Density and poverty prevent Los Angeles from fighting the virus

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LOS ANGELES – While most of California has had more places to eat, shop and play this holiday weekend, Los Angeles has not joined the party.

The most populous county in the country does not plan to reopen more widely before the next summer vacation on July 4, as it accounts for a disproportionate share of the state’s coronavirus cases and cannot even meet new standards relaxed states to allow the creation of additional businesses and leisure activities.

Los Angeles County, with a quarter of the state’s approximately 40 million people, accounts for almost half of its COVID-19 cases and more than 55% of the more than 3,600 deaths in the state.

In recent days, trends in death and hospitalization have improved, but on Friday, the White House coronavirus response coordinator named LA as an area where the spread of the virus is a concern. Dr. Deborah Birx asked the Centers for Disease Control and Prevention to help find the source of new cases to prevent future outbreaks.

Los Angeles is among a small number of the 58 counties in California that have not contained the virus enough to reopen more activities and trade or, in the case of several counties in the bay of San Francisco, have chosen to move more slowly.

Density is at the heart of Los Angeles’ problem – in nursing homes that have recorded about half of the deaths in the county and in some of the tightest, poor neighborhoods in the country where Latinos and African-Americans suffer from a disproportionate number of infections and deaths.

Unlike the compact city of New York, which was the epicenter of the country’s coronavirus, Los Angeles and the surrounding county extend into the suburbs and into many single family home communities. This lack of density, the highest in wealthy areas, and the use of cars as the primary means of transportation serve as shields against the virus.

But many large sections of the city center live an opposite reality. Several generations sometimes share an apartment. Essential workers at low wages do not have the luxury of teleworking. Grocery stores and pharmacies are scarce and fewer people with cars mean more to rely on buses, trains, bikes or trips, all of which often cannot be adequately separated from others.

A study released Wednesday by the University of California at Los Angeles found that 40% of blacks and Latinos live in neighborhoods where these living conditions make them more likely to be infected or to spread the virus.

“This only increases the vulnerability of these residents and ethnic enclaves,” said Sonja Diaz, co-author of the report and director of the UCLA Latino Policy & Politics Initiative. “They are the least equipped to deal with this virus, because now they live in neighborhoods where they cannot stay at home and practice physical distance, they are the hardest hit economically and they do not receive rescue and recovery. “

Jesus Ramirez has spent the past two months in a one-bedroom apartment with his parents and brother in south Los Angeles, where the UCLA study has identified 12 of the 15 most at-risk neighborhoods.

Neighbors did not always keep their distance when retrieving mail, and many did not follow the city’s now mandatory mask policy. Unlike some parts of the city where people could go out for exercise, Ramirez did not feel safe going to the nearby Martin Luther King Jr. Park because it was dominated by gang members, prostitutes and the homeless.

Ramirez drove to a gourmet restaurant where he prepared take-out meals for hospice patients. He planned to take a colleague to help the colleague avoid the risk of infection on a bus.

“It is a scary time. I have a lot of anxiety, “said Ramirez, noting that he had a hand sanitizer and that he and his colleague would be wearing masks. “If they get sick, I get sick. We do our part by minimizing our contact with anyone outside the workplace. They are now part of our family, just as we don’t want to make our parents sick. “

Almost half of the deaths in the county occur in other places where people are often in close contact – nursing homes and other facilities that care for the elderly and disabled.

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough, which go away within two to three weeks. But for others, especially the elderly and people with existing health conditions, it can cause more serious illnesses, including pneumonia and death.

Los Angeles has many more nursing homes – 388 – than any other county in the state. San Diego, the second most populous county in the state with about a third of the population of Los Angeles, has about a fifth of the number of nursing homes.

Barbara Ferrer, director of public health for Los Angeles County, who gloomily provides COVID-19 statistics during daily briefings, recently said that death rates by breed and class are “cause for concern”. People living in high poverty areas die four times more than those in low poverty communities.

Per 100,000 people, 18 of those who died were African American, 15.5 Latin American, 12 Asian and 9 white.

It didn’t always look like that. Earlier in the epidemic, when northern California was hit the hardest, cases in Los Angeles began to appear in greater numbers in the wealthiest areas of the city, especially those closer to the coast. . Beverly Hills, Bel Air and Brentwood all had relatively high numbers.

“LA kind of had a distorted picture at the start of who was infected,” said Karin Michels, a professor of epidemiology at UCLA. “The wealthiest people were able to get the test kits. So it seemed like there were more illnesses among the wealthy. “

As testing increased, the concentration of cases seemed to shift to downtown Los Angeles, where some neighborhoods had large populations of immigrants.

Many are self-employed and have no health insurance. Lack of health care means conditions such as diabetes, asthma or heart disease go untreated and make people more vulnerable to the consequences of coronavirus, said Michael Cousineau, professor of preventive medicine at the University from Southern California.

“This is not a new phenomenon,” said Cousineau. “It really just revealed it in a more dramatic way. I think this is probably the most significant impact of COVID-19, given the widening of these disparities. “

In southern Los Angeles, the impact of the home stay order has evolved, said Leslie Cooper Johnson, vice-president of Community Coalition, a non-profit organization.

At first, families asked for help getting Wi-Fi or computers so their kids could take the lessons from a distance. Low-wage workers have lost their jobs or have their hours reduced. Those who had to work were at risk of unintentionally transmitting the virus to family members, but could only be tested initially if they had symptoms or were old.

The region is considered a “food desert” because it lacks supermarkets, although there are many convenience stores selling junk food and liquor stores and smokehouses.

Over time, the needs became more basic: food on the table, help with paying the rent.

The virus, said Johnson, has exposed long-standing inequalities like the lack of health care and healthy food.

“Our community is so badly affected because of the pre-existing conditions of systemic racism,” said Johnson. “We are seeing higher infection rates in black communities due to this underlying condition.”

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