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For many immigrant Latino communities in the U.S., fears of jeopardizing legal status, underlying health conditions and long-standing disparities in wealth and health care access complicate efforts to control the pandemic. As NPR's Eric Westervelt reports, one hard-hit neighborhood in California's Marin County illustrates how that's playing out across the nation.
ERIC WESTERVELT, BYLINE: Marin County, just north of San Francisco, is best known as a picturesque gateway to wine country. It's one of the wealthiest counties in America. But the people who scrub the hardwood floors, wash the Teslas and care for the gardens in Mill Valley, Tiburon and San Rafael are being devastated by the coronavirus. Latinos comprise 16% of Marin's population, but they make up 75- to 80% of COVID-19 cases in the county. And many of those testing positive live here in the majority-Latinx Canal neighborhood.
OMAR CARRERA: You know, high-risk, high-poverty essential workers facing multiple challenges that other groups are not.
WESTERVELT: Omar Carrera runs the Canal Alliance, a San Rafael nonprofit that has supported Latinx immigrant communities here for nearly 30 years. The Canal neighborhood is a small, densely populated section of San Rafael packed with multifamily apartment buildings. Carrera says Canal residents were in survival mode well before the pandemic. Then when it hit, he says, the neighborhood was decimated.
CARRERA: Latinos have been the essential workers for this county before COVID-19, during COVID-19. So poverty, inequities, the jobs that they perform, the housing conditions - all of that create the perfect environment for the virus to spread quickly.
WESTERVELT: Overall, about 3% of the county's coronavirus tests are coming back positive. But here in the Canal, the positivity rate is averaging 20% and has spiked as high as 40%, says Dr. Matt Willis, Marin County's health director.
MATT WILLIS: The roots of this outbreak go so far beyond our health care interventions and are really rooted in how we've organized our economy. People who live in the Canal are three times more likely to live in poverty than the rest of Marin County and are 15 times more likely to share a room with two or more other people.
WESTERVELT: Activists in the county are ramping up help, but many say it's not enough. Here and across California, Latinx communities are in crisis from COVID-19. Because many here are undocumented, there's ongoing fear about getting tested and seeking help. Just about everyone in the Canal knows someone who's tested positive. Everyone's afraid they could be next.
Eighteen-year-old Zoila Garcia moved here a year ago from a rural village in Guatemala. She works in a bodega in the Canal.
ZOILA GARCIA: (Through interpreter) I live with my brother and others. There are five of us. If someone's positive, it's hard to isolate and keep distance with several people in the house. And it's difficult to stop working because we have bills to pay, and my brother and I have to send money back to our family in Guatemala. If we get sick, it would be catastrophic.
WESTERVELT: As in many low-income neighborhoods during the pandemic, officials here say they've been hampered by a shortage of testing supplies, trained contact tracing staff, support and the absence of a coherent national strategy from Washington. Testing at first was undermined because the company doing them didn't offer online registration in Spanish, and they didn't have enough staff who spoke the language. Then, like most everywhere, test results were taking up to two weeks, making the results almost useless. And then there's contact tracing. That's only now ramping up in the Canal, six months into the pandemic.
Sarah Ryan, who lives in the neighborhood, is a contact investigator with the Canal Alliance.
SARAH RYAN: You have to play part social worker, part therapist, you know, and still kind of find a way to steer them through to answer the medical questions. You know, I had a poor woman who was crying on the phone to me for, like, an hour because she had lost her father. And she kept telling me life isn't fair, life isn't fair - 'cause now she's positive. And we're trying to tell her not to go to work. It goes very deep.
WESTERVELT: The county is working closely with the Canal Alliance. New support here includes new efforts at antibody testing and 20 hotel rooms, free to people in the Canal who've tested positive and need to isolate - 20 rooms for hundreds of positive cases. Early on, California launched a multimillion-dollar effort to add testing in so-called testing deserts - mostly low-income and immigrant communities such as the Canal. That helped, but it wasn't enough. When counties asked the state for more help, the requests were almost always denied - not enough money or tracers or hotel rooms.
WILLIS: We need a lot more hotel rooms. There's no question. The question is, how does that happen?
WESTERVELT: Dr. Matt Willis says the county is doing the best it can with finite resources.
WILLIS: Yes, it is late, and yes, these problems should have been solved months ago. But we are inheriting a system that is categorically unequipped to manage a problem of this scale and complexity. I'll take - you know, the county will take what it needs to in terms of culpability and blame around that. But I think that ultimately, what we really need is a robust national plan. We're left scrambling at the local level to adapt to these problems.
WESTERVELT: The Canal Alliance's Carrera says Marin's sharp disparities are now coming home to roost in a stark and ugly way.
CARRERA: We have a county that is one of the wealthiest counties in the country, and yet you have these inequities. They existed for a long time. And that is the lack of policies. We need resources, but also, we need policies to support the people who need them most.
WESTERVELT: Topping Carrera's wish list - new debates and policies on housing, health, transportation and education equity. The virus, he says, shows that when you leave any community neglected, we all suffer.
Eric Westervelt, NPR News, San Rafael, Calif.
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