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Marin County residents wait in a line that stretched around the block at Canal Alliance in San Rafael for free COVID-19 testing on July 31. COVID-19 is disproportionately infecting the Hispanic and Latino community in Marin County, many of whom live in multi-family or multi-generational housing due to the high cost of housing in Marin. (Photo by Christina Gray/Catholic San Francisco)
Aug. 10, 2020
Christina Gray and Lorena Rojas
Catholic San Francisco
The unequal impact of COVID-19 on Hispanic and Latino communities has been noted with concern and alarm across the country, but the disparity is especially pronounced in affluent Marin County.
People who identify as Hispanic or Latino account for 16% of the county’s population but more than three-quarters of those testing positive for the virus that causes COVID-19, according to the latest county data. Hispanic and Latino residents also account for more than half of the county’s COVID-19 hospitalizations.
Of the more than 3,000 COVID-19 cases in Marin, nearly two-thirds are in the city of San Rafael, where the low-income Canal neighborhood is home to many Hispanic and Latino families who support the surrounding economy with limited ability to shield from the disease but elevated risk because many jobs are “essential” ones that require physical presence.
Poverty and “structural racism” are at the root of Hispanic and Latino vulnerability to the virus, Dr. Matt Willis, the county’s public health director, said in a June video message.
Hispanic and Latino residents are 10 times more likely to be diagnosed with COVID-19 than other county residents, Dr. Willis said.
“As a white doctor, my best understanding of the experience of structural racism is through the lives of my patients,” he said.
Dr. Willis said the virus is “taking advantage of” such conditions as crowded households, lack of sick pay and health insurance for those in jobs designated essential, lack of access to free testing and quick results, and inability to quarantine after testing positive.
“Due to rent and housing prices in Marin, people of low-income share housing to pool income for rent,” Dr. Willis said. “Living in crowded conditions increases transmission within the household and across generations.”
People with low incomes also need to work every day to make ends meet and are less likely to be able to work from home than salaried workers.
“Most have been out in the work force since the beginning of the shelter in place, with increased exposure while the virus has been circulating,” he said.
Marin County is the most affluent county in California, he said, and has the longest life expectancy.
“It also has some of the greatest disparities with the largest gap in life expectancy between communities,” he said.
San Rafael resident and Salvadoran immigrant Milagro Ramírez-Zavaleta told Catholic San Francisco that she has seen at least 10 acquaintances die from COVID-19 in recent weeks.
“The lack of equity is killing us,” she said about the price of housing in Marin County. “In Marín, there are many millionaires, but if you go to the Canal, there you will find families crowded into the same home.”
Many families of immigrants that live in San Rafael have to rent out bedrooms in their apartments and sleep in the living room of their homes to be able to cover their expenses as well as send money back home to their families where the economic situation is even worse.
Ramírez-Zavaleta said her prayer group at St. Raphael Parish gets calls every day from people in the Canal, some whose entire family is sick with COVID-19. Some die quickly and alone.
That was the case of her neighbor, Graciela, who got the virus and died in a local convalencent center before Ramírez-Zavaleta could arrive to bring food and support.
Marin County is working with the California Department of Public Health, the U.S. Centers for Disease Control and Prevention and regional and community partners to ease the impact of the virus where it is spreading fastest.
Dr. Willis said the county is working to offer temporary income support so people can step away from work if they are infected, hotel rooms so individuals can safety isolate from others, removing barriers to testing, and community-based partners to navigate patients into the support system.
Canal Alliance, a nonprofit organization in San Rafael, is one of those organizations. The agency provides legal services, education and food to immigrants in the Canal but has recently included health services including coronavirus testing, executive director Omar Carrera said.
"People in poor neighborhoods are more exposed to the virus," said Carrera.
Canal Alliance has become a bridge between the Canal community and the Marin Department of Public Health, coordinating free, walk-in COVID-19 testing on Wednesday and Friday from 1-3 p.m.
Canal Alliance is also working with the county to relocate COVID-positive people to hotels to quarantine to reduce family transmission.
Carrera sees a “complicated future” for a Canal community already handicapped by poverty and rising unemployment.
Carrera said another unexpected impact of the coronavirus pandemic has been a decrease in participation in the 2020 Census compared to 10 years ago.
“If these people are not counted they will have less federal funding and the community will need many more resources in the future to recover from the pandemic,” he said
Dr. Willis emphasized in his message that the county’s efforts are a “form of crisis intervention” and are not the “deep reforms we need to build a more equitable society.”