March 23, 2020: Streets are deserted in the Chinatown-International District during Governor jay Inslee’s Stay-at-Home order on March 23, 2020 in Seattle, Washington. (Photo by Karen Ducey)

International Community Health Services (ICHS) is one of the nation’s nearly 1,400 federally qualified health centers serving 30 million people, most of them low income, immigrants, and refugees. In February 2020, ICHS was also the nation’s first federally qualified health center with a positive COVID-19 diagnosis. ICHS staff have been on the frontlines with our communities since the start of the pandemic, having vaccinated over 28,000 people against COVID-19, conducted over 90,000 tests, and cared for those who tested positive who are recovering at home. ICHS offers a window into the pandemic and a tumultuous yearlong series of events. Our stories bear witness to those who were our champions, confidants, and caretakers. They show the resilience of our community and the transformative power of simple kindness.

This piece is part of COVID-19 in 2020: A look back on health equity & community resilience in Chinatown-International District. The project was led by Seattle photo-journalist Karen Ducey and former ICHS marketing and communications manager Angela Toda in partnership with International Examiner. The project was funded by Historic South Downtown, King County 4Culture, and Society of Professional Journalists.

After living through the uncertainty of the COVID-19 pandemic for one full year, new vaccines now offer hope that life can — and will — return to solid ground.

This challenging year will be hard to forget. It changed us forever.

Let’s look back.

In early March, 2020, the COVID-19 virus first found its way into the Chinatown-International District, the hub of the Asian Pacific American community. At the International House Apartments, an employee tested positive for the deadly new disease. Two other employees were in quarantine.

July 31, 2020: Rattana Chaokhote, Clinical Services supervisor at ICHS, dons a mask that reads, “This is not a health insurance plan,” at a COVID-19 drive thru and walk-in testing site held for people in the Pacific Islander community at Federal Way High School. A report by the Washington State Department of Health (DOH) and Bellevue-based Institute for Disease Modeling (IDM) analyzing COVID-19 data highlighted the pandemic’s disproportionate and increasing impact on communities of color. At the time, rates of infection for Native Hawaiian or other Pacific Islander people were reported as being nine times higher than those of white people. Hospitalization rates were reported as ten times higher for Native Hawaiians or other Pacific Islanders than those of white people. “We know the COVID-19 pandemic has intensified the health inequities historically marginalized and oppressed communities already experience,” said Dr. Kathy Lofy, former state health officer at DOH. “These data are deeply concerning and underline the critical need to address the COVID-19 impacts we’re currently seeing by prioritizing outreach, testing, education, and related materials for disproportionately impacted communities in ways that are culturally and linguistically appropriate and accessible.” (Photo by Karen Ducey)

The high-rise structure, constructed in 1978 after activists demanded more quality affordable housing for the area, was home to 100 non-English speaking seniors. No one knew if other residents there — or in the other low-income apartments in the neighborhood — had also been infected.

The International House Apartments is several blocks from the bustling medical-dental clinic operated by International Community Health Services (ICHS), the largest health care provider for APIs in Washington state. Today, ICHS provides services to 27,000 patients in more than 50 languages at 11 clinics and sites.

March 26, 2020: ICHS Health care workers set up a drive-through testing site for COVID-19 outside their International District location. Serving uninsured, low income, and immigrant communities, many who rely on federal aid programs, the COVID-19 pandemic devastated the finances of non-profit community health centers across the country at a time when they were gravely needed. The lack of federal response to aid community clinics led to furloughs, alterations of operations and a decrease in patients that may result in long-lasting, devastating impacts. (Photo by Karen Ducey)

Springing into action, ICHS President and CEO Teresita Batayola and other non-profit leaders established a drive-through testing site on March 16 in front of ICHS’ clinic on 8th Avenue South. The public health department provided 200 test kits. In the first week, ICHS staff administered 96 tests. Results for 16 came back positive for the virus.

As the pandemic raged through the state and the number of fatal infections soared, Washington Governor Jay Inslee ordered the closure of nonessential businesses.

July 30, 2020: Frances Pele, age 12, whose family is from Samoa, looks at nurse practitioner Tess Sorbo, as she is about to be tested for COVID-19 at Federal Way High School. Joseph Seia from the Pacific Islander Community Association said, “We have the highest infection rates, highest hospitalization rates. Not just here in Washington State for Pacific Islanders, but throughout the country and places like California, Oregon, Arkansas. And so we know our communities as most impacted during this crisis because of decades of health disparities, and systems that are unresponsive to Pacific Islander community health needs.” (Photo by Karen Ducey)

Restaurants and shops through the neighborhood were shuttered. Residents were advised to stay home and avoid public contact. Travel ground to a halt.

Meanwhile, ICHS operations and services were drastically curtailed. At one point, 40 percent of all staff were furloughed. There was a desperate search for protective masks, gowns, medical supplies, and financial support.

While ICHS waited for funding relief through the emergency federal stimulus package, it managed to keep its door open thanks to the scrappy commitment of staff and an outpouring of community support. ICHS received a stream of donated surgical masks and other vital supplies as well as financial contributions from individuals, foundations, and businesses.

June 18, 2020: Clinic supervisor Qing Weng (right) speaks Mandarin to a person coming in for a COVID-19 test that Erin Olanrewaju, ARNP, (left) administers at a drive-through testing site at the ICHS Shoreline clinic. (Photo by Karen Ducey)

On March 30, Crawfish King surprised ICHS staff with 80 packaged meals. On April 18, Maria Nguyen, an Everett resident, drove down to the ICHS Holly Park clinic with 100 cotton masks she had sewn herself. On June 5, Tasty Pot donated 40 packaged meals and 40 bubble teas to the Shoreline clinic. The Taiwanese American Professionals-Seattle brought 60 meals to the Bellevue clinic.

These unexpected acts of kindness and generosity have continued regularly—and frequently—to this day.

ICHS has weathered the storm, steadily ramping up its services once again.

July 30, 2020: ICHS nurse practitioner, Tess Sorbo, works out of the back of her car to give regular childhood vaccines to students who attend the Seattle World School in the parking lot of Dearborn Park International Elementary School. “We don’t want to get even more behind than we already are, right? And COVID has definitely limited the access to healthcare universally for a lot of populations who just don’t under-stand that they can still access their doc-tor and stuff like that,” said Sorbo. (Photo by Karen Ducey)

To date, ICHS has vaccinated over 28,000 people and conducted about 90,000 tests. “We have also informed many, many people about vaccine safety and cared for those who tested positive who are recovering at home,” Batayola said.

ICHS has put into place new protocols, including masking, increased hygiene, testing, and social distancing. “Telehealth appointments and prescription delivery are now available,” Batayola said. “We continue to adapt to the evolving health care environment.”

ICHS operates an assisted living program at Legacy House, adjacent to the ICHS clinic. The program is called PACE, an acronym that stands for Program of All-Inclusive Care for the Elderly. It currently serves 65 people. It’s the model for a new “aging in place” program that ICHS plans to open on north Beacon Hill in 2023, after completion of a $20 million fundraising effort.

March 20, 2020: Dr. Alan Chun of ICHS Legacy House checks on a patient who suffered a fall. Three days later, Washington state Gov. Jay Inslee issued a stay-at-home order to help curb the spread of the coronavirus. A mask mandate went into effect on June 26, and a faction of the Black Lives Matter protest swept through the CID on June 29. It took a toll on the elderly. “If you’re at Legacy House and all the windows are boarded up and you’re isolated, I mean, it can be very confusing for a lot of these older people. Some of them are confused about where they are or what the time is, or what’s happening. They don’t understand,” Chun said. (Photo by Karen Ducey / Getty Images)

Mike Wong, ICHS Healthy Aging and Wellness Program Director, said Legacy House residents were “hyper-aware of COVID-19” early on because many hailed from China. “Our participants were already staying home and declining mass gatherings like our regular day center activities when the virus was not yet global news.”

In late December 2020, the first deliveries of COVID-19 vaccines arrived at Legacy House. “Within about four weeks we had administered at least a first dose of the vaccine to many of our residents and participants,” Wong said. “Now we’re in a wait-and-see mode.”

Alan Chun, an ICHS physician for 27 years, proudly noted: “ICHS has successfully managed Legacy House through the past year of this epidemic without a single resident being infected.”

July 27, 2020: Rosa-lie Rivero, Clinic Care Coordinator at the Highland Health Center in Highland Middle School, delivers a camp kit to Sean Villanueva, 14, at his home in Bellevue. Since the COVID-19 pandemic hit in March 2020 and the middle school closed, the health center operated by ICHS has been reaching out to students through virtual summer camps. The camps allow health care workers to check on the mental and physical health of students who were insulated in their home due to the social restrictions of COVID-19. (Photo by Karen Ducey)

But battling the COVID-19 virus itself hasn’t been the only giant challenge.

Last year, President Trump fanned the flames of xenophobia and anti-Asian sentiment by using the terms “China virus” and “Kung Flu.” On March 26, vandals smashed a window at Jade Garden Restaurant. On April 12, three men plastered alt-right white supremacist stickers near Asian businesses. On May 11, the Viet Wah supermarket was burglarized.

Other incidents of vandalism and robbery have proliferated.

In 2021, increasing reports of attacks against Asian seniors in Chinatowns across the country—beginning around Lunar New Year—brought renewed concern about a hidden public health crisis that has been ignored. It was no different in the Chinatown-International District, where community elders have been frequently assaulted and robbed for many years.

December 2, 2020: Nurses stand six-feet apart during a weekly meeting at ICHS’ Holly Park clinic. Tram Le, health center manager for Holly Park, said, “We try our best to maintain [social distancing]. They show up at work every day to support the providers, to serve our patients. That really means a lot to me as a health center manager and to the providers.” (Photo by Karen Ducey)
“The disease of racial bigotry and hatred has been heightened during this pandemic,” Batayola said. “It’s so tragic that these acts of violence and scapegoating have targeted elderly and women. We need to put a stop to this.”

Batayola has been a leading voice among community health center leaders calling on the federal government to redress the historic inequities in policies and programs serving immigrants and refugees.

Following the May 25, 2020 murder of George Floyd, an unarmed African American in Minneapolis, thousands of demonstrators marched through Seattle streets, demanding an end to police brutality. Over 100 businesses were vandalized, including 20 in the CID. Jade Garden was struck again. The area looked like a scarred war zone. The protests further highlighted the fragility of the neighborhood.

August 7, 2020: Lisa DiFedele (left), Infection Prevention and Control Administrator at the Inter-national Community Health Services, sprays a sweet or bitter substance into the hood of Adriana Taquiva, a dental assistant at the ICHS Shoreline clinic, to make sure her N-95 mask is working and fitted properly. DiFedele says, “We’ve been at a critical shortage of masks, pretty much from the beginning. We’ve had a lot of masks. And we’ve had a lot of support from community mem-bers, donating masks, but as you’re seeing, they have to fit correctly in order for the staff to be able to use them.”(Photo by Karen Ducey)

Volunteers went up and down the streets, removing debris and covering storefronts with plywood. Over the next week, young artists painted the plywood with beautiful Asian murals and words of inspiration and racial unity.

Today, many storefronts and small businesses in the Chinatown-ID remain boarded up. Fears over public safety continue to deter visitors and to make residents hesitant to leave their apartments.

But community activists and longtime business owners remain optimistic that once the pandemic subsides, the neighborhood will rebuild.

Harry Chan, owner of the Tai Tung Restaurant, established in 1935, said, “Yes, I think things will return to normal. I don’t know when, but it will eventually. Hopefully soon.”

October 14, 2020: Health care professionals assist patients at the International Community Health Services Clinic. After the state relaxed its COVID-19 restrictions and people ventured outside wearing masks, there was a surge in demand for medical services. This caused great demand on the staff. (Photo by Karen Ducey)

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