Last year on Hart Island proved deadlier than any year during the AIDS crisis. More burials are expected as the disproportionate pandemic impact sends thousands to the final resting place of New York’s most vulnerable.
More people were buried on Hart Island in 2020 than any year during the AIDS epidemic — and the city is on pace to inter one in 10 of its COVID-19 victims in the potter’s field.
An exclusive analysis of city data, public records and interviews with dozens of local officials indicates at least 2,334 adults were buried on Hart Island in 2020 — 2 ½ times the figure recorded in 2019 and about 1,000 more than in 1988, the peak year for AIDS burials.
The analysis of Hart Island burials by the Columbia Journalism School’s Stabile Center for Investigative Journalism and THE CITY also shows how COVID-19 ravaged New York’s poorest neighborhoods and struck the sick and elderly in communities of color hardest.
Meanwhile, the city’s Office of Chief Medical Examiner is storing more than 780 bodies in refrigerated trucks. These COVID-19 victims will be brought to Hart Island unless claimed by family members.
If the city buries all the bodies currently in storage, roughly one in 10 New Yorkers who died of COVID-19 will have been interred on Hart Island.
Some one million people have been buried on the island since it became a public cemetery 150 years ago. Now the largest mass grave in the United States, Hart Island is expected to run out of burial space as soon as 2027.
Since the 19th century, Hart Island burials have provided a historical record of the New Yorkers who died poor, forgotten or alone.
COVID-19 is now part of that record.
The Hardest Hit Neighborhoods
More than 24,000 New Yorkers died of COVID-19 last year. But because of gaps in data collection, no one knows exactly how many of them were buried on Hart Island.
What is known is that since 2000, the number of adult burials has been steady at 650 to 850 per year. Most of the “excess deaths” in 2020, public health experts say, can be attributed to COVID-19.
The spike spurred U.S. Sen. Chuck Schumer (D-New York) and Rep. Alexandria Ocasio-Cortez (D-Queens, The Bronx) to help secure federal funds to reimburse families in need up to $9,000 for funeral expenses.
That marks a $2,000 increase over the amount previously announced for the program, which opens next month, Schumer and Ocasio-Cortez said Wednesday.
The duo cited the disproportionate impact of the pandemic’s toll, which is borne out by the Stabile Center and THE CITY’s analysis. Among the findings:
- Many neighborhoods hit hard by COVID-19 saw increases in Hart Island burials. In Co-Op City in The Bronx, where the COVID-19 death rate is almost twice the city median, eight and a half times more bodies were sent to Hart Island than the previous year.
- Outside of adult care facilities, nine of the ten ZIP codes that sent the most bodies to Hart Island during the pandemic were in neighborhoods where 90% of residents are non-white. Six of these ZIP codes were located in Bronx neighborhoods where the poverty rate is more than double the city’s overall rate.
- Six of the seven nursing homes that sent more than 10 bodies to Hart Island have been cited in the past for issues with infection control, according to data from the Centers for Medicare and Medicaid.
- Overall, about half of all New Yorkers buried on the island in 2020 died in hospitals while about a quarter died at home. The remainder primarily died in nursing homes. Another handful died in public places — a northbound 1 train, a parking lot at Flushing Meadows Corona Park, a street corner just outside a hospital in Washington Heights.
In many cases, the medical examiner’s office, which sends bodies for burial on Hart Island, did not confirm COVID-19 as a cause of death. In addition, many people tested positive but did not receive medical care and so were not counted as pandemic deaths.
As a result, an untold number of dead were transported to Hart Island before they could be officially added to the tally of New Yorkers who died from the virus.
“What is able to be determined is largely dependent upon the medical care that someone receives prior to death,” said Aja Worthy-Davis, a spokesperson for the Office of Chief Medical Examiner.
‘The Epicenter of COVID’
But Andrew Maroko, a geospatial health expert and professor at the CUNY Graduate School of Public Health, said the sudden influx of Hart Island burials is partly tied to the pandemic’s indirect health impacts.
Some struggled to obtain proper medical care due to an overwhelmed health care system and died as a result, while others also faced food and housing insecurity — and eventually death.
Hospitals with a majority of uninsured or Medicaid patients appear more often in the Hart Island database than hospitals serving more affluent populations, according to an analysis of hospital discharge data from the state Department of Health.
“What you see is not a representation of the COVID burden in the city, but a representation of the Hart Island burden” in the context of COVID, Maroko said. “So that’s going to be a sample that tends to be less socially connected and probably higher poverty.”
The Hart Island burial data bears this out.
Most were elderly from nursing homes; Black and Hispanic frontline and essential workers from low-income neighborhoods who risked losing a paycheck if they didn’t work during the pandemic’s peak; and residents of The Bronx and Queens, where life expectancy has long been lower than other boroughs amid a lack of access to health care.
Nearly a third of those who were buried on the island were from The Bronx, which recorded about 341 confirmed COVID deaths per 100,000 people — the highest confirmed death rate in the city.
“The suffering in The Bronx was so smeared over that the whole borough became vulnerable — and even the so-called middle-class areas felt the effect,” said Deborah Wallace, a public health expert and co-author of a book about race and class inequalities of COVID-19 in the city. “And The Bronx ended up to be the epicenter of COVID of the whole metropolitan region.”
‘Awful and Inhumane’
A little more than half of New Yorkers buried on the island were ages 70 and older, and nursing homes in The Bronx sent nearly twice as many bodies to Hart Island as senior facilities in Queens, which logged the greatest number of confirmed or suspected COVID-19 deaths of all the boroughs.
These numbers mirror existing poverty divides in the city: pandemic-related unemployment and income losses exacerbated the health problems of those who were already the most financially vulnerable, research by the University of North Carolina at Chapel Hill and Harvard Medical School shows.
People of color have been overrepresented on Hart Island, according to Melinda Hunt, who runs the Hart Island Project, a nonprofit that maintains a database of burial records and advocates for Hart Island.
“We know we have to look at the fact that that legacy is part of the history of the City of New York and we need to do things to properly reconcile that history,” Hunt said.
Hart Island’s burial process was designed to handle a large influx of bodies during an epidemic, an important feature when private funeral crematoriums reach capacity.
Meanwhile, the remains of many New Yorkers who died of COVID-19 are still being held by foreign consulates, funeral homes and the medical examiner’s office in makeshift storage units and trucks. As of mid-March, the bodies of 780 people were still in refrigerated trucks at a disaster morgue set up in April on the 39th Street Pier in Sunset Park.
In other cases, details of the dead have yet to be entered into city data portals. City data for Hart Island deaths currently lags behind by at least 20 days.
Once those New Yorkers’s names and information are logged and they are buried, the 2020 Hart Island figure will likely climb to nearly 3,000 buried.
In February, Ocasio-Cortez and Schumer announced at a joint news conference in Queens that New York State would receive more than $200 million of the $2 billion in federal funds earmarked to help pay for COVID-related funeral and burial expenses.
FEMA’s reimbursement of up to $9,000 in funeral costs is similar to a program the agency enacted after Hurricane Sandy, with aid geared toward lower-income communities.
“Many of these families because of COVID don’t have money for a proper funeral and a proper burial. And that is just awful and inhumane,” Schumer said.
Applicants have to provide receipts or other documentation and a copy of the death certificate.
Through the forthcoming program, family members of COVID victims will be able to apply for funds retroactively. A spokesperson for Ocasio-Cortez also confirmed to THE CITY that FEMA has agreed to establish a hotline in multiple languages “to ensure that the hardest hit communities are able to access the relief.”
According to FEMA, “eligible expenses” include the interment, reinterment, transferring and identifying of remains, as well as the costs of caskets, urns and headstones. The agency defines interment as the placement of cremated or deceased remains in the ground, an urn, or some other burial facility; disinterment refers to the unearthing of those remains; and reinterment to their replacement.
‘He was Not Alone’
It’s unclear whether Anita Perry will be able to tap into those funds to give a proper burial to her best friend, Roderick Paulus.
The duo first met in the 1980s, when they were both in their early 20s and working at a Wall Street office building, with Perry in the security office and Paulus in the mailroom.
Over the course of 30 years, Paulus would become the godfather to Perry’s children. They spent Christmas together almost every year.
As the pandemic struck last year, Perry began to worry about Paulus. He had continued his work as a mail clerk, despite a heart condition and asthma.
But Paulus shrugged off her concerns. “I’ve got to do my job,” he said to her.
It was important to Paulus that people could use the post office to keep in touch with family and friends when they couldn’t meet in person.
Paulus was born and raised in Brooklyn, though his parents and grandparents were immigrants from Trinidad. Outside of work, he was a well-known toy enthusiast.
“It looks like a toy store,” Perry said of his home.
The two spoke on the phone nearly every day at lunchtime. On Tuesday, April 14, Paulus cleared his throat frequently during the call, Perry recalled, but she did not think much of it at the time. She didn’t know it would be their last conversation.
Four days later, a police detective called her on the weekend.
Her best friend had died in his home from COVID-19, the detective told her. Paulus had listed her as his closest family member.
His sister had died the previous year, Perry told the detective, and he did not have any other living family.
When she asked for more information about his death, the detective refused because she was not a family member. She called him five more times, but each time he said he couldn’t take her call. Eventually, he stopped calling her back.
She suspected Paulus would be buried on Hart Island, but she did not find out for certain until the MISSING THEM project contacted her for an interview eight months later. She still doesn’t know what has happened to his possessions — including his collection of toys.
When Perry’s daughter, Christian, gets married this October, she will have a small portrait of her godfather in her bouquet of flowers, so that Paulus can walk her down the aisle in spirit. Perry said she plans to travel to Hart Island, when she can, to say goodbye.
“If you truly love someone, that person will live forever,” she said. “Roderick was a wonderful man.… He did not have family, but he was not alone.”