Last weekend, the coronavirus took the life of Femi Anderson, a popular restaurateur and artist, one of 30 people in Dougherty County who have died of the disease since early March. Outside the Renaissance Art Cafe, which Anderson opened in 2007 near the banks of the Flint River and Ray Charles Plaza in downtown Albany, three sets of flowers and a stuffed teddy bear sat at the entrance Tuesday.

Friends weren’t able to visit Anderson in the hospital as her case suddenly turned serious.

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When she was buried Saturday morning, only 10 family members and close friends were allowed at her gravesite at Floral Memory Gardens, in accordance with a local order prohibiting large gatherings.

But about 50 people showed up to pay their respects and say farewell. They sat in their cars outside the cemetery and along the streets encircling it, said Amna Farooqi, a local activist and friend of Anderson. Dozens more watched on Facebook.

The outbreak in Dougherty County has largely been attributed to a funeral in late February that drew more than 100 mourners, including a man from Atlanta who died a few days after the services. Soon, relatives and friends who went to the wake fell ill, as did employees of the funeral home and worshipers at the church where the service was held.

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The novel coronavirus quickly overwhelmed Albany, and, as of Friday, the county of 90,000 had seven more deaths than Fulton County, which includes the city of Atlanta and more than a million residents. So far, 521 people in Dougherty have tested positive for the virus, second in the state behind Fulton’s 747 confirmed cases.

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But long before covid-19 invaded Dougherty County, where African Americans make up more than 70 percent of the population, residents were already battle-worn from decades of struggle against social and economic inequities, including high unemployment, poverty and chronic disease, the lingering effects of slavery and racial discrimination that continue besieging communities of color across the country.

Black people account for “90 percent or better” of the Dougherty County deaths, said county coroner Michael Fowler. The dead range in age from 42 to 80, averaging about 60 years old. Fowler added, “Most of them had underlying conditions — diabetes, COPD [a lung disease], cancer, AIDS — all of these underlying conditions compromised their immune systems.”

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Data shows that people with these types of chronic diseases, many of which affect African Americans at a disproportionate rate, are at increased risk for hospitalization and death from covid-19. Similarly high rates of serious cases and deaths among African Americans are being noted in other cities, such as Detroit and Milwaukee.

“Historically, when America catches a cold, black America catches pneumonia,” said Albany City Commissioner Demetrius Young, who added that entrenched disparities for black residents are as much to blame as the person thought to have brought the disease into Dougherty County.

Recently, Sen. Elizabeth Warren (D-Mass.) and Rep. Ayanna Pressley (D-Mass.) sent a letter to Health and Human Services Secretary Alex Azar calling for the federal government to begin collecting racial data on those who have tested positive for the coronavirus. The Centers for Disease Control and Prevention and most state health departments have released breakdowns by age and gender only.

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“Any attempt to contain COVID-19 in the United States will have to address its potential spread in low-income communities of color, first and foremost to protect the lives of people in those communities, but also to slow the spread of the virus in the country as a whole,” Warren and Pressley wrote in their letter, which was also signed by Sens. Cory Booker (D-N.J.) and Kamala D. Harris (D-Calif.) and Rep. Robin L. Kelly (D-Ill.).

Young, 49, has sequestered himself and his teenage daughter at home for the past two weeks. He is diabetic and doesn’t want to take any chances. He has groceries and whatever else they need delivered.

He faults Republican leadership in the federal government, and some state governors, including Georgia Gov. Brian Kemp, for failing to act more quickly to protect the public from the disease. Amid criticism about his inaction, Kemp announced a statewide order to stay at home on Wednesday, citing new guidance from the White House coronavirus task force. The governor has been widely ridiculed for saying that he had just learned that asymptomatic people could transmit the coronavirus, though health officials had warned as much weeks ago.

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Kemp’s order started Friday and remains in effect through April 13.

“Republican governors are looking to and taking their cues from the federal level. Right now when we need their help, and they know we need their help, they’re saying, ‘We’re going to let you guys handle it at the local level,’ ” Young said. “Well, local folks don’t have state money, don’t have federal money.”

Dougherty County and other Georgia communities outside the state’s larger metropolitan areas also don’t have access to adequate health care. Georgia, like most red states in the Deep South, did not expand Medicaid for low-income adults, leaving more than 500,000 people without health insurance. The state also has seen several hospitals close in smaller cities and rural communities.

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Phoebe Putney Memorial is the only hospital in Dougherty County, and covid-19 is putting a strain on the 691-bed hospital’s resources in almost every area, said CEO Scott Steiner. As of Thursday, 55 inpatients had tested positive for the virus, with another 79 awaiting test results.

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Staff members are working 16- and 18-hour days, and patients without the virus are being moved or having surgeries delayed to make room, particularly in the ICU, Steiner said. The health system’s other campus, a sparsely utilized 200-bed facility called Phoebe North, is now a ward for covid-19 positive or presumptive positive patients.

Phoebe serves a population that has struggled economically, with a high percentage of Medicaid patients. Steiner estimates his hospital system is losing $1 million a day during the virus epidemic. More than three weeks have passed since the first positive coronavirus case hit Albany.

Kemp has called in the National Guard, which brought physicians, nurses and nurse practitioners from elsewhere to work at Phoebe. Coronavirus patients are kept in the same area to prevent spread to others in the hospital. However, any staff members who report symptoms are quarantined for 14 days, adding further strain to staffing.

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Albany Mayor Bo Dorough said the coronavirus came to his city “like a thief in the night.”

“We didn’t have any time to prepare,” he said. “We had people dying before anybody outside of the hospital appreciated the gravity of the situation.”

Local authorities issued a countywide order for people to stay home on March 22. Young acknowledged that compliance was lax initially, and the city doesn’t have enough police officers to enforce the mandate. Even one of his relatives wouldn’t stop working.

“I have an aunt who is a barber, and she was still working when all this was happening. I called her and said, ‘Auntie, this thing is in our community, and you really need to shut it down,’ ” Young said, adding that she has since retreated to her farm outside town to wait out the pandemic with her chickens and cows.

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Although many businesses — especially smaller businesses not deemed essential — have closed their doors, Albany’s Proctor & Gamble paper plant remains open. The facility is considered essential because it makes tissues and paper towels.

Loren Fanroy, a spokesperson for Charmin, said the plant, which employs just under 600 workers, is following guidelines from the World Health Organization and CDC “to make sure our employees are safe.”

She said the company conducts regular temperature checks, maintains six-foot distances between workers, did away with meetings and other group activities and disinfects all surfaces about every four hours. “We are making sure people are educated about the proper protocols and working around the clock to keep our employees safe,” she said.

Young said some workers have told him privately that they are concerned about safety conditions at the plant, but they are unwilling to make formal complaints for fear of losing their jobs.

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“When you bring this up, everybody gets quiet. They do not want to ruffle the feathers of the few industries they do have here,” Young said. “People are not going to be too loud when their paychecks are on the line.”

The median household income in Albany was $34,493, according to census figures from 2014 to 2018, and more than 32 percent of residents lived in poverty, nearly three times the national rate of 11.8 percent. The census also reported that more than 20 percent of the city’s residents younger than 65 had no health insurance.

Albany is part of the country’s Black Belt, a swath of the Deep South cutting through many of the former cotton-producing centers that fueled the wealth of the country in its early years.

Farooqi, a Maryland native and political organizer who moved to Albany a little over two years ago, said vestiges of the Old South are still evident.

“Just driving into the city, you drive by cotton fields and plantations, and I think there’s still a feeling that we’re not so far away from that because of racism and classism,” she said. “Even though we have elected people of color, the wealth is still primarily white.”

A geographic divide still exists. In the northwest, especially the neighborhoods around Doublegate Country Club, brick homes with manicured lawns line the streets, some with wrought-iron fences creating dramatic entrances leading to white-columned front porches. This is the city’s richer, whiter base. Nearby is the Albany Mall, with anchor stores including Dillard’s and Belk, big-box staples such as Target, and regional grocery stores Publix and Harveys. A new bank branch is under construction.

The opposite, geographically and economically, is an area of southeast Albany known locally as the Darkside. Here, the houses feature peeling paint, junk cars, unkempt lawns and general disinvestment. Many sit abandoned. There used to be two Harveys stores in the city’s south and east sides, but one closed recently, leaving a Family Dollar in the same strip mall to serve the local population.

Farooqi said these kinds of disparities made Albany’s black residents less prepared for the pandemic. She said the social distancing message “didn’t get out early enough and wasn’t internalized enough.”

“There’s a deep disconnect between local leaders and regular residents of the city on a lot of issues,” she said. “There is poor housing and a lot of slumlords, a lot of health issues. Outside of the virus, Albany already felt a little dysfunctional.”

There is also a legacy of resistance. During the early 1960s, a coalition of civil rights groups — including the Student Nonviolent Coordinating Committee, the NAACP and the Southern Christian Leadership Conference — joined with local activists to lead mass protests known as the Albany Movement. Dozens were arrested during marches, sit-ins and other acts of protest against racial discrimination and violence against the city’s black residents. The Rev. Martin Luther King Jr. took part in some of the demonstrations. Although the effort had limited success, King later credited it with helping to map a strategy for campaigns across the South.

Young was moved to run for the city commission after taking up a fight to block a liquor store from opening in one of the city’s black neighborhoods. His mother, Mary Young-Cummings, was one of the first black city commissioners, after she led a lawsuit that forced the city to change the way it elected local lawmakers.

Albany’s close-knit circle of black professionals has been devastated by the virus, Young said.

“That was a big blow for us here,” Young said of losing Anderson, a friend for decades. “She did some phenomenal things for the community here in the arts arena, especially for the black community.”

The church community has taken umbrage over criticism about the virus starting at a funeral and complaints that some pastors were too slow to stop holding in-person services. Some residents also noted the Snickers Marathon, held March 7 and drawing several hundred runners from around the country, as another large event that could have played a part in bringing the virus to the city.

Carl White, senior pastor of Friendship Baptist Church in downtown Albany, said there was a feeling around town initially that churches were being singled out for spreading the virus.

“When you go to church, people don’t know how not to hug and shake hands. That’s what you do at church,” he said.