When Maryland health officials began releasing coronavirus case counts by ZIP code last month, a large area in Northwest Baltimore surged to the top of the state’s list.
For several weeks, the 21215 ZIP code — home to more than 58,000 people representing a variety of demographics — has emerged as a “hotspot” in terms of total cases and cases per capita. As of Sunday, 470 residents of 21215 have tested positive for COVID-19, the upper respiratory disease that has sickened thousands of Marylanders and more than 3 million people worldwide.
While the state’s case counts are updated daily, 21215 has consistently ranked among the top ZIP codes with the highest concentration of cases, and leads all other Baltimore districts.
Still, those who live and work in 21215 say the data tells only part of the story. ZIP codes often bind together large swaths of neighborhoods with unique identities and needs for avoiding infection.
“When you hear 21215, that can mean a lot of things,” said Sean Stinnett, resident and West Arlington Improvement Association president.
Health experts say it could take years before they have a full grasp of why some ZIP codes like 21215 have higher case counts than others.
In the absence of clear answers, Northwest Baltimore leaders, including Stinnett, have banded together to fight the spread of COVID-19 — crossing the geographic and cultural lines that form distinct pockets of a shared home.
Communities look within
The 21215 ZIP represents an array of demographics — elderly communities and nursing homes, both majority black and majority white neighborhoods, Jewish and Muslim places of worship and poorer areas with below-average health outcomes.
The oblong ZIP code stretches from Mondawmin Mall to the northwest corner of the city, blanketing neighborhoods like Park Heights, Pimlico, Ashburton, West Arlington, Woodmere, Cylburn, Glen and Fallstaff. About 58,448 Marylanders live in 21215, U.S. census data shows, making it one of the most populous in the state.
City leaders say the region’s diversity requires a nuanced approach to virus prevention and treatment that acknowledges each community’s cultural and sociological differences. Some grassroots efforts to combat the coronavirus have 21215 communities turning within to make custom adjustments to their ways of life.
For example, Muslims reported celebrating the Ramadan season without traditional iftar meals at local mosques and religious centers. The Hilltop 4100 Community Association set up regimented check-ins for elderly residents who may not feel comfortable leaving their homes. And Safe Streets Baltimore dispatched its “credible messengers,” normally used to combat violence, to the Park Heights area to encourage people to stay home.
Leaders of Baltimore’s Jewish community in 21215 say that as serious cases have emerged within their ranks, the populace has bucked ancient religious rituals to comply with the state’s stringent stay-at-home orders designed to keep the virus from spreading.
“We usually get the brunt of these issues because of how close the community is — we go to the same supermarkets, the same schools, the same synagogues,” said Baltimore City Council member Isaac “Yitzy” Schleifer, who grew up in the area and has coordinated much of its behind-the-scenes approach. “Especially in the Orthodox community, you’d expect a bigger issue here, and thank God, there just hasn’t been.”
Schleifer said the Jewish community has heeded warnings from public officials related to social distancing, canceling holiday celebrations, refraining from sitting shiva and forgoing communal worship. And although Jewish law, or halacha, specifies that 10 men must assemble to satisfy the quorum necessary to daven, or pray, Schleifer said the community has all but suspended in-person rituals outside the immediate household.
“Never in my lifetime have I seen synagogue rabbis say, ‘We’re shutting down.’ It is nothing short of historic,” he said. “Synagogues came out strong on making it clear to people that if you consider yourself part of our congregation, then you value our values, which is, there is nothing more important than human life.”
Rachel Massre, a resident, had grown accustomed to socializing in and around her neighborhood, which is home to several Jewish families with young children, she said.
Now, she feels compelled to keep her community at arm’s length.
“It’s not the same,” she said. “Everyone’s a little more nervous and distant.”
Social and economic factors in a person’s life can influence their odds of recovering from infectious diseases, said Dr. Letitia Dzirasa, Baltimore’s health commissioner.
That means some communities fighting off coronavirus in 21215 could fare better — or worse —based on individual circumstances.
For example, more Marylanders over age 80 have died from COVID-19 than any other age group. Nearly half of all cases in 21215 can be attributed to FutureCare Lochearn, a nursing home where 156 residents and 75 staff members tested positive for the coronavirus. At least 21 people have died, according to state data.
And early figures show black Marylanders have disproportionately contracted and died from the coronavirus, a disparity noticeable in other U.S. cities and states.
Dzirasa said many black residents in the 21215 ZIP code are essential employees who do not have the option to telework. Some might not have the same access to health insurance or primary care doctors as their more affluent counterparts. Generational mistrust of the medical system might also influence who seeks out help and who suffers alone, she added.
“They’re less inclined to seek medical evaluation in the first place," she said. “It could also be a lack of social supports to do social distancing, because you can’t stay at home if you’re also the primary breadwinner.”
Data supports the notion that 21215 residents do not have homogenous health backgrounds and vulnerabilities. In 2017, the city health department classified at least four distinct health profiles for clusters of neighborhoods within the ZIP code.
The profiles for Southern Park Heights and Pimlico/Arlington/Hilltop had higher mortality rates for people with heart disease, strokes and certain cancers than the city as a whole. Profiles for Glen-Fallstaff and Dorchester/Ashburton neighborhoods said those areas fared better than the city as a whole in the same categories.
Geographic lines, as well as the invisible lines of class, separate these communities from one to the next, with the wealthier neighborhoods scoring more favorable health profiles.
Medical experts who serve 21215 say the area’s high case count could reflect several factors — such as a high volume of residents, proximity to testing centers and cultural factors specific to each of the communities that live there.
Epidemiologists will have to wait for more data to emerge before they can make an actual judgment, said Dan Blum, president of Sinai Hospital of Baltimore, which is located in 21215 and is part of LifeBridge Health.
“Health conditions, density of housing, socioeconomic issues — all of them are relevant factors and likely accurate factors,” Blum said. “It’s just one of the things we’ll know when we know.”
Doctors at Sinai say they’re treating a mix of people of all ages and racial and ethnic backgrounds, and no clear trends have emerged.
“Patients don’t come to the hospital in clusters; we treat them as they come,” said Dr. Jonathan Ringo, former president of Sinai Hospital.
As president of the West Arlington Improvement Association, Stinnett has plenty of practice coordinating with neighboring groups to find resources for residents.
But lately, Stinnett says, more grassroots groups are crossing geographic lines to team up across 21215.
Stinnett says he joined other area leaders in handing out hygiene kits complete with hand sanitizer, soap and other essentials to people along Garrison Boulevard. And next week, he plans to distribute cloth face masks alongside members of the Grove Park community in the MTA parking lot at Northern Parkway and Wabash Avenue.
“Even though we’re going through this crisis, the good thing is there’s more solidarity, more morale,” Stinnett said. “You have organizations looking out for one another.”
Rebecca Altman, chief integration officer at LifeBridge Health, said the hospital system is coordinating with community leaders throughout 21215, sending out educational newsletters and resources, assisting with food accessibility and donations, and checking in on patients with prior health conditions, such as diabetes, to ensure they maintain their treatment regimens at home.
“Maybe it’s a blessing in disguise, but we’ve grown closer together as a community,” she said.
Breaking News Alerts Newsletter
As it happens
Get updates on the coronavirus pandemic and other news as it happens with our free breaking news email alerts.
Still, some said the outbreak has exacerbated its existing deficiencies — not cured them.
Kwame Rose, a Baltimore-based activist, has been helping seniors in the region amid the outbreak, partnering with Jose Andres’ World Central Kitchen to distribute hundreds of hot meals every day.
He said while the initiative has helped restaurants stay open and seniors fed, the work should signal structural, racial and class-based inequality among 21215 communities in dire need of reparation.
“Park Heights receiving meals is nothing new,” he said. “It should make us think: What can we do to make sure people stay safe, that people get tested? And what we can do so that individuals who can’t afford health care can right now?”
Baltimore Sun reporter Phil Davis contributed to this article.