USA TODAY International Edition
Virus ravages San Francisco’s Asian American communities
A lethal mix of tight housing, language barriers and poverty
SAN FRANCISCO – Mandy Rong was terrified her 12- year- old daughter had COVID- 19. It was 2 a. m. and the young girl was hours into a fierce fever and a racking cough.
“Mommy, why are my eyes on fire?” asked Amy Rong.
The mother and daughter, along with Rong’s parents, live in an 80- square- foot windowless singleroom- occupancy Chinatown building that is a home of last resort for many impoverished Asian immigrants. Hallways are cramped, bathrooms and kitchens are communal. A ripe setting for the spread of the highly contagious novel coronavirus.
That early March night felt endless. Rong, 42, repeatedly touched Amy’s forehead, wondering if her child would die in the small loft that the two shared. Down below, her father slept on the floor while her mother took the lone sofa bed.
In the morning, the fever had vanished, only to return a week later. Once again, the family endured a restless night. Rong made soup, but Amy wouldn’t eat it.
Getting tested for COVID- 19 didn’t seem like an option for the Rongs. The rumor was that the tests were expensive. Rong also feared the reaction from
neighbors.
“If you test positive, everyone would be scared of you,” said Rong. “Everyone would think you are the devil.”
It is easy to mistake San Francisco for a thriving Asian American haven. The city, which is its own county, boasts a bustling Chinatown, as well as a popular Japantown. Native Hawaiians, Pacific Islanders, Vietnamese, Indians and Filipinos also have made their homes here. All told, Asians in San Francisco represent upward of 20 countries.
But many Asian American immigrants in the county lead a fragile existence rendered even 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, the most of any ethnicity.
Experts also are concerned that positivity rates among Asian Americans in San Francisco could be far higher than the 12% reported, a by- product of the decades- in- the- making model minority myth, which characterizes this ethnic group as financially successful, physically healthy and upwardly mobile. This belief has caused segments of the Asian American community to long be overlooked when it comes to social services for housing, employment and health.
San Francisco is one of the few places in the nation tracking data on Asian Americans and COVID- 19 deaths at a time when officials don’t know the ethnicity of the person affected in nearly half of the nation’s 7.8 million coronavirus cases. Around 17 million Americans are of Asian descent, or 5.6% of the population.
In many cases, Asian Americans in this city have received imprecise or no information in their native language about testing, safety tips, housing and other critical care services during the pandemic. At the same time, the community is struggling with inadequate access to comprehensive health care, the need to keep front- line employment and growing incidents of anti- Asian hate crimes.
“This model minority thing, that’s not us,” said Judy Young, executive director of the Southeast Asian Development Center, a San Francisco nonprofit that helps area residents from Vietnam, Laos and Cambodia.
“There is the language barrier and our community is small,” Young said. “So the city doesn’t think we have any problems when we do.”
That risk of invisibility is only heightened by the pandemic. Since city health officials do not break down COVID- 19 statistics beyond “Asian American,” many advocates for the city’s various groups said they are left to speculate about coronavirus infection and death rates within their individual communities. How many people are dying, and are those people Japanese Americans? Vietnamese? Filipino?
“There’s this feeling that there’s excess death out there,” said Jeffrey Caballero, executive 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.”
What is the model minority myth?
For many Asian Americans in San Francisco, the high rate of COVID- 19 deaths is directly linked to the corrosive and distorting effects of the model minority myth, said Dr. Tung Nguyen, a University of California, San Francisco professor of medicine.
Nguyen co- authored a report in May by the Asian American Research Center on Health that called attention to the fact that 50% of San Francisco’s 31 COVID- 19 deaths at that time were among Asian Americans, disproportionately high considering they make up just over a third of the population.
To be sure, the fortunes and contributions of many Asian Americans have skyrocketed in past decades. The median annual income of households headed by the nation’s 22 million Asian Americans is $ 73,060, compared with $ 53,600 for all U. S. households, according to the Pew Research Center.
A closer look at San Francisco’s two dozen Asian ethnicities reveals many groups within this broad categorization are struggling financially and remain outside the mainstream. About 43% are non- English speakers, according to a USA TODAY analysis of U. S. census da
ta. About a third of San Franciscans are foreign- born, and 13% are not U. S. citizens.
“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,” said Margaret Simms, a nonresident fellow with The Urban Institute in Washington, D. C., who specializes in race and labor economics. The think tank found nearly 13% of Asian American senior citizens live in poverty compared to a 9% national average.
Discrimination also is keeping some Asian Americans from getting tested for COVID- 19. The website Stop AAPI Hate, the acronym for Asian American Pacific Islander, has logged more than 2,500 incidents of discrimination across the U. S. since mid- March. The attacks have ranged from verbal assaults to acts of physical violence.
When Asian Americans hear President Donald Trump, who contracted COVID- 19 in October, repeatedly call 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,” said Karthick Ramakrishnan, professor of public policy at the University of California, Riverside and chair of the California Commission on Asian and Pacific Islander American Affairs.
Decades of racist policies
Chinese citizens began passing through San Francisco’s then bridgeless Golden Gate en masse during the Gold Rush of 1849.
By the late 1800s, the Chinese were not just vilified but outright barred from entering the country, with few exceptions, by the Chinese Exclusion Act of 1882. White officials charged they were taking jobs from other Americans, despite having been integral to the Gold Rush’s boom and the construction of the Transcontinental Railroad.
At the height of World War II, Japanese Americans around the country were rounded up and sent to internment camps, feared as the traitorous “yellow peril” after years of citizenship. Despite painful and humiliating treatment at the hands of the U. S. government, many Asians resolved to engrain themselves in the society at large with an image of themselves as patriotic, hardworking Americans.
The model minority image gained momentum during the civil rights movement of the 1960s. Asian American success stories were highlighted by white U. S. officials both as a way of signaling to other nations, namely the Soviet Union, that America was not racist, but also to shame other ethnic groups, notably Black Americans.
The logic went that if Asian Americans were doing so well, surely failure on the part of other ethnic groups was their own fault.
Then came the Vietnam War, a quagmire that resulted in a U. S.- sponsored evacuation of 125,000 refugees followed by countless others who escaped Southeast Asia in rickety boats. Many landed in San Francisco.
California Assemblymember David Chiu, a Democrat who represents the eastern half of San Francisco and chairs the California Asian & Pacific Islander Legislative Caucus, said lawmakers must recognize that Asian Americans are a loosely linked group of immigrants
with distinct challenges and needs.
“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 said.
One small demographic victory for Asian Americans came in 1997 when President Bill Clinton directed the Office of Management and Budget to expand its data classification system to break out “Native Hawaiian or Other Pacific Islanders” from the Asian American group. That geographic list includes countries such as Micronesia, Tonga, Vanuatu, Guam, the Marshall Islands and Fiji.
As a result, we know today that Pacific Islanders rank third in terms of COVID- 19 deaths, behind Native Americans and Black Americans.
A COVID- 19 language barrier
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 popup 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.
Department of Public Health officials declined an interview request about outreach efforts.
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.
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.
After pursuing a series of online testing- site leads through a variety of cityand 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 frustrating for me, and I
speak English,” said Huang. “I can’t imagine what it would be like for someone like my mother- in- law.”
Some refuse to get tested
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.
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 point of being tested?’ or ‘ We don’t know where to go if we get infected,’ ” he said.
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.
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.
No end in sight
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.
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.