Latino advocates are worried that the toll the COVID-19 pandemic has taken on immigrants on Long Island is greater than what state statistics reveal because of their reluctance to seek hospital care due to fear of deportation, medical costs and other concerns.

In Nassau County, the death toll from COVID-19 is 2,182, including 236 Hispanics, with their death rate per 100,000 people at 133.5, second-highest behind Blacks, according to the most recent data from the New York State Department of Health. In Suffolk County, 1,979 have died of the virus, 212 of them Hispanics, with a death rate of 113.8, also the second-highest behind Blacks.

The Washington, D.C.-based Brookings Institution says the age-adjusted death rate from COVID-19 among Hispanics and Latinos is 2.5 times that of whites.

Gil Bernardino, founder of Long Beach-based Hispanic immigrant advocacy group Circulo de La Hispanidad, said immigrant families living in the country without legal permission face tough decisions when a relative is diagnosed with COVID-19.

“The fear is real,” Bernardino said. “People in the community, when you’re working and you are facing deportation and you have your wife and children, you’re living in fear, the entire family. When you have this kind of health crisis, you’re not going to go to the hospital just because you have the virus, even though the test is free.”

Cheryl Keshner, a senior paralegal and community advocate with the Empire Justice Center, a statewide nonprofit law firm advocating for low-income families, agrees. The center has an office in Central Islip.

“We know that the pandemic has disproportionately affected communities of color, particularly people who are low-income,” Keshner said. “A lot of people can’t socially distance if they’re living in super-crowded conditions, which a lot of people are because we don’t have enough rent regulations on Long Island. And a lot of Black and Latino workers are essential workers.”

According to data from the Brookings Institution, only 16% of Hispanic Americans can work from home. And the CDC has acknowledged in its guidance that “people living in densely populated areas and homes may find it harder to practice social distancing.”

Patients with severe cases of the virus that require admission to the intensive care unit, intubation and lengthy hospital stays can have bills that exceed $300,000. The median cost of a coronavirus hospitalization is about $14,366, according to a study from The City University of New York (CUNY) Graduate School of Public Health and Health Policy.

The Trump administration announced in April that through the Coronavirus Aid, Relief, and Economic Security (CARES) Act, federal aid would be given to help hospitals with costs of treating uninsured COVID-19 patients. However, additional coverage and funds for testing and treatment — such as Medicaid, pandemic unemployment assistance or direct cash payments provided under the bill — are not available for nonresidents who don’t have green cards, are not work authorized, or haven’t been physically present here long enough to establish “substantial presence.”

Martha Maffei, executive director of Patchogue-based Latina immigrant advocacy group SEPA Mujer, said a woman from one family who is living in the country without legal permission said her elderly father was diagnosed with COVID-19 and they simply isolated him at home because they were concerned about potentially high hospital bills if they sought treatment. Despite the separation, the family remained worried that they could contract the virus themselves within the small apartment.

“Unless they see it’s really very bad and try to go to the hospital, they are just dying at home,” Maffei said.

She and other advocates said they have heard from several Latino immigrants that they have been using home remedies such as herbs, gargling salt water, special teas and natural medications to treat the virus, which are not viable.

Rebecca Sanin, president and CEO of the Health and Welfare Council of Long Island, said the challenges facing not only Latino immigrants, but all other immigrant communities on Long Island during the pandemic, involve two major factors. One is that a large portion of the immigrant community works as essential workers in grocery stores and hospitals, and the other is that immigrants in certain areas tend to live together in “higher density,” or with multiple people inside a household.

“What has changed is that the trajectory of this disease is so frightening that a lot of people who have been living in the shadows and who have been socially isolated aren’t coming out to get tested because they are concerned about the safety of their family and their future,” Sanin said.

She noted that as a result of the Trump administration’s hard-line policies on immigration, fewer immigrants had been applying before the pandemic for services such as Medicaid and the Supplemental Nutrition Assistance Program.

“The fear of scrutiny and family dissolution is so severe that people are forgoing basic needs and have been for several years,” she said. “I don’t think that’s different now. I think there has been a very cruel targeting of the immigrant community, and the response to that is that people have moved further into the shadows, particularly our really low-income immigrant community that is struggling.”

Maffei said her group had been doing outreach through several measures, including a Spanish-language hotline, to answer immigrants’ questions about seeking treatment. In addition, SEPA Mujer has put out a resource guide for immigrants pointing out testing sites, food drives and deliveries and unemployment and temporary assistance services available for them.

SEPA Mujer also provides rent assistance to single immigrant mothers who are living in the country without legal permission and also has brought cases to Suffolk County regarding employment and worker abuse involving immigrants being forced to stay on the job despite being infected with COVID-19, Maffei said.

Keshner said immigrants need to know they could qualify for certain kinds of insurance such as emergency Medicaid and other financial assistance available through hospitals that would offset the costs of being treated for the virus.

Bernardino said more needs to be done across Long Island to send the message that residents who are living in the country without legal permission are welcome to take a free coronavirus test, and potentially save their lives or others.

“We need to have this kind of information reaching out to communities in a very clear way, that they can get the test without any repercussions,” Bernardino said.