LOS ÁNGELES (AFP) - Fear of deportation. Fear of facing an unpayable bill. Fear of becoming a "public charge" and unable to obtain legal status. These are some of the reasons undocumented migrants are avoiding hospitals during the Covid-19 pandemic.
As a result, many have contracted the disease and died, and the novel coronavirus is spreading with little check in the community.
Case in point: the undocumented and jobless ex-husband of Victoria, a Mexican nanny living in New York City. The 69-year-old man had kidney problems and diabetes, and died last week after becoming ill with Covid-19.
"He was very ill but did not want to go to the hospital," said Victoria, who did not want to give her last name.
"After two weeks, when he could no longer walk or breathe, my daughter took the risk, loaded him into the car and drove him there. He died three weeks later." Victoria's ex-husband lived in nearby New Jersey with 12 other immigrants - all of whom were infected with the novel coronavirus.
New York, where nearly 20,000 people have died of Covid-19, is the epicentre of the US virus pandemic. Latinos and African-Americans are the principal victims, experiencing a mortality rate nearly double of that of white Americans.
The pandemic is especially hard on the 11 million undocumented Latino migrants in the United States. Many are "essential workers" labouring in supermarkets and in clean-up crews, or in jobs like meatpacking, and are exposed to contagion.
Only 16 per cent can work from home, according to US Department of Labour figures.
Many live in tight quarters with roommates and have underlying chronic diseases such as asthma, diabetes and hypertension.
Often they lack health insurance and have little education. Some don't even speak English.
They don't get unemployment benefits and can't expect the US$1,200 (S$1,700) federal coronavirus stimulus check, even though they all pay taxes.
Some states have offered help: California will hand out a US$500 one-time payment to 150,000 undocumented migrants. In New York, thanks to help from George Soros's Open Society Foundations, some 20,000 undocumented migrants will get US$400.
But this hardly addresses the needs of the 2.5 million such migrants in both states.
"My community doesn't have the luxury of escaping to a second house in the Hamptons. They have to stay here and they have to work," said New York Councilman Francisco Moya, in reference to the seaside communities that rich New Yorkers fled to when the pandemic hit.
Moya represents three of the neighbourhoods worst affected by the pandemic in New York.
Since the start of President Donald Trump's administration the federal government "put anti-immigrant policies in place that makes immigrants fear going to the hospital," he told AFP.
Immigration and Customs Enforcement (ICE) agents have said that, with few exceptions, they are not arresting people at hospitals.
Nevertheless "there's that fear," said Jae Young Kim with the Bronx Legal Services, a group that offers free legal aid to migrants.
Kim said that her clients are especially worried about Trump's new "public charge" rule that makes it hard for migrants to obtain legal status if they use public benefits like food stamps or seek emergency medical care.
The rule offers an exception for Covid-19 cases - but many migrants don't know about this, or simply don't trust the government.
In California's Coachella valley, 26 year-old Rosa, who lost her job harvesting cauliflowers, said that if she gets sick with the virus the last place that she'll go will be the hospital.
"It's tough when you don't have money to pay," said Rosa, who declined to give her last name.
When her father was wounded and needed an operation he was stuck with a US$40,000 hospital bill. Years later he's still paying it off.
Carlos Buri, a 46-year-old Ecuadoran who lives in New York City, finally went to the hospital because his wife thought that he was dying.
After days of showing Covid-19-like symptoms - high fever, diarrhea, difficulty breathing and walking - he was rushed off in an ambulance.
Buri tested positive, but was turned away and told to quarantine for 14 days at home, his wife Blanca Velez told AFP.
Velez and the couple's 10 year-old son then also contracted the disease.
As they recovered the family was in for a new shock: the bill for the short ambulance ride was US$1,330, which neither Buri nor Velez can pay because both lost their jobs.
"Now we're afraid to go back to the hospital. They're going to tell him to take out emergency Medicaid and then he'll become a 'public charge,'" said Velez, speaking as she lined up for free food at a local charity.
In nearby Brooklyn, 40-year-old Mexican-born street vendor Guadalupe Galicia suspects that she came down with the virus but was too afraid to go to the hospital.
"I'm terrified of getting infected," said Galicia.
She has not ventured outside for the past two months to sell tamales and has already told her landlord that she can't pay the rent.
With the schools closed and in lockdown Galicia, who speaks no English, has to home school her four children.
Sometimes her family has only beans for dinner. "For the children it's distressing," she said.