A man brings his daughter to the health clinic "Andocken" in Hamburg, which caters to undocumented foreigners.

The young woman is very ill, she has a cough and a fever. Father and daughter have come to Germany via Italy, a coronavirus flashpoint. Now they are sent to wait outside while the nurse tries to reach a doctor on the phone — in vain. In the end the daughter is told to go to a regular hospital for a COVID-19 test and medication.

That is not a good solution, says Teresa Steinmüller, a doctor and psychotherapist working in the Andocken facility: "These patients are afraid of identity checks." She suspects father and daughter did not go to a regular hospital, where they would have to register and provide documents showing their name and place of residence — and risk deportation.

Read more: Pregnant and undocumented in Germany

That's a dangerous gamble, Steinmüller points out. If the young woman is indeed COVID-19 positive and does not go into isolation, she is sure to spread the virus.

Undocumented immigrants seek treatment only if they can remain anonymous. Before the coronavirus broke out in Germany in mid March, 20 to 30 patients would crowd into the small waiting room at Andocken at any given time. Now, with social distancing regulations stipulating a distance of one-and-a-half meters between people, there is space for no more than six. And everyone first needs to make an appointment to see the doctor.

Nurse Maike Jansen says Andocken is not the only clinic to have scaled back its service. Some have even closed down. Help centers for people with no health insurance offer advice only by phone now.

NGOs demand urgent action

An estimated 200.000 to 600.000 undocumented immigrants live in Germany.

These people are often cleaners, care givers or work in restaurants. They go to work even if they are ill, because they have no savings and no access to [any form of] financial support. " In the context of a spreading pandemic, states must ensure that preventative care, goods, services and information are available and accessible to everyone, regardless of their residence status," writes PICUM (Platform for International Cooperation on Undocumented Migrants), a network of NGOs, in a press release.

NGOs like Andocken have called on the German government to act: When the SARS-CoV-2 pandemic started, almost all official information was available in German only. In an open letter to the government 40 NGOs demanded urgent measures to ensure that tests and treatment for COVID-19 are made available to migrants free of charge — and that their personal data may not be passed on to immigration authorities. They got no response.

Read more: Refugee sues German government for invasion of privacy

Go for a test — risk deportation

An interior ministry spokesperson told DW that there was no plan to change the regulations on data distribution. She also pointed out that all immigrants have access to tests and treatment for COVID-19 infections.

That is true only in theory, says Stefanie Kirchner from the NGO "Ärzte der Welt" (Doctors of the World). She points out that asylum seekers can indeed get free COVID-19 tests, but they need to show a document from the social welfare office — and this office is obliged to pass all data to the immigration authorities, which can trigger deportation procedures.

High-risk groups even more vulnerable

The Medibüro NGO network, catering to illegal immigrants, demands standardized Germany-wide regulations providing health insurance and data protection to everyone.

Maria Hummel and Hanna Schuh work with the "Medibüro" in Berlin. They are worried about their many patients who rely on free medication for a variety of serious chronic conditions: A diabetic from Togo, who needs his daily dose of insulin, a woman from Serbia needs medication to lower her blood pressure. Not only do such patients need free medication, they also run a high risk of falling seriously ill should they contract the coronavirus and reduced medical service poses a serious threat.

Read more: German health care system under pressure

Social distancing not an option

The clinic Andocken, meanwhile, is planning to remain open, despite the pandemic.

"Who else is there to help all these people?" asks doctor Teresa Steinmüller, pointing to several especially vulnerable patients. Like a pregnant woman from Ghana, who tested HIV positive. She was advised to keep a distance to other people, as a COVID-19 infection would likely put her life at risk.

But social distancing is not an option for her, says nurse Maike Jansen: Members of her local church take turns in giving her a bed for a night. She sleeps wherever there is a bed for her and has no chance to limit her contacts or stay at a distance.

"She put on a brave face when we spoke to her, " Maike Jansen recalls. "But at some point she just broke into tears."