The Brief

Thousands of Ukrainians seeking asylum are trickling into the U.S., displaced by war with Russia. As more Ukrainians enter Los Angeles, testing and treatment for an insidious disease has quietly spooled up, as health workers search for a contagious bacteria that still poses a threat.

“We did TB testing with Afghan refugees, and now we’re doing it with Ukrainians,” said Dr. Julie Higashi, director of L.A. County’s Tuberculosis Control Program.

Tuberculosis may seem like a relic of the past in wealthy countries, yet it still kills more people worldwide than any other infectious disease besides COVID-19 — with about 1.6 million people dying from TB annually.

“It’s the No. 1 infectious disease killer in the world. And a fourth of the world’s population is infected,” Higashi said.

A 'disease of humanity'

The temporary Uniting for Ukraine program, put in place by the Biden administration, allows Ukrainian citizens and their families to live in the U.S. for up to two years. Under the streamlined program, anyone 2 years of age or older must meet vaccination requirements and infectious disease screenings — including a blood test for tuberculosis.

To meet the requirement, Dimitri Loboda went to a county-run health clinic in Van Nuys. The 35-year-old arrived in L.A. from Ukraine a few weeks ago to escape Russian bombs and military enlistment.

“For me, I don’t want [to] kill people,” he said.

In Ukraine, he owned a small delivery company. But when the borders to other European Union countries closed, his business crumbled.

“I have before [the war a] logistical company, but [it’s] not possible now. Is really catastrophic for me,” he said.

Loboda said he doesn’t mind getting his blood drawn and tested. He studied dentistry at university, and though he didn’t pursue it as a career, he said he understands the importance of testing for diseases and getting treatment. He laughed when asked if he knew anyone in Ukraine with tuberculosis.

“No, no. No one I know,” he said.

According to the World Health Organization, Ukraine has the fourth highest incidence of tuberculosis in Europe and one of the highest rates of multi-drug-resistant TB anywhere in the world.

Thousands of Ukrainians need to get tested for TB, but reaching them was a challenge, said Public Health officials.

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But not everyone infected with TB bacteria becomes sick or even knows they have it. Higashi said most of the people who test positive in L.A., whether they be asylum seekers or residents, have latent tuberculosis. That’s where the bacteria lives in the body without making the person sick, and they are not contagious.

But one in 10 develop active tuberculosis, with symptoms people might associate with tuberculosis patients in movies, such as hacking, bloody coughs, wheezing breaths and a pale complexion. They can spread the bacteria by coughing, talking or even laughing.

“It is still a deadly disease. If you look at the percents, it’s 10 times deadlier than COVID,” Higashi said.

For people whose immune systems are weak, especially those with HIV infection, the risk of developing TB disease is much higher than for people with normal immune systems.

The L.A. County Department of Public Health produced fliers in multiple languages to reach Ukrainians.

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“In Los Angeles County, we have high rates of TB here. We report almost the highest number of TB incidents on average per year [in the United States] second only to New York City,” Higashi said.

To explain the high numbers, Higashi pointed to L.A. County’s gigantic population of more than 10 million as well as being an immigration center for people coming to the country.

“We have a lot of people traveling internationally, coming in and out of the country. We have a large population of people experiencing homelessness, a large incarcerated population,” she said.

“It’s a disease of humanity,” Higashi said. “TB is referenced in operas. It’s in the Bible. It’s been with us for thousands of years.”

L.A.’s long TB history

The battle against the deadly bacteria has long shaped Los Angeles. It started in the 1840s, said Tamara Venit-Shelton, a history professor at Claremont McKenna College. While tuberculosis plagued the nation, cities like Los Angeles swelled as health-seekers traveled west to climates that promised to cure.

“Especially after the Transcontinental Railroad connected California to the rest of the country, health tourism became a more reliable source of income for Californians,” she said. ”It didn't take a lot of capital to set up a place that middle- and upper-class tourists could come to rest and recuperate.”

Until the discovery of antibiotics, treatment for TB was limited. Doctors advised patients to stay warm, rest and eat good food.

“In the first half of the 19th century, there really weren't many ways of treating people with tuberculosis or other respiratory ailments. And so one of the really common treatments was travel,” Venit-Shelton said. “The idea that if you left your environment, your urban environment most of all, and went to the countryside, that the fresh air, maybe the journey itself, too, would cure you of your respiratory issues.”

As L.A. swelled with migrants, so did poverty, overcrowding and tuberculosis. Fear of infection was used to justify racist policies from elected California officials, culminating in mass deportations in the 1930s.

“When Mexican Americans and Mexicans were forcibly removed from their homes and sent to tuberculosis wards [they became] a place for immigration officials to come and find them, put them on buses and trains, and send them back to Mexico,” she said.

After World War II, antibiotics became widely available, and wealthy Western countries had the resources to pay for them, and cure and control tuberculosis. Developing countries didn’t, and the inequality remains.

Today, for every one person in the U.S. who has tuberculosis, about 35 people in Ukraine have the disease.

Dr. Julie Higashi, director of L.A. County’s tuberculosis control program called TB "a disease of humanity."

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Public Health offers treatment

 
Now, instead of putting themselves at risk of deportation, asylum seekers who show up for testing are offered help.

“Everybody today is going to get a call with their results,” said Higashi, the county’s TB control program director. “If it’s a negative test they are all done and they can proceed with their health attestation. If it’s a positive result then we will link that person to one of our clinics where they will get a chest X-ray, and then depending on those results they’ll get the appropriate treatment.”

Local health workers took out bus ads and billboards in Ukrainian and Armenian, and spread the word among leaders in those communities to come and get tested.

“It was really hard, trying to figure out how to reach them,” Higashi said. “It’s been really gratifying to us that we put up our shingle, and figured out how to get to the population and we’re seeing them come.”

Gov. Gavin Newsom has signed a bill aimed at protecting children who are abused.

The law, which went into effect this week, is named “Gabriel’s Law,” after Gabriel Fernandez — an 8-year-old boy in Palmdale who died in 2013 after being tortured and abused by his mother and her boyfriend.

“It devastated the community. Still has,” said State Assemblymember Tom Lackey (R-Palmdale), who worked on legislation related to Gabriel’s case for years. “It hasn't gone away, right? It’s something we still acknowledge.”

Since Fernandez’s death, the Antelope Valley has seen a number of high-profile child deaths at the hands of their parents.

The new law requires social workers to make sure a child gets emergency medical care when needed, and it makes it easier to prosecute social workers who knowingly falsify records.

Officials said there had been warning signs about Fernandez’s abuse, but social workers with the L.A. County Department of Children and Family Services failed to follow up on them. The high-profile case prompted internal reforms in the agency.

What happened to Gabriel

Gabriel died in May 2013, after months of abuse from his mother and her boyfriend. He was found with a number of injuries, including a fractured skull, broken ribs and BB pellets lodged in his body. His mother and her boyfriend were both sentenced.

A teacher had reported signs of abuse to the county, but social workers did not remove him from the home. Then they ended the investigation. Prosecutors charged the social workers with child abuse, but the charges were later dismissed.

“He was literally tortured. And there were many, many, many documented events, and there are many encounters that he had with people that lacked follow-up,” Lackey said.

What does the law change?

Before this week, the law said that social workers may authorize care if a child needs immediate emergency care, but did not require it. Gabriel’s law requires a social worker to secure medical care for a child.

“ They call for an ambulance or escort the child to an emergency room— make sure a physician has the opportunity to provide some level of remedy and documentation of the injury,” Lackey said.

It also clarifies the law so that social workers who are guilty of falsifying or destroying public records can be imprisoned or fined.

Why did the law take so long to change?

Lackey’s previous legislative efforts related to Fernandez’s case failed over the years. He introduced at least five different pieces of legislation that failed to advance.

“I'm not even saying that I blame the pushback and the concern, because if you're too aggressive, there's a tendency to accuse people of wrongdoing when they are not guilty of wrongdoing, so we wanted to make sure that the balance was reasonable,” he said.

Lackey terms out this year. “We're trying to do something as a community to not only pay tribute to [Gabriel], but to prevent it from reoccurring,” he said.

A series of community listening sessions will give residents a chance to weigh in on whether streets, monuments and public parks bearing the name of former labor leader César Chávez should be renamed. 

The sessions, scheduled for October and led by the Los Angeles County Chief Executive Office, come after the county launched a survey in June asking the public what mattered most to them in a renaming process.

In March, the Board of Supervisors approved a motion, authored by Supervisors Hilda Solis and Lindsey Horvath, to rename county honors following a New York Times investigation that alleged Chávez sexually assaulted women and girls within the United Farm Workers movement, including fellow labor leader Dolores Huerta.

“The County of Los Angeles has a firm responsibility to ensure any public recognitions reflect our shared values of justice, dignity, and respect,” Solis said in a statement at the time.

Following the investigation, some Eastside residents called for Cesar E. Chavez Avenue to revert to its former name, Brooklyn Avenue, and for murals depicting Chávez’s face to be taken down.

The board also approved a motion by Solis to rename the César Chávez holiday as Farmworkers Day across the county, which will continue to be observed on the last Monday in March instead of Chávez’s birthday on March 31.

How to weigh in

Three in-person community listening sessions will be held in East LA in October. Online registration is encouraged but not required. To register, click here.

Saturday, Oct. 10 – Anthony Quinn Library

Time: 10 a.m. to 12:30 p.m.

Location: 3965 E. Cesar E. Chavez Ave., Los Angeles

Saturday, Oct. 17 – Ruben F. Salazar Park

Time: 10 a.m. to 12:30 p.m.

Location: 3864 Whittier Blvd., Los Angeles

Note: This session will be held in Spanish only 

Saturday, Oct. 24 – East LA Service Center

Time: 10 a.m. to 12:30 p.m.

Location: 133 N. Sunol Dr., Los Angeles

*Spanish-language interpretation will be available

The post LA County wants your input on renaming Cesar E. Chavez Avenue. Join these meetings to weigh in appeared first on LA Local.

Republican State Assemblyman Carl DeMaio is seeking to distance the voter ID measure Californians will see on their November ballot from President Donald Trump’s efforts to restrict voting at the federal level. During a Monday night speech at the Orange County GOP Central Committee meeting, DeMaio said the ballot measure, Proposition 39, is “not the same” as the failed federal SAVE Act, which would have required proof of U.S. citizenship when registering to vote.

Speaking to dozens of O.C. Republican leaders, DeMaio acknowledged Californians’ overwhelming embrace of mail-in voting, calling Prop. 39 a “bipartisan solution that keeps mail ballots, so that voting is convenient, but improves trust and confidence by requiring an ID to vote.”

What would Prop. 39 do?

• Prop. 39 would change California’s constitution to require voters to provide a government-issued ID when they cast a ballot.
• Mail-in voters would have to include the last four digits of that ID on the ballot envelope.
• The measure would also require election officials to use “best efforts,” using government data, to verify that voters on registration rolls are U.S. citizens, and to report annually the percentage verified.

Reaction to the ballot initiative

Supporters note that nationwide polling has shown widespread support for voter ID across political parties. They also say using a voter’s signature on their mail-in ballot to verify identity, as California currently does, delays election results and causes some valid voters to have their ballots rejected.

Opponents of Prop. 39 say the initiative feeds into President Trump’s claims of widespread election fraud, which they say are false. Opponents also say the measure would make voting more burdensome and expensive, while opening up mail voters to potential identity theft.

How Prop. 39 is being pitched to voters

The latest polling on Prop. 39 suggests it could face an uphill battle in November.

Registered Republicans make up only about one-quarter of California’s electorate, which means Prop. 39 will need significant support from Democrats and independent voters to pass.

A recent poll from the Public Policy Institute of California found a sharp partisan divide in interest in Prop. 39, with a majority (52%) of Republican voters saying it was the ballot measure that most interested them compared to just 7% of Democrats and 23% of independent voters.

In an effort to appeal to the state’s liberal majority, DeMaio and his Reform California PAC recently launched an ad campaign aimed at persuading Trump foes that Prop 39 is unrelated to the president’s efforts to curb mail-in voting and implement stringent checks for U.S. citizenship.

“Can you dislike Trump and still vote ‘yes’ on Prop 39 for voter ID?” a voice in the ad asks. “Yes, you can.”

During his speech Monday, DeMaio said Prop. 39 would boost confidence in elections “whether you think voter fraud is a big problem or a small problem.”

In a subsequent interview with LAist, DeMaio said he thinks voter fraud is a problem. “ How much fraud is hard to prove because we're not looking for it; we don't have internal controls,” he said.

Trump has claimed that large numbers of noncitizens are voting. In California, a handful of recent cases have made headlines. But nationwide efforts to find and prosecute noncitizen voters have thus far turned up few culprits.

The Texas example

Julia Gomez, a senior staff attorney with the ACLU of Southern California, which opposes Prop. 39, blamed the decrease in voter confidence on the “chaos” sowed by people including Trump and DeMaio in questioning the integrity of elections with scant evidence of fraud.

“The way we build trust in elections is not by adding more hurdles to voting, which the data shows will disenfranchise voters every election, but by educating voters, by not lying to voters about what is and isn't a problem,” she said.

Gomez pointed to Texas as a cautionary tale about the potential consequences of adding an ID requirement to mail-in voting: After Texas passed a similar requirement in 2021, a large percentage (14%) of mail-in ballots were rejected, according to a study last year from the Brennan Center for Justice at New York University School of Law.

The study found that non-white voters were more likely to have their ballots rejected. Also, many of those voters stopped casting ballots in subsequent elections.