Imelda fled sexual violence at the hands of drug cartels in rural Puebla, about two hours outside of Mexico City, and arrived in New York City in 2013. She had no health insurance, barely spoke English, and as an undocumented immigrant, she avoided situations that required revealing her identity.

So in March 2020, even as the city became the national epicenter of the COVID-19 pandemic, Imelda, who asked that her surname not be used due to risk of deportation, resisted going to the hospital for her escalating fever and fatigue. “When the symptoms began, I wanted to go,” Imelda says, but her fears outweighed her desire for treatment.

Since arriving in the U.S. Imelda had visited a hospital only once, for the