Los Angeles Times - 03.04.2020

(C. Jardin) #1


areas threatens to give resi-
dents there the false and po-
tentially deadly impression
that they have less to fear
from the pathogen, and
hence little reason to heed
physical distancing orders.
“There’s a lot of misinfor-
mation and indifference in
the black community,” said
Sadio Woods, an Inglewood
resident who sought unsuc-
cessfully to be tested for
COVID-19, only to be told lat-
er by a doctor that she prob-
ably had the disease but re-
covered. “There’s this narra-
tive it’s a rich white man’s
disease. They travel. They
are the ones who are spread-
ing this disease all around to
each other.”
Nationally, cities with
large black and Latino
populations such as Chi-
cago, New Orleans and
New York have become hot
spots in the spread of the
Worried that race and in-
come are playing a role in
these outbreaks, California
Sen. Kamala Harris and a
group of fellow Democratic
lawmakers have urged
health officials to record
comprehensive demo-
graphic data on those tested
and treated for the disease
—information that is now al-
most nonexistent.
“This lack of information
will exacerbate existing
health disparities and result
in the loss of lives in vulnera-
ble communities,” the law-
makers wrote in a letterto
Health and Human Services
Secretary Alex Azar.
In Los Angeles County,
more than 21,000 people
have been tested for the co-
ronavirus, and roughly 12%
have tested positive. Howev-
er, the county does not track
the location of all negative
tests, so it is impossible to
determine whether tests are
being given equally across
the county.
On Wednesday, county
health officials said they
were “aware of geographic
disparities” in testing and
are now asking labs to report
negative results along with
positive results, “so we
have a full picture of what
is happening.”
“Our hope is that we’re
paying attention to some of
the areas where in fact we
know there has been less
testing,” said Barbara Fer-
rer, director of the L.A.
County Department of Pub-
lic Health.
Alack of accurate and
readily available test kits
has hampered the response
to COVID-19 since the first
cases appeared in the
United States, making it all
but impossible for local offi-
cials to track and slow the
outbreak. Ferrer said it re-
mains difficult for most
symptomatic residents to
get tested for COVID-19.
“You still need a provider
to write an order for the
most part, and I think some
people in some communities
may have easier access to a
provider that is willing to
just write that lab order than
others,” Ferrer said. “So I do
think there is an issue still

about who is getting tested
and who is not getting
Wealth, she said, could
play a role in both the spread
and detection of disease, al-
though it was unclear to
what extent.

A vacationing virus
In the weeks before the
novel coronavirus hit the
county, some residents of
Brentwood and West Holly-
wood were infected while
traveling in Europe and
brought the virus home, cre-
ating a “cluster effect,” Fer-
rer said. “I do know with cer-
tainty that in the beginning
we had a lot of travel-related
positives, and that those
tended to be more people
who were traveling for vaca-
tion, which would imply that
they’re wealthier.”
The Times also reported
last month that “concierge”
doctors who cater to rich
people and celebrities have
been selling testing kits to
patients and their families.
The doctors are based in
Santa Monica and Beverly
Hills, wealthy areas that
rank high in the county for
infection rates.
Ferrer said it’s too early
to know if these types of ex-
clusive medical services
have had an effect on the
confirmed case totals, and
she stressed that people are
transmitting the virus in ev-
ery community.
When comparing com-
munities, county health offi-
cials emphasized the impor-
tance of looking at the rate of
cases per capita, rather than
the total number of cases.
They began publicly report-
ing those rates this week.
“The place that had fewer
cases might actually have a

higher burden of disease
relative to the number of
people in that community,”
Ferrer said.
For example, the county
health department has re-
ported that the wealthy en-
clave of Beverly Crest has re-
corded 22 total infections for
a rate of 177 per 100,000 peo-
ple, compared with the
larger working-class neigh-
borhood of Pacoima that
has a rate of fewer than 10 per
Nickie Miner, a longtime
resident of Beverly Crest,
bristles at the idea that resi-
dents of wealthier areas
have easier access to testing
and said hillside communi-
ties might actually be safer
because of their tucked-
away locations. Her neigh-
bors, she said, are following
city guidelines that urge
residents to stay home and
avoid nonessential travel.
“It’s somehow targeting
the ‘elite,’ as people like to
say, for having better health-
care whether they do or not,”
said Miner, vice president of
the Bel-Air/Beverly Crest
Neighborhood Council. “I
think the whole situation is
universal and we’re all in this
together. It really doesn’t
matter if you isolate a
wealthy segment or a work-
ing-class segment.”
About 17 miles southeast
in Bell Gardens, a 95% Lat-
ino city with one of the low-
est rates of reported co-
ronavirus cases in the
county, Mayor Alejandra
Cortez said she suspects the
disparity is a result of a lack
of access to healthcare and
“the fact that not a lot of peo-
ple have been tested.”
“People have been turned
away from testing until they
develop further symptoms,”

Cortez said. “I think that
contributes to the low num-
ber of cases.”
In a letter last week,
Cortez and leaders from 15
neighboring communities in
southeast L.A. County
urged the county to set up
drive-through testing sites
in the area, citing its large
percentage of low-income
Latino families and high
population densities “which
in some cities exceed that of
New York City.”
Cortez said reducing bar-
riers to testing is especially
important in communities
like hers with large numbers
of people whose lack of legal
immigration status and
health insurance can be a
deterrent to seeking care.
“Making testing more ac-
cessible and less intimidat-
ing for our community, I
think that’s one way to have
people come out,” she said.
Area hospitals have already
reported a lot of cases, she
added, “so I know people are
scared to even go to these
hospitals to be tested, be-
cause they think they’re go-
ing to get it just from enter-
ing the facility.”
Awoman who answered
the phone at a local clinic,
the Bell Gardens Family
Medical Center, said the fa-
cility isn’t offering COVID-
testing, though people are
calling to request it. She
said workers there have
been told to send those peo-
ple to county hospitals,
and though they are trying
to get test kits, they’re not
sure how or when that will
There is variation in the
data, as some middle-class
communities also have
higher infection rates. West
Hollywood currently has the
second-highest rate in the
county at 179 cases per
100,000 residents, but its me-
dian income is about aver-
age for the county.
Given the city’s long-run-
ning initiatives regarding
testing for sexually trans-
mitted diseases, residents in
West Hollywood are quicker
to seek testing for COVID-19,
city spokeswoman Lisa Bel-
santi said.
“We certainly have a
population that was dispro-
portionately affected by
HIV back in the early days,
and still HIV has not been
eradicated,” she said. “You
could make that correlation
that people with preexisting
conditions, people who are
HIV-positive, might seek out
early testing if they had

Social inequality
Though testing capacity
has improved since the co-
ronavirus outbreak began, it
remains spotty and incom-
plete, with California lag-
ging far behind New York in
the number of people tested
despite having about double
the population.
Some point to the geo-
graphic divide in confirmed
cases as evidence that our
understanding of the virus’
spread is twisted by social
Victor Cuevas, an urban
planner from Mount Wash-

ington who has created his
own county coronavirus
maps, said he is concerned
that insufficient testing in
lower-income Latino com-
munities is already having a
dangerous effect. “I’m telling
my parents who live in the
northeast Valley to stay
home, but they have neigh-
bors not taking it seriously,
saying, ‘We’re OK, there’s no
cases here in Pacoima,’ ”
Cuevas said.
Ferrer said that, because
of the lack of testing, it would
be a “really, really erroneous
assumption” to think that
the number of cases re-
ported in any given commu-
nity is reflective of how many
it actually has.
“There are thousands of
people who are positive for
COVID-19 that have not
been tested, don’t necessari-
ly know that they’re positive.
They may have mild illness,
they may be fairly asymp-
tomatic,” Ferrer said.
“There are people in every
community that have the
potential to infect others.
And you could be one of
them that’s infecting others.
Or you could be one of them
that’s getting infected.”

Paucity of testing
One of the lowest rates of
confirmed cases is in Po-
mona on L.A. County’s east-
ern edge. Resident Dwight
Pennington said that could
be because the city experi-
enced the county’s first
COVID-19 fatality — that of a
patient who died after being
brought in by ambulance in
full cardiac arrest, Pomona
Valley Hospital Medical
Center announced March 9.
“I think people got the
message because it was in
our own backyard,” said
Pennington, 27. But he
thinks, based on personal
experience, that Pomona’s
low numbers could also be
due to lack of testing.
Pennington, who works
as a wellness advocate for
the Tri-City Mental Health
Center, recently tried to get
tested for COVID-19 because
he had developed a cough,
but he was told by his pri-
mary doctor and three ur-
gent care facilities that they
didn’t have test kits. He said
he would’ve kept calling
more hospitals if there was a
guarantee they’d have the
kits. Though Pennington
said he’s confident he
doesn’t have the virus, he re-
members the experience as
“really nerve-racking.”
Chandra Ford, professor
at the UCLA Fielding School
of Public Health, said there
is probably “testing bias” in
the data because tests
haven’t been equally avail-
able across the county.
As more people get
tested in the coming
months, areas with greater
shares of homeless people
and uninsured workers will
see infection rates rise dis-
proportionately, she said.
“Over the long run, the
population of people who
were missed are likely to be
the most vulnerable mem-
bers of our society,” said
Ford, founding director of
the Center for the Study of

Racism, Social Justice and
Health at UCLA. “I expect
what we will see is the nature
of the epidemic in Southern
California will actually shift,
where these vulnerable
populations will account for
a greater share of the new
University of Minnesota
epidemiologist Ryan Dem-
mer said the available data
on current infections at the
neighborhood level here re-
flect a broader nationwide
trend of healthcare access.
“More affluence is usually
linked to a higher likelihood
of being diagnosed with a
chronic disease if the disease
is actually present,” Dem-
mer said.
Still, focusing on con-
firmed cases can be mislead-
ing in the first place because
so many people have been
unable to get tested, accord-
ing to health experts. A
much better indicator of the
outbreak’s spread, they say,
is the number of deaths and
hospitalizations, including
how many people end up in
intensive care units.
L.A. County Department
of Public Health data show
the number of people who
have died or been hospital-
ized with the virus has risen
in recent days, but those fig-
ures are not broken down
beyond the county level.
Back in Inglewood,
where the rate of infection
has been reported as 32
cases per 100,000 people,
Woods said she has little
faith in the accuracy of re-
cent statistics, “because I
know that people are not be-
ing tested widespread.”
She worries a that long-
standing mistrust of the
healthcare system and other
barriers play a role in the
nonchalance she has seen in
the black community.
Men in her neighborhood
still cluster on the corners.
Teens ride their bikes in
groups. Her neighbors are
still gathering and partying.
Very few people are wearing
gloves or masks. There’s
hardly any social distancing
“I know what happens in
low-income, underserved
communities and communi-
ties of color,” she said. “It
could be like New Orleans.
I’m afraid for South L.A.”
She worries that people’s
behavior will not change un-
til they know somebody who
has tested positive. By then,
it might be too late and dis-
ease could be rampant in the
The coronavirus has al-
ready touched Woods in
more ways than one. On
Tuesday, she spoke of a fam-
ily friend — a black man from
South L.A. — who was fight-
ing for his life after contract-
ing the virus along with doz-
ens of other black people af-
ter going on a ski trip to
Later that day, Woods
learned that the coronavirus
had claimed his life.

Times staff writers Soumya
Karlamangla, Ryan
Menezes, Ben Welsh and
Priscella Vega contributed
to this report.

HEALTH OFFICIALSsaid they were “aware of geographic disparities” in COVID-19 testing across L.A. and would seek a fuller picture of where tests are being given.

Robert GauthierLos Angeles Times

Cases as of Wednesday. Areas shaded gray had 1 to 4 cases.

Los Angeles County Department of Public Health
B e n P o s t o n Los Angeles Times

Disparities in infection rates
Higher rates of reported coronavirus infections in wealthy
areas of L.A. County are probably due to easier access to
testing and international travel before the outbreak,
officials say.

Cases per 100,000 residents

0 50 100 150 200


Brentwood Hollywood






Calabasas Tarzana










A class divide in contagion data

[Disparity,from A1]

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