Wall Street Journal Logo

Detroit Approaches Its Coronavirus Peak

The city’s role in the global auto industry and its poverty are factors; Central City Integrated Health shows the struggles downtown

By Ben Foldy | Photographs by Emily Rose Bennett for The Wall Street Journal
April 7, 2020 800 am ET

DETROIT—Detroit, the center of one of the worst coronavirus outbreaks in the country, is forecast by public officials to hit its peak of new cases this week, and its neighborhoods of poverty and populations with poor health outcomes are compounding the outbreak’s ferocity.

In many ways, the Motor City might seem like an unlikely hot spot for such a concentrated outbreak: It lacks the population density of other major U.S. cities and, with fewer public transit options, residents are heavily reliant on the automobile to get around.

A lone truck driving down Michigan Avenue in downtown Detroit on Monday morning.

A lone truck driving down Michigan Avenue in downtown Detroit on Monday morning.

Some health experts say Detroit’s busy international airport, which connects the region’s auto industry to other global car-manufacturing hubs, such as those in China and Northern Italy— both virus hot spots—may have contributed to the virus arriving here early. Detroit’s auto makers have factories in both.

It is also harder for manufacturing workers to work from home and many can’t afford to take sick leave.

Poverty, lack of access to health care and other basic needs, and the prevalence of poor health conditions could all contribute to the severity of the outbreak in the city and surrounding counties, say health experts and health-care workers. In New York City, the biggest hot spot for the virus in the U.S. so far, the most cases have been in more densely packed, lower-income areas where social-distancing guidelines are harder to implement.

Dr. Abdul El-Sayed, the city’s former health director, said the severity of the virus is determined by the people who become infected and their environment.

“The story is about the host and the environment, and the environment here has been beating up on the hosts for a long time,” he said.

A nearly empty bus traveling along Woodward Avenue in Detroit on Monday morning.

A nearly empty bus traveling along Woodward Avenue in Detroit on Monday morning.

As of Monday, the state had recorded over 17,000 positive cases and 727 deaths, with nearly 90% of the fatalities occurring in the Detroit metro area, according to state figures. There are about 4.3 million people in metro Detroit and around 673,000 in the city limits.

The outbreak has been particularly fatal for the state’s black residents, who make up 41% of Michigan’s reported deaths but only 14% of the state’s total population, according to state and federal data. White people make up another 28% of the state’s reported deaths, while the racial identities of another 26% weren’t reported.

Virus-related deaths in the Detroit area have quickly outpaced everywhere else in the country but New York and New Jersey, according to data from the Covid Tracking Project.

“I can tell you without a doubt, it’s going to get worse before it gets better,” said Denise Fair, the city’s chief public health officer.

To prepare, the city’s massive convention center—long home to the Detroit auto show, which was recently canceled for June—is being converted into a 1,000-bed field hospital for virus- stricken patients.

The Spirit of Detroit statue is seen wearing a mask, with the GM Renaissance Center in the background in downtown Detroit on Monday.

The Spirit of Detroit statue is seen wearing a mask, with the GM Renaissance Center in the background in downtown Detroit on Monday.

With many in the city lacking health insurance and access to health care, the prevalence of underlying health conditions, such as diabetes, asthma and heart problems, are much higher here than elsewhere in the country. That makes for a population more vulnerable to getting sicker from the virus, doctors and public health officials say.

The city recently said it would start using new tests that deliver results within 15 minutes. It is also participating in a treatment experiment that aims to use hydroxychloroquine, an antimalarial drug, to prevent infections among first responders, Mayor Mike Duggan said.

“There is no evidence that this spreads more quickly among the poor than the wealthy,” he said, pushing back against the idea that the city’s poverty is exacerbating the virus.

“It seems like the situation just blew up all of sudden,” said J. Drew Sheard, a minister in Detroit, whose elderly parents have been hospitalized after testing positive for the virus. His brother also is sick but recovering well at home, he said.

Central City Integrated Health, a primary-care clinic near downtown, has struggled to provide protective gear for staff, with suppliers focusing on orders from larger hospitals. The dearth has left the clinic to treat most patients virtually. The problem is that not all patients have regular access to phones and computers, said Dr. Kimberly Farrow, chief executive of Central City Integrated Health. “We’ve had a major breakdown of our system.”

A U.S. Army Corps of Engineers arrived Monday to transform the TCF Center, formally known as Cobo Hall, into an emergency �field hospital.

A U.S. Army Corps of Engineers arrived Monday to transform the TCF Center, formally known as Cobo Hall, into an emergency field hospital.

For instance, she had one asthmatic patient go to the hospital complaining of symptoms but was turned away because her case wasn’t deemed severe enough for a hospital bed. When Dr. Farrow tried to help her patient by phone, the woman’s prepaid cellphone minutes had run out.

Steve Ware, a social worker at Central City, said many of his clients want to stay home, but lack the savings to stock up on days’ worth of food, forcing them to venture out. Most lack the car necessary for the city’s drive-through test site, though the city is looking to coordinate rides for those without transportation.

The clinic is working hard to transform into a test site, but a lack of resources and a spike of new cases is hampering the attempts to move quickly, Mr. Ware said.

“We’re setting it up as quickly as it can be set up, but the disease is obviously much faster than us,” he said.

Read the Full Story Here
Elevate Your Brand