County of San Diego's Discriminatory COVID-19 Practices Are Hurting Latinos
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There are three groups of people who have responded to the COVID-19 pandemic in different ways. First, there are those who choose to hunker down and make all attempts to avoid even minimal interactions. Second, there are those who choose to not maintain social distancing and, therefore, are exposing themselves and others to becoming infected with COVID-19, either because they feel the risks of social isolation outweigh the risks from COVID-19 or they simply refuse to follow public health directives. Third, there are those who don’t have a choice, the essential workers who have bravely risked their own health so that the rest of us can have some semblance of normalcy.
Due to my respiratory issues with asthma, having my 87-year-old father at home and generally because I believe the scientific community, I am a part of the first group that has rarely left home since school went virtual for my kids in March. Our position of privilege has allowed my wife and I to work from home where all we have had to do is have more patience as parents, learn a few new recipes, and make some minor modifications to our lifestyle.
However, last week I realized my “hunker down” mentality made me unaware of a devastating reality happening around me. COVID-19 has been disproportionately disastrous to Latinos in San Diego. Actually, things are getting worse for Latinos and there is no strategy to address the biggest disparity in recent San Diego history.
It is time for leaders in the San Diego Latino community to speak up, ask for accountability and demand immediate action from the County of San Diego and the State of California where the numbers are as bad if not worse for Latinos. Underlying discriminatory practices of San Diego like lack of access to healthcare, social economic factors and cultural incompetence have been claimed for decades but are now being unmasked with facts and hard data. As of Aug. 2, there were a total of 323 contact tracers with 109 who speak Spanish. The number does not include "promotoras," those working through SDSU and South Bay Community Services.
In San Diego County, Latinos represent only 32 percent of the population, however, they are 62 percent of COVID-19 cases. Compare that with Whites who are 45 percent of the population but only account for 24 percent of cases. Sadly, more Latinos have died in San Diego due to COVID-19 than any other ethnicity. The virus does not discriminate, but it is clear that Latinos have been discriminated against.
Those responsible should not be surprised by the alarming numbers. While my attention to this issue has been more recent, months of data indicate a clear and simple trend. Things were becoming predictably worse for Latinos in San Diego and in California. That is why leaders like National City Mayor Alejandra Sotelo-Solis, Chula Vista Mayor Mary Casillas Salas, Imperial Beach Mayor Serge Dedina and San Diego Councilwoman Vivian Moreno stood together months ago requesting that the County of San Diego take action to address the disparities in the majority Latino communities they represent. As an outsider, it was shocking to see the leaders of these communities begging the County of San Diego to do their job.
And how did the County of San Diego respond? It failed.
As months progressed, testing failed. The opportunity for testing was not made available to majority Latino communities. Facilities and efforts to test did not increase in majority Latino communities as significantly as the number of cases did. In circumstances when someone in a household tested positive for COVID-19, other family members were not tested unless severe symptoms were reported. Federal statistics describe Latino households as larger in size than non-Latino households. This can only lead us to conclude that the number of Latinos with COVID-19 is likely much higher than the current reported cases. It is not illogical to believe that someone without a formal diagnosis could have had the virus and ventured out into the community further exposing others.
In an effort to try and get a handle on the pandemic, epidemiologists and public health experts called for contact tracing. This is the most effective proven way to prevent the spread of infectious disease. The County of San Diego and the state made major announcements around the significance of deploying resources to initiate a contact tracing program.
Contact tracing failed. As contact tracing began, we saw the number of COVID-19 cases in July skyrocket in San Diego and in California, and the proportion of Latino cases grew at faster rates. Central to the tracing program were case investigators and contract tracers, but data made available last week shows that the number of both investigators and tracers of Latino origin are 18 percent and 39 percent respectively, significantly disproportionate to the Latino COVID-19 reality.
Long-standing research demonstrates that best practices in public health include culturally competent and appropriate methods. Lack of ethnic representation in the contact tracing program in San Diego, without even mentioning language barriers which only exacerbate disparities, is a sure way to fail at preventing the spread of COVID-19.
While this pandemic will not be eliminated soon for a variety of factors, we know this will end. But, the inequity and discriminatory approach to the health and well-being of Latinos, Blacks, and other minorities in San Diego and in California must be addressed now. Future treatments, vaccines and herd immunity that doctors describe as necessary to end this pandemic or the next one depend on everyone, regardless of race or ethnicity. That means that all of us must get off the sidelines and demand public health policy and action proportionate with the massive disparity.