians mentioned they’re largely uncared for by authorities officers.

What disappoints Marc Belocura most, he mentioned, is that he feels ignored regardless of dwelling in part of city that metropolis officers as soon as highlighted as a bastion of Filipino tradition.

“Since the city obviously knows we are here, why is there not more outreach that is culturally sensitive and linguistically appropriate?” mentioned Belocura, 23. “Or maybe we just are not on their radar.”

People walk and shop at the produce market in Chinatown in downtown San Francisco on Sept. 29, 2020.

People stroll and store on the produce market in Chinatown in downtown San Francisco on Sept. 29, 2020.
Harrison Hill, USA TODAY

Belocura girds himself every time he prepares to go away the one-room studio he shares along with his dad and mom and sister to buy meals and provides.

Even earlier than COVID-19, his growing older neighborhood simply south of Market Street was crumbling. Now extra storefronts have shuttered. To keep away from the homeless camps which have mushroomed throughout the realm, Belocura walks in the road and hopes he doesn’t get hit by a automobile.

When he makes it house, he should then navigate a slender stairwell to get into his one-room condo on the second flooring of a five-story constructing. 

Belocura’s dad and mom, who’re 71 and 60, share the lone mattress. His sister, 35, and he put pillows on the ground every night time. Transmission in the studio’s confines would probably be speedy.

“That’s why I just can’t get COVID when I go out,” he said. “I can’t.”

Asian American communities in San Francisco speak a range of languages including Mandarin, Cantonese, Japanese, Korean, Tagalog, Laotian, Samoan, Tongan, Vietnamese and Hindi. The city’s website notes that COVID-19 information is available in English, Chinese, Filipino and Spanish.

Efforts by city health officials to inform Asian residents about COVID-19 safety precautions and testing in their native languages have sometimes resulted in confusing or alienating translations.

For example, information about pop-up virus testing sites sometimes can come across as demands, while in other cases the language is just plain confusing.

One flyer written in the Filipino language of Tagalog told people to “cover their entire face,” said Luisa Antonio, executive director of the Bayanihan Equity Center, a Filipino American support group. 

In another instance, an Aug. 11 health advisory issued by the city showed Tier 1 Priority were those hospitalized with symptoms, Tier 2 was anyone with symptoms or close contact with confirmed cases, and Tier 2A included a list of ethnic groups “experiencing marginalization, systemic inequity and health inequities.” 

Black, Latino, Native American and Pacific Islander residents were mentioned – but no other Asian groups, said Dr. Amy Tang, director of immigrant health at North East Medical Services, a health clinic that focuses on the city’s Chinese American population.

“To not include other Asians among ethnic minorities who should get tested is pretty appalling,” said Tang. 

Dr. Amy Tang, director of immigrant health at North East Medical Services
To not include other Asians among ethnic minorities who should get tested is pretty appalling.

Department of Public Health officials declined an interview request about outreach efforts. An e-mailed response from the city’s COVID-19 Command Center offered condolences to the loved ones of those who died from COVID-19 and noted that a majority of people who died were over 60 and had underlying health conditions.

In California, about 5 million of 40 million state residents are Asian American, and in three-quarters of those homes, languages other than English are spoken regularly, according to the U.S. Census.

Sasanna Yee, co-founder of the nonprofit Communities as One, said city officials need to pay closer attention to capturing the cultural nuances that are sometimes lost in poor translations.

Depending on how things are written, they can trigger alarm, Yee added. “Who is asking me to come out? What is this information used for? Can I trust who is asking me to do this?”

Even some Asian Americans who speak fluent English said government officials have not made it easy to get information about the virus. 

Huiting “Rita” Huang grew alarmed when her mother-in-law told her that there had been a positive coronavirus case among the Chinese emigres to whom she was providing nursing services. The mother-in-law was unsure what to do and feared her poor English would make getting information about where to get tested even harder.

Huang felt confident she could help. Her English was solid and she had experience getting COVID-19 information as a project coordinator and health educator for the nonprofit NICOS Chinese Health Coalition.

Instead, she wound up mired in a bureaucratic doom loop. After pursuing a series of online testing-site leads through a variety of city- and community-run websites – all requiring fluency in English – Huang soon learned that there were no available appointments at testing facilities close to their neighborhood.

Huang eventually found a city-run testing site near Pier 30 along San Francisco Bay. The test was negative.

“That was irritating for me, and I communicate English,” said Huang. “I can not think about what it might be like for somebody like my mother-in-law. Well, I think about you’ll merely hand over on the hope of getting examined.”

Asian Americans in San Francisco are often left behind by city partnerships aimed at helping vulnerable populations. Efforts to increase COVID-19 testing sites largely involve Latino groups, such as Unidos En Salud. The city’s various isolation and quarantine sites for the homeless and partially housed also are being used largely by the city’s Latino population, with Hispanics making up 45% of those in shelters while Asians account for 7%.

Asian activists and health care workers trying to fill the void said they face a population that often is wary of Western medicine, fatalistic about getting the virus, culturally averse to passing along bad news to elders and nervous about losing employment.

Natalie Ah Soon, health planner with the Asian Pacific Islander Health Parity Coalition advocacy group, said some people have told her, “If God means for me to be COVID-19 positive, then OK.”

Kent Woo, executive director of the NICOS Chinese Health Coalition, said residents sometimes are suspicious of health care workers when they visit local low-income buildings to talk about coronavirus safety tips. 

“Folks say, ‘What’s the purpose of being examined?’ or ‘We do not know the place to go if we get contaminated,'” he said. “When we provide the choice to anybody who exams constructive to go away the premises and go to a resort, they refuse.”

Teams have started to be more proactive, he said, heading to single-room occupancy residences and other housing complexes before there is any rumor of a positive test. The goal is to prepare residents so they know how to respond if someone falls sick. 

The need is dire. Amy Dai, project coordinator for the Chinatown Community Development Center, an advocacy group that also manages low-income properties, learned that in a building she manages, 10 residents out of 30 families had tested positive.

A deserted Grant Street in Chinatown on April 1, 2020, in San Francisco.

A abandoned Grant Street in Chinatown on April 1, 2020, in San Francisco.
Justin Sullivan, Getty Images

When she approached two of the residents who had come down with a fever, they assured her they couldn’t be positive because they had not left the building. A subsequent visit to a doctor confirmed they had COVID-19. 

If they had not waited to get tested, “it could have prevented the other infections,” said Dai.

The virus has many of San Francisco’s Asian Americans living like shut-ins.

Only reluctantly did Sisong Thepkaysone, 70, recently make her way from her public housing building overlooking a freeway to her doctor’s office for a routine check-up. She hasn’t seen any information about COVID-19 testing in her native Laotian. All she knows is she must stay healthy.

The trip filled her with dread. With some public transportation routes canceled, she had to change buses, prolonging her exposure. Worse yet, some passengers weren’t wearing masks. 

Sisong Thepkaysone, a former Thai-restaurant cook
I’m old, I have asthma. I’m not sure what I would do if I got the virus.

“I’m old, I have asthma,” Thepkaysone, a former Thai-restaurant cook who fled war-torn Laos with three young boys and no husband in 1981, said through an interpreter. “I’m not sure what I would do if I got the virus.”

Once at the doctor’s office, an interpreter was called by phone to translate medication directions. Thepkaysone grew upset. She expected quality medical care after the risk she had put herself through, not a faceless voice. 

“It was not a personal experience, she said. “I didn’t like it.” 

Thepkaysone prefers to spend her days at home making Laotian dishes for relatives. She used to go out to shop and visit a local Buddhist temple to give alms. But now her children shop for her and the temple is closed. Sometimes she checks in on friends through Facebook. She watches television, but her limited knowledge of English renders programs a pantomime.

“I’m careful,” she said. “All I know is the virus is easy to get.”

Rong never found out whether her daughter had COVID-19. But her days remain filled with dread.

For the past few months, the family has had little money for food or rent, which is $750 a month. Sometimes, neighbors give them something to eat; other times she goes to the local food bank. 

“We eat lots of potatoes,” she said.

It’s a far cry from the life she envisioned for herself. In Guangdong Province, Rong had a promising job as a clothing store clerk. At the urging of her former husband’s parents, she emigrated 12 years ago to California, where she found work as a janitor to keep the family afloat. Since the pandemic hit, she has been on unemployment insurance.

That’s left the family with no option but to remain in their Chinatown apartment. The communal kitchen isn’t cleaned regularly. Sometimes, leaks from a floor above make their way to the shower on the floor below. Often, the leaking fluid smells like urine. 

“Smell me, Mom, I’m more dirty than before I showered,” Amy Rong once told her mother.

Rong doesn’t know anyone who has contracted the virus. For her neighbors in the building, getting tested remains a common fear. 

Mostly, Rong waits for the day when the pandemic is over. For a day when it will feel safe to venture outside. For a day when her American dream can resume.

Contributing: Myron Lee, Mark Nichols

Follow USA TODAY nationwide correspondent Marco della Cava: @marcodellacava