LOS ANGELES — Twice a week, Ismelda Reyes leaves the home she shares with her husband, adult daughter and 93-year-old mother to clean rooms at a tony Santa Monica hotel across the city.
She takes her own mask to work, just one for the whole day, and does not receive a temperature check or any other kind of health screening. Reyes, an immigrant from El Salvador, said she often comes in close contact with co-workers in elevators or inside the laundry room.
In the lobby and in hallways, she sometimes encounters guests who are not wearing masks even as she sweats through her own.
"I am scared because of what you hear on the news with so many people dying," she said in Spanish. "There is always that concern that I can get it at work."
With its sandy beaches and year-round sunshine, Los Angeles conjures up images of celebrities and tanned residents comfortably scattered in a sprawl of roomy single-family homes.
But the popular images of L.A. belie the reality for millions of residents, many of whom are considered essential and live in dense or multigenerational housing at a time when public health officials recommend working from home and maintaining social distance.
On Saturday, Los Angeles became the first county in the nation to surpass 1 million confirmed Covid-19 cases. Public health officials also confirmed at least one case of the new U.K. variant of the coronavirus in a man who spent time in L.A. and is now quarantining in Oregon.
Los Angeles County has now recorded at least 1,003,923 coronavirus infections and 13,741 deaths, public health officials said. California has more than 2.9 million confirmed cases and roughly 33,000 deaths, according to NBC News counts.
In a county of 10 million residents, the coronavirus pandemic has had a disproportionate effect on Latinos, who comprise 40 percent of the state's population but 55 percent of all confirmed Covid-19 cases and 46.5 percent of all deaths, according to state public health data.
Death rates among Latinos in L.A. are twice as high as in the rest of the population, according to Los Angeles County public health officials. And Latinos, who are about half of all county residents, are hospitalized three times more often than white people.
"As cases surge, it's very clear and very alarming that certain groups are, once again, bearing the greater burden of illness than others," the county's public health director, Dr. Barbara Ferrer, said Wednesday during her daily briefing. "The surge shows what happens as the gaps widen between the people living in the highest-resource areas and those in the lowest-resource areas."
Despite a regional stay-at-home order, Reyes must report to work every week to maintain health insurance and pay her mortgage, she said. She worries about infecting her mother and what could happen to the family if she or her husband got too sick to work.
"I've lived here 34 years. I've given more to this country than to my home country," she said. "More than anything, I want [local] leaders to see the plight we're in."
Kurt Petersen, co-president of Unite Here Local 11, a union that represents hotel and food service workers in Los Angeles, said it is "a false choice" for people like Reyes, who is a member of the union.
"They're caught in this horrible decision of 'Do I go to work and risk infection, or do I stay home and risk eviction?'" he said.
Of the union's roughly 30,000 members, about 70 percent are Latino, Petersen said. Since December, Unite Here has lost one member a week to Covid-19 on average. All of those who died were Latino, he said, which closely mirrors what the county is experiencing overall during the deadly winter surge.
Since early November, when the surge started, the death rate among Latino residents in L.A. increased by more than 800 percent, from 3.5 deaths per 100,000 residents a day to 28 deaths per 100,000 residents a day, according to public health officials. Over the same period, the death rate among Black residents increased from less than 1 per 100,000 people a day to more than 15 per 100,000 people.
Deaths also have increased among Asian residents, from 0.5 deaths per 100,000 people in early November to 12 deaths per 100,000 people. White residents are now at 10 deaths per 100,000 people, according to county public health data.
"You have the combination of poverty and density, and that leads to rapid spread of the virus," said Dr. Anne Rimoin, an infectious disease expert and professor of epidemiology at UCLA. "It's hard to stop the momentum once it's started."
The problem is particularly acute in Latino and Black neighborhoods, where residents face the highest burden of sheltering in place during the pandemic. According to a study by the Latino Policy & Politics Initiative at UCLA, 40 percent of Black and Latino residents live in neighborhoods with high density, lack of green space and few grocery stores.
The environmental disparities also extend to workplace inequities. In the L.A. region, more than 50 percent of essential workers are Latino, according to the Los Angeles Economic Development Corporation. They work in low-paying jobs that do not always include health care coverage or paid sick leave.
"People go to work not to be heroes but because they need money to exist," said Sonja Diaz, director of the Latino Policy & Politics Initiative. "They're more likely to live in communities that are not resilient to overcoming or surviving a pandemic."
In a county where researchers estimate that 1 in 3 residents has been infected with the coronavirus since the beginning of the pandemic, workplace dangers remain high. Public health officials are investigating more than 500 workplace outbreaks, some of them at highly frequented businesses such as Target, Whole Foods and Costco, the county announced Wednesday.
Because infection rates remain rampant, health officials this week recommended that essential workers and people who run errands wear masks inside their own homes.
"It would be better if people got enough money to stay in their home, pay their rent and feel safe," Petersen said. "If we gave people the ability to stay home, we could get through this spike."
William, a construction foreman in Los Angeles who asked that NBC News not use his last name for fear of retribution, would prefer to follow regional stay-at-home orders, but he continues to report to work daily. He and his wife, who is unemployed, have two teenage daughters and rent to pay.
While William wears a mask to work every day, he often has to enter apartments and houses where people are living. Not all of them wear masks, he said. To keep distance between himself and others, he posts yellow tape to encourage people to stay away, but "they don't care," he said.
Since the start of the pandemic, William has lost three friends to Covid-19. One of his adult sons also contracted the virus and survived. He feels lucky to have avoided getting sick, but he recently learned that one of his co-workers had been exposed, and now his entire team is waiting on test results.
"I would rather stay home," William said. "The problem is that I don't have enough money to keep me at home. I have bills to pay."