COVID-19 affecting lower-income L.A. County residents at high rates while the more affluent have better access to testing

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The coronavirus is killing and infecting L.A. County’s lower income residents and communities of color at high rates, the county’s public health director Dr. Barbara Ferrer said Wednesday.

Rates of confirmed COVID-19 deaths and cases in L.A. County have been “extremely high” among Native Hawaiians and Pacific Islanders, Ferrer said, adding they’re also higher among African Americans and Latinx residents compared to white and Asian residents.

The number of COVID-19 cases in L.A. County climbed to 22,485 with 1,056 deaths Wednesday.

Officials had race and ethnicity data for more than half of those who had tested positive for the coronavirus in L.A. County as of Sunday. The Department of Public Health released a report detailing racial and economic disparities among patients.

It found that Native Hawaiians and other Pacific Islanders had the highest population rate of COVID-19 cases, with 840 infections for every 100,000 people in that group.

They were followed by Latinos, who had 114 confirmed infections per every 100,000. And there were 102 known coronavirus infections per 100,000 African American residents.

For the 977 of those who have died whose ethnicities were known, 1% were Native Hawaiian/Pacific Islander even though that group only accounts for 0.4% of the county’s population, and 13% were African American despite comprising 9% of the population.

Taking each group’s population into account, black residents have experienced a higher mortality rate than any of other race groups, the department said.

These findings mirror trends nationwide and statewide.

Black Californians have accounted for nearly 11% of COVID-19 deaths statewide but only 6% of the population, according to state’s health department.

How income levels affected outcomes in the pandemic

Rates of coronavirus infections and deaths are also higher among lower income residents, and there appears to be more testing among higher income residents, Ferrer said.

“As relative income decreases, rates of confirmed cases and deaths increase,” officials wrote in the report. “However, the data on COVID-19 testing indicate a social gradient in the opposite direction. As relative income increases, the rate of testing increases.”

Ferrer called the trends “troubling and of great concern.”

“They suggest more affluent residents may have better access to COVID-19 testing and health treatment services, even as the rates of infection appear to be higher among lower income communities, and many communities of color,” she said.

The county has addresses for people who have died of COVID-19, and found that more than 18% of them lived in L.A. County communities with the most people under the poverty line.

But only 11% of those tested lived in areas were most residents live under the poverty line, the data shows.

Ferrer said the county needs to step up testing in those underserved communities.

As of Sunday, the health department knew the race and ethnicities of 32% of the 123,737 people who had been tested for the coronavirus at that point. Of the top three racial groups tested, about 30.3% were white, 16.7% were Latino and 9.2% were African American.

While white residents account for the largest percentage of those tested for the virus in the county, Latinos accounted for the largest number (47.9%) of those who requested a free coronavirus test on the county’s online portal and the majority of those who requested a test by phone.

This means that while requests for testing at county sites are consistent with L.A. County’s population, which has a majority of Latino residents, the percentage of those actually getting tested is not.

“If you can’t get easy access to testing, it’s pretty hard to know whether you need to isolate and your close friends or family members need to be quarantined,” she said. “We’ve got to improve the ability for people to get tested.”

How the health department is addressing the disparities

The health department’s report laid out a plan to address the inequities in deaths, illnesses and testing.

It involves making coronavirus testing more accessible to communities of color, coordinating health care for highly impacted communities and making sure that people have access to treatment and other supportive services.

The county recently opened up more coronavirus testing sites in South L.A., which has a population that is 38% black. A drive-up site also opened up recently in Inglewood, where over 46% of residents are black.

The plan also calls for more robust outreach and education on COVID-19 in communities of color.

Where L.A. County stands in the pandemic

With 22,485 confirmed coronavirus cases, Los Angeles County accounts for nearly half of all cases in California — even though it is home to about a quarter of the state’s population.

And with 1,940 people with COVID-19 in the county’s hospitals on Wednesday, it also has half of the state’s patients currently hospitalized for the respiratory illness.

Ferrer reported 56 new deaths attributed to COVID-19 Wednesday, and that’s most of the 78 cases reported statewide in same period.

The county also reported 1,541 new cases Wednesday. Ferrer said the high number is primarily due to an increase in testing, mostly in institutional settings, and a lag from labs reporting results from the weekend.

Neighboring counties have been reporting far fewer cases and deaths each day.

“There are many unique challenges here in our county,” Ferrer said, explaining that certain neighborhoods are densely populated and people live close to each other, making those areas more vulnerable to the spread of the virus.

The county also has a large homeless population and high numbers of groups living in poverty and residents in skilled nursing facilities, Ferrer said.

All are at higher risk of more severe illness.

As of Thursday, there were 4,950 residents and staff with COVID-19 at 329 institutional settings in the county. And 498 of people who tested positive in those settings have died.

The vast majority of them were in skilled nursing facilities, and all had underlying health conditions, Ferrer said.

While the number of cases in L.A. County continues to rise by the hundreds each day, the rate of hospitalizations for COVID-19 has remained stable in recent weeks, and projections show the county will able to meet demands for hospitalizations and ventilators.

Officials say they hope to loosen some restrictions on movement and business in the coming weeks.

Both county and state officials have stressed that lifting stay-at-home orders would come gradually and it’s all contingent on ramping up testing, among other prerequisites.

“If we were to pare back suddenly to pre-order levels, the situation would be dire with the vast majority, or virtually all of the … residents of the county infected by summer,” director of L.A. County Health Services Dr. Christina Ghaly said.

And even with the state allowing some settings to reopen in the next phase, L.A. County is the most populous of all the counties in the state and its efforts will look “very, very different than others,” County Supervisor Kathryn Barger said.

“Physical distancing will be our new normal for quite some time,” Ghaly said.

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