California is among the more than a dozen states that have seen a rise in coronavirus cases as cities continue to reopen amid the pandemic.
Medical professionals like Dr. Don García in Los Angeles are sounding the alarm over one group in particular — the disproportionate number of Latinos who have contracted the disease.
"We can’t let the discrimination of this pandemic continue this way," said García, the medical director of Clínica Romero, which provides health services to underserved communities in the predominantly Latino neighborhoods of Boyle Heights and Pico-Union in Los Angeles County.
The coronavirus has killed at least 2,825 people in Los Angeles County, 41 percent are Latino.
Los Angeles County reported having about 60,000 positive COVID-19 cases June 5. The number rose to about 80,000 cases Friday, many of them Latino men. So far, the county has conducted a total of nearly 870,000 coronavirus tests, according to the Department of Public Health.
Clínica Romero has also seen an increase in cases over the same time period.
On June 5, "our clinic reported 90 positive cases and one death," García said. The number of COVID-19 cases rose to 115 Friday. Most of them are Latinas, he said.
"The positive case rate for the county is 8 percent — we have done 286 tests, our positive case rate is 40 percent. There’s something going on!” he said. "Just reporting the data does not deal with the discrimination our population faces."
Essential workers, greater risk
"Even in early data that was shared, we know that our Latino and Black communities do work in essential workforce positions. That limits their capacity to do telework, to have paid sick leave and so on," Dr. Erika Flores Uribe, director of language access and inclusion at the Los Angeles County Department of Health Services, told NBC News.
García sees this firsthand. Most of Clínica Romero's Latino and immigrant families — including many who lack legal immigration status — are part of the service industry.
"They’re the gardeners, they’re the housekeepers, they’re the ones cleaning dishes, they’re the busboys, they’re doing maintenance at hospitals and nursing facilities. They’re the cashiers, they’re the ones stocking up our stores," he said.
These workers, he explained, are more likely to use public transportation, live in tight spaces or in densely populated areas, where practicing physical distancing can be challenging.
Flores Uribe, who is also an emergency physician at the Los Angeles County + USC Medical Center, one of the largest public hospitals in the country, recalled an instance in which she was taking care of a COVID-19 patient in the emergency room. The man told her he lived in a two-bedroom apartment with eight other people, making it almost impossible to be able to isolate himself at home. In California, the lack of affordable housing gives families few options to avoid crowded conditions.
"The big question that has come up is, how do you take care of yourself when you're living in multigenerational housing?" she said. The patient was placed in a program that "allows us to provide medical quarantine or sheltering" for those who can't isolate themselves at home for 14 days.
As businesses reopen, "they have to show up to work"
Officials said last week that Los Angeles County entered phase 3 of their plan to reopen businesses that were forced to close down to stop the spread of the coronavirus. Over the past month, businesses such as retail stores, restaurants, museums, day camps, gyms and zoos have been able to reopen. Officials have also allowed film productions to resume with social distancing and other precautionary measures in place and have also reopened beaches.
Starting Friday, the county will be reopening additional personal and recreational services to residents including nail and tanning salons, bars and casinos, as well as tattoo and piercing shops.
Government officials and other experts had anticipated a rise in cases as testing capacity increases and stay-at-home orders are lifted to allow more people into public spaces.
But if reopening efforts go wrong or take place too quickly, García said, Latinos are among the vulnerable populations who could be most exposed to new infections because of the nature of their work.
"They have to show up to work because, if not, they could lose their jobs," he said. "They have to go to work and sometimes they don’t want to get tested because if it comes back positive, they have to report it to their employer and be off work for 14 days."
García added that persistent health disparities — many are uninsured or eligible for Medi-Cal, the state's Medicaid program — often make Latinos more vulnerable to the coronavirus, since they're more likely to suffer from pre-existing conditions, such as diabetes and obesity.
On Thursday, California flagged nine counties that are experiencing "elevated disease transmission” rates. All of them are predominantly Latino counties: Fresno, Imperial, Kern, Kings, Riverside, Stanislaus, Tulare, San Joaquin and Los Angeles.
Overall, data from the California Department of Public Health shows that more coronavirus tests are being done in predominantly white counties.
Counties in California should be able to do an average of more than 150 daily coronavirus tests per 100,000 people, according to guidelines from the state's Public Health Department. Thirteen out of California's 58 counties have met or surpassed the state's testing threshold — and 10 of those are predominantly white.
Flores Uribe said that staying healthy includes access to housing, food and basic necessities. "That's why in a lot of our communications, we're supplying them with the 211 number," a free telephone line providing information about access to local community services.
In the meantime, she continues to try to give out the most important message.
"As we reopen, it's going to be really important for us to continue to do those safe practice measures," Flores Uribe said, such as wearing a mask, keeping a 6-foot distance from each other and frequently washing hands. "This will be our new normal for now."