Imbalance
community had exploded. In the last week of May, Latinos made up a staggering 78% of all new coronavirus cases in the six Bay Area counties.
Yet some health leaders still were missing the signal. At a May 26 San Mateo County Board of Supervisors meeting, Supervisor Warren Slocum, whose district includes East Palo Alto and heavily Latino North Fair Oaks, asked Public Health Officer Dr. Scott Morrow if there was “cause for concern” in the rising number of Latino cases.
Morrow declared the data “not representative,” adding that, “at this point in time, it doesn’t mean anything.”
Meanwhile, county policies kept employees in the dark about risks at work. For one, no Bay Area county — nor the state of California — was willing to publicize specific information on workplace outbreaks, citing privacy concerns. It was a sharp contrast to the strategy in Los Angeles and the state of Oregon, which believed workers had a right to know.
That left Dr. Noha Aboelata, chief executive officer of the Roots Community Health Center in East Oakland, to do the job herself.
Roots was conducting free testing in poor communities and using the data to piece together workplace clusters, discovering at one point that 68% of construction workers it was testing had COVID-19. Aboelata recalled becoming so frustrated with the lack of communication she considered using a bullhorn to warn workers and employees about an ongoing outbreak at a local grocery store.
“You have entire industries where people are not protected, and that probably accounts for the disparity we are seeing,” she said. “The Latino population didn’t have protections.”
The first reopenings were quickly followed by a summer spike in cases — the majority among Latinos. By mid-July, the governor
had rolled back the state’s reopening plan and businesses once again shut down, only to reopen and close again during a huge winter surge.
The sequence of events showed the costs of overlooking persistently high case rates in Latino communities, UCSF’s BibbinsDomingo said.
“It is not enough to say in my neighborhood, I don’t know anyone who has COVID, nobody around me has COVID, therefore we should open up,” she said. “Wherever there’s a pocket of high transmission, it’ll be impossible to get a city or county under control.”
Persistent pattern
As 2020 progressed, leaders at the local and state level began to address the Latino disparities publicly and offered some targeted programs. But they came in fits and starts and Latinos in overwhelmed communities said the neglect continued.
The California Department of Public Health declined repeated requests from the Bay Area News Group to provide a top official to discuss its efforts in the Latino community. But in a detailed email, a spokesperson said department officials “began to notice” the Latino case and death numbers in summer 2020; a surprisingly late time frame.
In July, the email continues, the department convened an internal work group to address the problems of COVID-19 in the Latino community, focusing on testing, contract tracing, isolation and quarantine and health care access. It launched a Spanish language media campaign two months later. In late September, Gov. Newsom unveiled a new series of equity measures to ensure that counties wouldn’t reopen if case or testing positivity rates in the most vulnerable communities were significantly higher than the county average.
“The data show us that when the case rates grow, so too do the disparities,” the email said. “Eliminating these is a priority equivalent to eliminating COVID-19
itself.”
In fact, the data on Bay Area infections contradict the state’s assertion: Although Latino case rates were persistently the highest of any group, disparities actually declined during the massive winter surge as the virus raced from neighborhood to neighborhood and case numbers for Latino and non-Latino residents rose in tandem.
Despite its efforts, the state’s approach to vulnerable populations often neglected urban areas. Its temporary isolation housing program, for example, was aimed at farmworker communities in the Central Valley and Imperial County. California didn’t offer an equity playbook that included specific strategies for Latino community outreach and support, as it did for high school sports or auto dealerships or cardrooms, until December.
Some Bay Area leaders are harsh in their assessment of the state’s efforts. Asked if his county had received
useful resources — in terms of testing, data or communicating with the Latino population — from the state, Santa Clara County Executive Jeff Smith said no.
“Everything that they’ve actually done since last year has impacted the equity populations in a negative way,” Smith said.
Lacking better guidance, county programs have continued to vary widely.
In the Bay Area, local advocates single out Contra Costa County as an area that should have done more sooner.
While the county had a robust Spanish-language website, they said, there was little on-the-ground outreach to Latinos in many neighborhoods until late fall. For example, Bay Point — an unincorporated area with the county’s second-highest case rate — didn’t get its own testing site until October.
In late fall, there were still no signs or billboards and no on-the-ground outreach workers telling residents
of the largely Latino Monument Corridor neighborhood in Concord how to avoid the virus or where to get tested, said Alejandro Hernandez, a Monument resident, well-connected PTA volunteer and assistant manager at a Moraga Taco Bell.
In that vacuum, rumors spread, so Hernandez became a self-appointed coronavirus resource, sharing information he got online or from his children’s school — doing at a small scale what he said the county should’ve been doing for months.
“They don’t have any sort of campaign. For instance, we all go to FoodMaxx. We all go to the Meadow Homes Park,” he said. “It would be great to have promotions there or people there telling you, ‘Here’s how to get a test.’ ”
Contra Costa County Health Officer Dr. Chris Farnitano disagrees that the county was slow to act, noting that, among other things, the county set up a bilingual telephone line in March 2020 to provide information to people without internet access, had five testing centers in high-risk communities by April and in June began meeting regularly with a working group focused on the Latino community.
“The information was there and the testing was there and we’ve been promoting it since day one,” he said.
But when Edgar Quiroz, a retired Kaiser Permanante executive and member of United Latino Voices of Contra Costa County, volunteered at a two-day mass testing event in September in Oakland’s Fruitvale neighborhood, it became obvious to him what his own county wasn’t doing: A culturally competent event such as that one.
Two months later, working with United Latino Voices, Contra Costa County held its first testing event aimed specifically at the Latino community at San Pablo City Hall. More than half the people tested that day were Latino, more than one-third were Spanish speakers and more than three-quarters were being tested for the first time.
“Had we reached out earlier to the community,
there would have been more testing earlier and what would that have meant for the case rate?” county Supervisor John Gioia asked. “I don’t know. … But clearly, I feel that piece could have happened earlier.”
By the end of 2020, Latinos made up nearly half of Californians who had died of COVID-19 and 63% of the fatalities among workingage Californians — a statistic that shows the perils of essential work.
“We actually created this differential harm for the Latinx community. Not all of it, but a lot of it,” said Solano County Health Officer Bela Matyas, who argues that a smart containment strategy would have focused from the very start on routes of transmission — specifically safeguarding essential business workplaces and providing advice on living more safely in a crowded home.
Bay Area health officers note that they’ve adapted their approach as the months have worn on, delivering walk-up community testing, implementing fines and stricter workplace protections and working more closely with trusted local groups.
But as vaccines roll out, Latinos are again suffering disproportionately. Among Bay Area residents who had received at least one shot by early March, Latinos accounted for 12% while White residents made up 40% of the total.
“We haven’t been able to close the disparities,” Alameda County’s Moss said. “We have done quite a bit. We have focused our efforts on (East Oakland) and various Latinx communities. But I acknowledge that we are still seeing the same patterns.”