Coronavirus
Special Report: As cases surge, California struggles to slow COVID-19 in Latino communities
Gov. Gavin Newsom calls them the unsung heroes of the California economy in dangerous times. They are the workers, many of them Latino, who can’t afford to shelter in place. They harvest crops, work shoulder to shoulder in factories, prep food in restaurant kitchens and put roofs on houses.
Yet until recently, few local public health officers and experts in California focused on another fact about that group: Latinos of working age are getting sick and dying from the coronavirus in disproportionately high numbers.
Now, the alarm bell has sounded. After virus testing sites branched out to more diverse communities in recent weeks, the grim severity of the situation is clear.
“We have failed our under-served communities,” said David Lubarsky, chief executive officer for UC Davis Health, speaking of the overall response to date to the pandemic. UC Davis partnered with Sacramento County and community groups such as La Familia on recent testing in more neighborhoods of color that helped highlight the issue.
As California scrambles to respond, there’s the question of whether officials should have noticed the surge in cases among Latinos sooner and acted more assertively. But there’s a more pressing issue now.
Can the state and its disparate counties muster the data, strategies and community connections to take the fast and focused steps needed to identify and snuff out COVID-19 clusters in under-served communities?
The governor led off his daily video press briefing Thursday by acknowledging the problem.
“The most impacted community in the state of California is the Latinx community,” Newsom told The Sacramento Bee in a private interview. “These are the heroes of the front lines, the essential workers that we relied on at the beginning of this pandemic to keep us fed and to take care of our most acute needs.”
“We could not afford to neglect 39 percent of our population,” he said.
His office has deployed Spanish-language public service announcements, billboards, TV and radio ads, and social media outreach. Newsom has conducted interviews on Spanish-media news outlets. The state’s emergency preparedness campaign, Listos California, is connecting diverse and vulnerable populations to COVID-19 resources, including in areas where there are large farm worker populations.
“We’ve been trying to think proactively about messaging that is really important for families, and especially the immigrant community,” said Maricela Rodriguez, director of civic engagement and strategic partnerships for the governor’s office.
The governor’s office anticipates spending $1.7 million in the next two-plus weeks on outreach through Spanish-language TV and radio. Newsom showed a Spanish-language video at his Thursday press conference, with what has become the current core message in the fight against the virus that has now afflicted roughly 250,000 people in California and killed more than 6,200.
“A little piece of cloth shows that you care about others,” the ad says. “Please wear a mask.”
‘They don’t care about us’
The Gomez and Tinoco family of McFarland, a farming town in Kern County, tried to hunker down when the virus hit California. But six of them, two parents and four children, ended up getting COVID, with varying degrees of illness.
It started with Eder Gomez, 34, who rode each day an hour to work at an almond orchard in a van that holds up to 16 workers. Their supervisor drove. They wear bandanas in the fields, but took them off in the van. Gomez and five other members of the crew, including the supervisor, have now tested positive. His wife, Ana Tinoco, fell severely ill and tested positive, followed by most of their children.
“This virus, it’s a monster,” Tinoco said, speaking to The Bee in Spanish. “This disease is so ugly, and we don’t all get it the same.”
“We’re the ones who have to go out to work,” Tinoco added. “A lot of people in McFarland are getting infected like this.”
Gomez was well enough to go back to work last week. At his wife’s insistence, he’s driving alone in the family car.
In the secluded Kings County town of Avenal, 52-year-old Rosa Barajas, a $12-an-hour factory line worker at an onion processing plant, was worried about getting sick, but couldn’t afford to take days off.
She said her employer wouldn’t provide workers with masks or gloves. She worked eight-plus hours a day standing next to a dozen coworkers in cramped quarters. Coworkers began getting sick. Then the mother of two started to feel unbearably tired. In a matter of days, she became congested and felt bone-chilling body aches.
“I spent three days without sleep, my fever went up and I lost all of my appetite,” she said in Spanish.
Last week, a coworker died. Barajas, who is diabetic and has high blood pressure, was terrified that she would die., too.
“Everything started feeling worse and I couldn’t even breathe,” she said. “I thought I was getting better, then it would start all over again. I prayed to God to take me because I felt like I couldn’t go through with it anymore.”
She believes she is recovering, but Barajas has come away with a sad realization about her workplace: “They don’t care about us.”
How did the message get buried?
State officials didn’t exactly miss the early warnings about surging cases in the Latino community. Some saw it coming in late April. The Newsom administration put up a COVID-19 website in Spanish two weeks into that month.
Newsom also provided disaster relief assistance to undocumented workers impacted by the pandemic. About $75 million of the taxpayer-funded aid is planned to help an estimated 150,000 undocumented Californians. An additional $50 million will be raised through philanthropic efforts.
Public health experts have long known of health disparities in the Latino community such as increased rates of chronic diseases, including diabetes. Coupled with obstacles in accessing healthcare and other socioeconomic factors — such as a high percentage of multi-generational households — it was clear Latino residents would be more vulnerable to the coronavirus.
But, in the early weeks of the outbreak, Latino death rates had not yet reached the peak, and state and local officials had their hands full with what was the biggest coronavirus issue — deadly outbreaks hitting nursing homes and assisted care living facilities.
In Sacramento County, health officer Dr. Olivia Kasirye and her small staff initially used many of the county’s limited coronavirus testing kits in those facilities and focused their meager resources on working with those facilities to limit the spread.
In April and May, as the state, counties and healthcare entities such as UC Davis Health began bringing resources to what had been “test deserts” — typically low-income and nonwhite areas — they ran into a new surprise: Not only were Latinos infected at higher rates than the general population, they were testing positive in younger age groups.
“It kind of hit everybody like, ‘Oh my god, why is this hitting Latinos more?’” said Stanislaus County health educator Kamlesh Kaur. Although officials had a general sense that the spring agriculture season would bring more cases, the big jump among younger Latinos was “not something anybody predicted or saw coming.”
Leticia Berber, a health educator with the Fresno County Health Department, said it would be wrong to suggest that the county made no targeted effort to reach out to Latinos in the county.
Her agency sent mailers and regularly updated its website in multiple languages, including Spanish, Punjabi and Hmong. It put up billboards and is now partnering with a California State University, Fresno professor to form a task force to target hard-to-reach migrant populations.
“I believe we’re doing a good job,” she said. “This is a new situation that we’re in, a new virus. But we’re getting to know our community better, and we’re getting to know our community’s needs.”
Getting the word out
Still, disparities in access to information plagued the state’s early response to the pandemic.
Yamilet Valladolid, a public health administrator based in Modesto, described confusion in Stanislaus and San Joaquin counties amid an over-reliance on word of mouth.
Absent solid government outreach, “There was a lot of stress, there was a lot of fear, and instead (Latinos) were relying on misinformation from social media.”
Gloria Magaña, a 38-year-old Mexican-American from Modesto, knows how dangerous those misconceptions can be.
She ruefully acknowledges that she didn’t take the pandemic as seriously as she should have. She joked with her boyfriend about their ability to dodge the disease, and even took a 200-mile road trip to Pismo Beach – a popular tourist spot Central Valley locals flee to in the summer – despite government “stay at home” orders.
Days later, she awoke drenched in sweat and gasping for air. She had COVID-19. It led to pneumonia and a hospital stay. Three weeks later, Magaña still struggles to talk between breaths. It’s the worst illness she’s had “by far.”
“I didn’t take it as seriously as I should have,” she said.
Magaña, the youngest of 15 siblings, said many in her family still refuse to wear masks. They doubt the coronavirus is anything more than a cold or flu. Some, she says, cite social media rumors that the virus is a hoax.
“They think it’s like the government is trying to control you,” she said. She pleaded with one sister to wear a mask, but her sister refuses. It’s left Magaña not only sick, but frustrated.
“I’m struggling to breathe and she’s still like, ‘No, I’m not going to wear a mask,’” Magaña said. “But there’s a lot of people in the Latino community that are still like that.”
Valladolid, like many community advocates, has tried to combat the conspiracy theories. She created a Facebook group in Spanish called the “Espanol Informes de Coronavirus Stanislaus/Merced/San Joaquin,” and includes updated public health orders, testing site locations and information about resources on financial and housing assistance. The page had more than 1,500 members as of Thursday.
But while technology is a tool, it doesn’t reach everyone equally.
“There is a digital divide,” said Mark Hugo Lopez of the Pew Research Center. “The digital divide does exist when you include immigrants and Spanish speakers, because they are less likely to be accessing the internet.”
Even when the message reaches people, State Sen. Anna Caballero, D-Salinas said, “the instructions to the public have been really confusing, which is why I was getting phone calls from farm workers saying, ‘What are we supposed to do to keep ourselves and our families safe?’”
Caballero said a recent Spanish town hall meeting about COVID-19 in her district was translated to Mixtec, an indigenous language spoken in Mexico.
“They need information just like everyone else,” Caballero said.
California counties in crisis mode
A Bee review found notably ramped up efforts in recent weeks among many California county officials to reach Latino and other communities with more information, more testing and more assistance.
Stanislaus County — where Latinos make up less than half the population but more than 70 percent of COVID-19 cases — started aggressively distributing masks to farm workers two weeks ago with the help of community organizations and local churches. The county also recently moved one testing site to west Modesto, which has one of the highest concentrations of Latino residents in the area, and another to west Turlock.
And, county health educator Kaur said, officials are trying to get the word to families that when the breadwinner is sick, he or she should tap into county and community social and economic services like free food delivery, rather than attempt to forge ahead by going to work.
“They don’t realize there are resources to help them stay home, they will keep shopping and working,” Kaur said. “That’s one of the gaps we’re recognizing.”
In Sacramento County, Sacramento City Councilman Eric Guerra, La Familia and other community organizations have launched their own mask drive to supplement a food distribution program.
Guerra, whose parents brought him to the United States when he was 4 years old as an undocumented immigrant, has been critical of the lack of early multi-language outreach programs.
The current “crisis” in the Latino community is, he said, a potential harbinger. “It could quickly be any other (ethnic) community if we don’t get the right information out.”
Guerra got Sacramento Mayor Darrell Steinberg, county health chief Dr. Peter Beilenson, La Familia director Rachel Rios and other Latinx leaders together last week for a bilingual Facebook Live broadcast to the community about the importance of a socially distant, mask-wearing Fourth of July.
The Mexico Consulate in Sacramento sponsors a popular daily testing site.
Sacramento County officials are hiring Spanish-speaking “virus contact tracers,” and this month will launch a virus response “navigator” program made up of people from various communities who can act as liaisons between county health officials and small businesses to help them and their employees follow safety guidelines.
During Guerra’s Facebook event on Thursday, though, La Familia director Rios told county health chief Beilenson he needs to involve Latino groups more in assembling the navigator program.
“That should be something we should be working together in conjunction,” she told him. “We need to be at that table with you.”
Communities need ‘boots on the ground’
Santa Maria Councilwoman Gloria Soto is worried. A recent outbreak at a dorm-style housing facility for temporary farm workers in nearby Ventura County has left at least 176 residents and staff members infected with the coronavirus.
“It’s low-wage earners who are picking our crops who are being treated as if they’re disposable,” Soto said. “That’s what it feels like.”
Soto fears it’s only a matter of time before a similar outbreak occurs in Santa Maria, a city in Santa Barbara County of mostly Latino residents already hard hit by the coronavirus. She sounded an early warning in March about the likely impact to farm and factory workers, but she feels she is still struggling to get her county officials to make a concerted effort in her city.
“We need to have boots on the ground, visiting restaurants and stores, going out to the fields making sure social distancing is happening,” Soto said.
But when counties do make a push into diverse communities with higher positive rates, they will need to be strategic and informed, given their still-limited resources, a leader in healthcare equity says.
Dr. Sergio Aguilar-Gaxiola is founding director of the UC Davis Center for Reducing Health Disparities. He’s been watching the pandemic infection and death data, as well as the state’s response.
He says counties need to double down on contact tracers, the county health workers who contact people that have tested positive, to find out who they have associated with lately, then contact those people to warn them. That allows “pinpoint accuracy” and early identification of where COVID clusters are forming.
“Unless we do a better job on case identification and contact tracing, we might see even worse statistics,” Aguilar-Gaxiola said.
In some corners of the state, though, the push to get the word out appears to be working.
Janeth Garcia, 26, of midtown Sacramento, has known for months what to do to stay healthy. She works from home, steers clear of restaurants and bars when they are open, wears a mask and washes her hands diligently.
Garcia’s job is on the front lines of efforts to improve the health of the Latino community, with a focus on tobacco health risks. It was a hard task, however, to persuade her parents, who live in Long Beach and are from Mexico, that the pandemic could land at anyone’s front door.
Then, when the Univision television station began reporting about COVID-19’s high rates in Latino communities, her family listened, to Garcia’s relief.
Now, her mother sends her masks in the mail.
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