As Many Angelenos Stayed Home, LA County Saw A Spike In Coronavirus Among Latinos. Here's Why
By Elly Yu and Yingjie Wang
As Los Angeles County and the rest of the state started sheltering in place in March, Rina Chavarria, 52, knew she couldn't.
"As Latinos, we have to work," she said in Spanish. "People have to risk their lives to put food on the table. I also support family in my country, so I have to work."
Chavarria, an immigrant from Guatemala, has been helping others put food on the table, too. She works at a meat processing plant, Farmer John, near downtown Los Angeles where she trims pork loin.
Chavarria was afraid of getting the virus. She works in close proximity to her colleagues. Even so, she tried her best to maintain her social distance. But on April 21, she started feeling sick.
"Around noon, I began having chills, lots of chills, and I wanted to be in the sun... and later in the afternoon, I got home, and I started having a fever," she said.
Chavarria went to the doctor the next day. Her test results showed that she had what she feared: COVID-19.
A SPIKE IN INFECTIONS AMONG LA COUNTY LATINOS
Chavarria is far from alone.
As many Angelenos were under stay-at-home orders, disparities in how the virus was affecting people became clear. People of color and in low-income communities were becoming infected at higher rates in L.A. County.
Starting around late April, L.A. County saw an especially big surge in infections among Latinos, according to an LAist analysis of data from the L.A. County Department of Public Health.
Earlier in the pandemic, the infection rate among L.A. County's Latino population was lower than for other racial and ethnic groups. But in late April, that rate surpassed that of other groups and continues to climb, according to county data.
As of last Friday, Latinos were known to make up 51% of the county's known coronavirus cases; they make up 49% of the county's population.
Health experts say part of the late jump in Latino infections may be attributed to better testing -- but not all of it. That's because for people like Rina Chavarria, exposure is hard to avoid.
David Hayes-Bautista, director of the Center for the Study of Latino Health and Culture at UCLA's School of Medicine, projected this kind of spike would happen as those Angelenos who could self-isolate did so, while others -- particularly low-wage workers of color and those living in dense housing -- could not.
"You have these people that were making it possible for the wealthier families to shelter in place," Hayes-Bautista said. "But in doing so, they had to expose themselves to the potential of coronavirus infection."
In California, Latinos are overrepresented in the service, production, construction and maintenance industries. They are the group least likely to be able to work at home, followed by African Americans, according to a May survey from UC Berkeley. White workers are the group most likely to be able to work at home.
Many essential workers, like grocery store workers and farmworkers, weren't immediately given the right protective equipment, Hayes-Bautista said.
Also, among Latinos and in other communities of color, there are risk factors associated with housing: Families living in tight spaces, densely populated neighborhoods, and multi-generational households, where infected people can more easily pass the virus onto their family members.
Hayes-Bautista said he'd also expected to see a delay in the reported infection numbers, as those who lacked health insurance or were otherwise reluctant to seek care fell ill.
"That's basically what we're seeing is that now they're finally entering the data. So they've been exposed, they've developed COVID, finally, they're getting, seeking [medical] attention," Hayes-Bautista said.
He said many working-class Angelenos in essential jobs are less likely to have access to health care, Latinos in particular, and this is a problem as people are exposed.
"Even to this day, Latinos are twice as likely as anybody else not to have health insurance," he said. "So it's no wonder now we're starting to see this surge, although it's been building for a while."
Community health clinics, like St. John's Well Child and Family Centers have been testing an increasing number of patients for COVID-19, and report seeing Latinos disproportionately sickened by the virus.
"A lot of our patients and the community members that we're testing are domestic workers, grocery workers, factory workers, warehouse workers, truck drivers, and they're bearing the brunt of exposure," said Jim Mangia, CEO of St. John's, which has 18 sites around the county.
Mangia said that in April, St. John's clinics were testing about 100 people a day. By the end of April, that number was up to 300. More recently, the centers have been testing about 500 people a day.
Dr. Don Garcia, medical director of Clínica Romero, whose clinics in Pico-Union and Boyle Heights serve a predominantly Latino clientele, said the positive test rate for the patients his clinics are seeing is much higher than the county as whole.
He said 34% of patients at Clinica Romero who have been tested for COVID-19 have tested positive.
Countywide, according to health officials, only about 8% of people tested for coronavirus get a positive test result.
"I believe that the reason for this is that we are seeing...a very vulnerable population in the sense of their immigration status, their food insecurity, their transportation insecurity," Garcia said.
ISOLATING IN A 'PLASTIC BUBBLE'
When Rina Chavarria found out she was infected with the coronavirus, her next focus was on how she could keep her family safe. It would not be easy to do: She lives with her husband, and two kids in a one-bedroom apartment in Huntington Park. They share two bunk beds in one room.
"That's the worst fear anyone can have, to infect your children, and that something worse might happen to them. My son has bronchial problems, and I was afraid he could become infected," Chavarria said.
She bought 25 yards of a clear vinyl plastic, the kind of material used to cover dining tables. She wrapped it around her lower bunk and secured it in place with tape, making sure air couldn't get in easily. She isolated herself there for two weeks.
"These were very sad weeks, behind plastic, without being able to hug or kiss them - this was the hardest part - away from your family, as if you have some kind of pestilence," she said.
Chavarria said her 12-year-old son -- the one she was most worried about -- would ask for "air hugs" while she was inside.
She said thankfully, none of her family members got sick. But she's known people in her community -- like her neighbor just three doors down -- who've gotten the virus too.
Jose Guzman, a coworker at the meat processing plant, also got sick with coronavirus.
Guzman, 61, is still recovering. After getting sick on April 17, he was hospitalized for more than a week. Since being discharged, he's been staying put at home in San Bernardino, where he typically commutes from, and using an oxygen tank.
"I still feel that I cannot catch my breath completely. And I feel weak," he said.
When the pandemic hit, Guzman was worried about going in to work, too. By his estimate, between 80% to 90% of the people at his workplace are Latino.
"Immigrant people and poor people, they have to work. They cannot afford to stay home," he said.
"The worst thing is that if you are infected with the virus, you can go home and infect somebody else in your home, your wife, someone in your house," Guzman said. "It's really bad."
Guzman's wife ended up getting the virus, too. She was not hospitalized, and is recovering.
'MULTIPLE EPIDEMICS OCCURRING SIMULTANEOUSLY'
L.A. County health officials say early on, coronavirus cases were concentrated in more affluent populations, which may have reflected people traveling abroad.
Then, as some mapping projects have illustrated, the brunt of the pandemic began shifting to less affluent neighborhoods.
"The epidemic is not a single epidemic in Los Angeles County, it's really multiple epidemics that are occurring simultaneously," said Paul Simon, chief science officer at the L.A. County Department of Public Health. "It's multiple outbreaks occurring over different timeframes in different populations."
There's also been an outbreak in nursing homes, where the demographics look different than in the general population. But, he said, the epidemic continues to evolve.
While Latinos make up a majority of COVID-19 cases in L.A., as of last Friday, they made up 41% of the county's deaths -- a number that's below their 49% share of the population, but has been steadily rising.
By contrast, some groups have all along been overrepresented in their share of the county's COVID-19 deaths, African Americans and Pacific Islanders in particular, many of whom share similar exposure risks.
Simon said one reason why the overall coronavirus death rate for Latinos may be lower in L.A. county is that Latinos in the county skew on the younger side.
"We know that the risk of mortality or death among someone with infection is very much influenced by age," he said.
This doesn't mean that Latino youths are spared from infection: In fact, in an analysis of statewide data, the rate at which Latino children were contracting the virus was more than three times that of other groups. But so far, there have not been any known deaths among children and teens under 18 in the county.
However, looking at state data broken down by age coupled with race and ethnicity, Latinos ages 18 and over throughout California are overrepresented among those who have died from the coronavirus. L.A. County does not report coronavirus data broken down by age with race and ethnicity, as the state does. But a recent LAist analysis of county data found that for Latinos, the gap between COVID-19 deaths and population share narrows when you count adults only.
OVERALL LOOK AT LA COUNTY NUMBERS:
Here's a look at longer-term trends in the county. To see more visit our California COVID-19 Tracker and choose L.A. County or any other California county that interests you. These numbers are current as of Monday, June 8:
In L.A. County, about half of all COVID-19 deaths have happened in institutional settings, like nursing homes. Simon, with the county health department, said those facilities skew white and Asian, but when looking at coronavirus deaths in the community, Latinos make up the majority.
"In fact, 60% of the deaths that occurred in people outside of skilled nursing facilities, you know, 60% of those deaths were Latino. So they're over-represented," he said.
Simon said there could also be more deaths among Latinos ahead due to the infection spike, since deaths occur about four to six weeks after infections are reported.
He said that while there's now better access to testing in communities around the county, obstacles to testing and medical care remain. Trust is one issue.
"We've been told that some groups don't feel comfortable necessarily going to doctors' offices," he said. "In the Latino community, there may be lots of fear. If someone is an immigrant, and undocumented, they may be fearful about seeking testing. And so that's why I think we have to work with community groups to help build trust, and help people access the services that they need."
BACK TO WORK
For Rina Chavarria, she hopes the worst is now over after recovering from the virus. But she's still worried, because she still has to report to work every day. As with countless other essential workers, she can't work from home.
"Unfortunately, we don't get much support and we have to live off of our work," she said," and our families also live from our work."
After a month of being out sick, Chavarria went back to work at the meat processing plant two weeks ago.