Thursday, August 6, 2020

The Fight For Our Lives: COVID-19 in MKE

A mural by Mauricio Ramirez at 6th and Lincoln Ave.

Following are five profiles of people and organizations at the center of the COVID-19 pandemic in Milwaukee in its early months in the spring of 2020. The profiles were originally published in the June/July issue of Milwaukee Magazine.


A Man, and a Symbol


Milwaukee changed forever at 6:05 p.m. on March 19. 

Lawrence Riley, 66, was pronounced dead at Froedtert Hospital, becoming the first person in Milwaukee County to die from COVID-19. Well-loved in life, in death Riley became Milwaukee’s ground zero, solemnly representing that moment when our world split in two: before coronavirus and after coronavirus. 

It didn’t take long for authorities to realize that Riley’s death heralded another disturbing reality: The virus was tracking the region’s racial disparities. Beginning with Riley, the first 11 deaths in the county were of African Americans, and people of color would dominate COVID-19 deaths for weeks to come.

If one were to look for a figure to represent Mr. Everyman Milwaukee, Riley would fit the bill. A graduate of Rufus King High School, Navy veteran and retired firefighter, Riley was a long-standing resident of Sherman Park. Father of six children and grandfather to eight, he was married to his wife, Linda, for 29 years.

In early March, Riley seemed well. Whitley, his 20-year-old daughter, had come home from spring break at Prairie View A&M University, a historically black university in Texas. “He looked fine to me,” she recalls. “The same old dad.” 

Whitney Riley with her favorite picture of her father, Lawrence.

By Friday, March 12, “he was feeling really sick,” she said. “We thought it was a cold, or the flu.” 

By Monday, his condition had deteriorated, and family members convinced him go to the hospital. Struggling to breathe, weak and unable to drive, his wife and 25-year-old son, Langston, drove him to Froedhert. “While they were riding to the hospital, my dad was asking, ‘What’s wrong with me?’” Whitley recalls. “And my mom didn’t have an answer.”

Riley was admitted, scans taken, and he had severe pneumonia. Although Riley had pre-existing health problems, the doctors suspected COVID-19. The next day, the official diagnosis was made. Family members were sent home for fear they could become infected.

Riley was put into a medically induced coma and on a ventilator. He died Thursday night. 

Riley’s wife and children never had the chance to say goodbye. To a person, family members credit the nurses for easing that pain. “They nurses were amazing, and called my mom almost every hour,” says Riley’s 28-year-old son, Elvaughn. “Eventually, when he passed, they pre-warned her and she was able to tell the nurse to say something in his ear.” 

The family remains mystified how Riley caught the virus. “He was a homebody,” Elvaughn said, and left the house only for grocery shopping or to drive their mom to work as a state social services worker.

Just as Riley’s death highlighted the region’s racial disparities, it exposed the inadequacies in what public health officials agree are two key components of controlling the coronavirus pandemic: testing and contact tracing.

More than a month after Riley’s death, family members had yet to be called for the “contact tracing” that identifies and notifies people who may have come into contact with Riley. Nor were any family members tested for COVID-19. The only advice they were given was at the hospital, when Riley’s wife was told that she and the two children living with her, Langston and Whitley, should quarantine. “It’s kind of odd,” Whitley said. “It makes you wonder.”



Undocumented and unemployed


Ten years ago, Marta Beatriz lived in Fort Collins, Colorado, and came to Milwaukee on vacation. She enjoyed the pace and sense of community on the South Side, so even though she did not have family here, she moved.

“I like Milwaukee a lot,” she says in Spanish during a late April interview. “It almost feels like I am in Mexico.” 


Marta, 42, was born in Durango, Mexico, a city roughly the size of Milwaukee, but left there as a teenager in search of a better life. She found it here in Milwaukee. She married, had two children (a girl, now 1, and a boy, now 6) and enjoyed her job waitressing at a Mexican restaurant. 


Today, that life is falling apart. 


Milwaukee’s Latinx community, like the city’s African Americans, has been disproportionately affected by COVID-19. The disparities are complicated by language and cultural barriers and, for undocumented people like Marta, the lack of legal immigration papers


Marta has always paid taxes, but because she does not have a Social Security number, she cannot get unemployment benefits or a stimulus check. Nor can she get a driver’s license, which might open up farther-flung jobs. Even if she spoke perfect English, fear of U.S. Immigration and Customs Enforcement (ICE) would make her think twice before going to a hospital. Marta’s husband, meanwhile, was detained for driving violations last year, which spiraled into problems with ICE and possible deportation. 

Marta Beatriz

Without legal papers, it is unlikely Marta will find a new job except at small, family-owned Latinx businesses, whether a restaurant, a grocery store, in child care or home cleaning. But those are precisely the businesses that have had trouble accessing federal stimulus funds. Many are in danger of going under. 


Nelson Soler, president of the Latino Chamber of Commerce of Southeastern Wisconsin, says that as of late April he did not know a single restaurant that had gotten any federal small-business assistance. Home remodeling and child care businesses were also hit hard. “People called my office, crying,” he said. 


The irony is that for the last 20 years, the growing Latinx population stabilized the city and region. Milwaukee’s population, for instance, would have significantly declined if not for the Latinx community. Roughly 114,000 Latinx people live in the city, and it is estimated that 20%-30% are undocumented. 


Marta, like many undocumented, relies on the solidarity and support of the Latinx community. She is particularly thankful to Voces de la Frontera, an immigrant rights group that provided her a $250 grant through its COVID-19 relief fund.


After keeping food on the table, Marta’s biggest concern is not having a place to live. She couldn’t pay her rent in April, but the property’s owner, a Mexican, was understanding. “He told me that I once I begin working again, I could pay,” she said.


Luckily, neither Marta nor her children have gotten COVID-19. And if you want to see Marta’s face light up, ask about her kids. The 10-month-old is starting to walk, and the 6-year-old makes her laugh: “Sometimes,” she says, “my son will go the window and he’ll say, ‘We’re in quarantine, right?’”


“He’ll talk about COVID-19 and coronavirus, in English and Spanish,” she says proudly.


Marta wants a future not just for herself, but her children. The lack of a job haunts her most. “I try to move ahead with the little I have,” Marta says. “But I need to find work.”


Marta Beatriz did not want to provide her last name, for fear of repercussions from ICE. 




Working in the Shadow of Fear


Alicia Smith does not consider herself overly religious and, having grown up on the streets of Chicago, doesn’t frighten easily. But she’s often scared these days. And she prays a lot.


Smith is one of about 50 housekeepers who clean the patient rooms at Ascension St. Francis Hospital on Milwaukee’s South Side. The housekeepers get a fancy title – environmental service workers – but not much else. Starting pay is a tad over $11 an hour, and there is no hazard pay. In the hospital hierarchy, their status is low. 


But as much as doctors and nurses, housekeepers are front-line workers in the battle against COVID-19. 


Smith prays before she cleans a room that had a COVID-19 patient. “God, please wash me with your blood and watch over me as I clean,” the prayer goes. “Protect me and my family and my friends and my enemies from the corona.” 


The prayer does not keep away the fear.

Alicia Smith

 Smith was used to cleaning rooms with blood, feces and infection. She can’t remember the exact day but it was sometime in March when, seemingly without warning, normally upbeat nurses “had this scared look, and my heart started pounding.”


She has worked at St. Francis for six years, and had learned that when the nurses are scared, you should worry.


At least four housekeepers quit in March saying they were not given proper protective gear. TouchPoint, the subcontractor that runs housekeeping, said in response that “We adhere to the highest standards and protocols in infection prevention to keep our team members safe.” 


Just over half of the cleaners at St. Francis are people of color, and about three-quarters are women. 


Smith and her husband, both 50 years old and sweethearts since their teens, have been unable to have children. She often takes extra shifts to help out co-workers, and it’s not uncommon for her to work from 3 p.m. until 6 the next morning.


Entire wings of the hospital are reserved for COVID-19 patients, Smith said, with three levels of rooms. The Level 3 rooms that had a seriously ill COVID-19 patient are the ones that many housekeepers are afraid to clean. 


The doors are closed at a Level 3 room, Smith said, with someone sitting outside to control who goes in. The cleaners enter after a patient is discharged – hopefully home, but not always. 


Before they go in, the cleaners are covered with special gear: a cap on the head, booties on the shoes, gloves, a white body suit, a mask, and a protective shield over the eyes. 

Once the sitter makes sure the gear is on properly, the cleaner opens the door, enters, and immediately closes the door. They strip down the room, everything from sheets and covers to hand lotion, and tie it up to be thrown out.


“Everything,” she emphasizes. “It’s infected, and it’s COVID.”


Smith then wipes down surfaces and mops the floor, sometimes even the walls. When done, she opens the door, takes out the bagged-up items, and the sitter helps her undress. The protective gear is also bagged and thrown out – except for the plastic shield over the eyes, Smith said. It’s wiped down and put in a paper bag for her to reuse.


Asked if she had a message for the general public, Smith paused before answering. “Stay positive,” she said. “We are going to pull through this all together. Just keep on doing what you’re supposed to do, like wash your hands and everything. Except drinking Lysol. Don’t do that.”


Alicia Smith is a pseudonym.



Building on Lessons of the Past 


On a recent Spring day, Mike Gifford, CEO, was at his nonprofit’s pantry packing food – mac ’n cheese, canned corn, baked beans, even spices donated by Penzeys. Fresh produce, milk and eggs would be added before the food was delivered to people’s homes.


Gifford heads what was the AIDS Resource Center of Wisconsin but is now Vivent Health, operating in four states with a $150 million annual budget. He has one main goal in life: keep alive people with HIV. That mission has been complicated by COVID-19, but the fundamentals are the same: Do anything and everything for your patients and clients. And don’t wait for government initiatives.


Perhaps more than any other group in Wisconsin, Vivent Health has experience with the suffering and death unleashed by a global pandemic. In the last four decades, more than 32 million people have died from AIDS. There is still no vaccine.


Realizing the seriousness of COVID-19, by March 10 Vivent Health had restructured and developed a “radical response.” At the time, many people in Milwaukee were still preparing St. Patrick’s Day parties, and it would be two weeks before Gov. Tony Evers’ safer-at-home order. 


“We remember the lack of government response in the early years of the AIDS epidemic,” says Gifford, who’s been with Vivent almost three decades. “We all remember that President Reagan didn’t say the word ‘AIDS’ until 1987, six years after the first cases were diagnosed.”


“That led to a very powerful community response,” Gifford continued, “and that really has become part of the culture, part of the DNA, of organizations such as Vivent.” 


As part of its “radical response,” Vivent’s wide-ranging services – the food pantry, medical clinics, needle exchange programs, mental health therapy, housing and legal assistance – went online or to a delivery model. And there was one overarching message to its clients: Stay at home. We will come to you. 


To safeguard employees, all but a handful would work from home. At the same time, Vivent’s roughly 200 employees in Milwaukee, from the CEO down, would take weekly shifts to help out, and not just in the food pantry. Vivent, for instance, did not want to wait for people to call for help. So every week, someone on staff makes a personal call to each of the roughly 1,000 patients and clients in Milwaukee. (Gifford estimates there are about 4,000 people in the Milwaukee area living with HIV, about half of them African American.)


Rather than having patients pick up their medicines, Vivent filled and arranged for the delivery of about 1,500 prescriptions a week in April. The food pantry ended its drop-in format and increased the number of people served, delivering 12 bags of food that month to about 1,000 people, enough food to last 10 days.


In line with its philosophy of self-reliance, Vivent also provides at-home HIV testing kits with online support, and COVID-19 testing through its medical clinics. A handful of patients had tested positive for COVID-19 by late April, but none had needed hospitalization. Gifford was keeping his fingers crossed.


People who lived through the early years of AIDS learned to combine a sense of urgency with hopeful patience, according to Doug Nelson, who led the AIDS Resource Center of Wisconsin from 1988 to 2012. It’s a tricky balance.


“Back then, we had to look to science to lead us out of the darkness of AIDS,” Nelson said. “And we have to look to science today.”

That’s not the only lesson, Nelson added. At his home not far from the Urban Ecology Center, he decided to leave up the Christmas lights on the porch. But he re-arranged the lights to read “HOPE.”


“’Hope’ is a universal word that helps people overcome fear,” Nelson explained. “It inspires confidence that there will be better days.”



A New Look for Justice


In a post-coronavirus world, there will inevitably be more online learning, working and shopping, and “social distancing” will be the norm. But will our institutions fundamentally change? Will we address social inequalities that, while long acknowledged, became painfully clear during the pandemic?


When it comes to Milwaukee County’s criminal justice system, an unlikely trio is addressing that question – Milwaukee County Chief Judge Mary Triggiano, District Attorney John Chisholm and Tom Reed, head of the public defender’s office for the region. As fans of Law and Order know, you don’t usually get the prosecution, defense and judge together in a room to work out solutions. But it’s happening in Milwaukee County.


“Relationships matter,” Chief Judge Triggiano said during a joint Zoom interview in April. The three work together on a reform effort known as the Milwaukee Community Justice Council – an effort that purposefully substituted the word “community” for “criminal.”


With that learned trust in hand, they acted quickly when the threat of COVID-19 became clear. Beginning March 12, they reduced operations at the county courthouse by about 85%. Courtrooms were closed, replaced by virtual hearings where possible. Those arrested on misdemeanors were generally not booked at the jail. Nonviolent offenders, especially those with little time left on their sentence, were selectively released. Overall, the population at the Milwaukee County Jail and the House of Corrections was reduced by almost 25% from December through April. 


“We have probably done more to redesign the front end of the criminal justice system in the last three weeks than in years,” Reed said. “We’ve been forced to do it because we had to respond to the threat of COVID-19.”


But still, disaster struck. At the House of Corrections in Franklin, there were 94 confirmed cases of COVID-19 by April 30 and another 25 of the fcility’s roughly 800 inmates had recoveredAt the Downtown jail, only three of the 664 inmates had tested positive, with four results still pending.


Why the difference? One lesson is the importance of social distancing. At the jail, inmates were kept in individual cells. The House of Corrections (HOC), meanwhile, relies on dormitory-style living. 


Another lesson, learned too late at the HOC: non-symptomatic people can infect others, so any way forward must involve widespread testing and immediate isolation of those with COVID-19.(In late April, the National Guard helped test all inmates at the HOC. In May, Milwaukee County used federal money to help renovate a facility in Franklin to house both county and state prisoners with COVID-19.)


With health officials warning of a second wave of infections in the fall, what does the future hold? The issue goes beyond returning the criminal justice system to its pre-coronavirusstatus, because everyone knows the system was broken. “We have to go to a different model, a community justice model,” Reed said. 


Reed, Tiggiano and Chisholm all said that one positive effect of COVID-19 is the growing understanding that public health cannot be separated from public safety. As a result, medical professionals are increasingly involved in discussions that had been dominated by lawyers, judges and law enforcement. That input has bolstered perspectives that early intervention, treatment and community-based solutions, not just jails, are integral to any future justice system. 


The challenge, Chisholm said, is to maintain a focus on those who are truly a threat to society, and not have a lot of people incarcerated for lower-level offenses.


What this ultimately means is a work in progress. What is clear is that a public health/public safety approach leads to different policies than the “lock ’em up” mindset behind the era of mass incarceration and its devastating impact on Milwaukee’s African-American community. (Wisconsin, led by figures from Milwaukee, locks up blacks at a rate 10 times higher than whites, double the national average.)


Chisholm, an elected official in a strongly Democratic county, can speak openly about what else he believes is important. The November elections “are absolutely critical,” he said. “We cannot continue to reinforce policies that benefit the few and leave so many behind.”



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