After months of having some of the fewest coronavirus cases in the country, Vermont is now trying to contain an outbreak that has hit an immigrant community in a small but densely populated city.
What health officials described as a small cluster in Winooski that they first noticed on Memorial Day has jumped to 83 cases and expanded into neighboring Burlington and other surrounding communities. No hospitalizations or deaths have been reported.
"It is kind of spreading pretty badly," said Kamal Pradhan, a Bhutanese American, who said last week he knew of roughly 40 in the Bhutanese community who have been infected with COVID-19.
Harka Khadka, a landlord and community organizer who lives in Winooski and is also from Bhutan, said several of his tenants from Africa also have been infected.
About 40% of the cases have been in children. As of Monday, only 17% of those who tested positive showed any symptoms of COVID-19, Vermont Health Commissioner Dr. Mark Levine said.
Levine said the state's efforts to contain the outbreak through aggressive testing and contact tracing appeared to be paying off.
"Clearly, boxing it in is having an impact," Levine said Monday during Republican Gov. Phil Scott's regular virus briefing.
But he wasn't ready to declare the outbreak over.
"It is something we are still watching day-to-day," Levine said. "It's way too early, knowing the incubation period of the virus and the number of people who were involved, to just put a check mark and move on."
Compared with larger states, Vermont's current outbreak is small. But for several weeks before the Winooski outbreak, the number of new cases reported in Vermont was frequently in the low single digits, with occasional days with no positive cases.
Since late May, the number of deaths in Vermont from COVID-19 has stayed steady at 55.
As some states have reopened, virus cases have spiked, but Levine said he didn't believe Vermont's opening led to the Winooski outbreak.
Vermont officials have said the outbreak was contained in "one social network of families," which they have declined to describe, and said spread also has occurred within households. They see no reason to stop the state's gradual reopening.
Contact tracing has been unable to identify the source of the Winooski infection.
"We don't have a definitive answer and likely never will on where that first case acquired their infection," Vermont Epidemiologist Patsy Kelso said last week.
Nationally, immigrant communities have been hit hard by the pandemic. In some areas of the country, immigrants who can't work at home and often live and sometimes work in crowded conditions have been especially impacted by the virus.
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While the Vermont outbreak is tiny by comparison to neighborhoods in New York City or communities near Boston that have suffered greatly, state health officials say many of the people infected in Winooski live in what are described as multi-generational households.
Winooski, with a population of about 7,300 in 1.4 square miles of land, describes itself as Vermont's most diverse community — a place that's home to many non-English speaking immigrants from across the world. Last year, the city proclaimed June 20 World Refugee Day, while recognizing its long history of welcoming refugees as new Americans.
Immigrants from Bhutan and Nepal and their advocates say language barriers and a need to work may have prevented some from staying home or knowing how best to prevent the spread or get tested. Many are getting tested now.
Bhakta Pradhan, who owns the A&A Asian Market in Winooski where a lot of immigrants shop, said he's worried about the virus but needs to operate the store to pay his bills, said Kamal Pradhan, translating for the brother of his sister-in-law.
"He's concerned about the disease, the outbreak, but at the same time he doesn't know what to do, how to survive," Kamal Pradhan said in a phone interview.
Some immigrant advocates have questioned whether enough outreach was done to the immigrant community before the outbreak. They turned out at a press conference earlier this month in Winooski held by Vermont Health Commissioner Dr. Mark Levine, Winooski Mayor Kristine Lott and others.
Levine said one of the prime foundations of public health is education and prevention.
Anyone who didn't take the virus seriously enough is doing that now, Pradhan said.
"I think this kind of event will initiate awareness seriously. I think people will become serious after this one," he said.