Throughout San Mateo County, and across the U.S., it's becoming increasingly clear that COVID-19 is hitting some communities harder than others.
In San Mateo County, the new coronavirus is hitting residents who are Latinx or Hispanic at the highest rates of any racial or ethnic group, and the number of cases compared to the number of residents is the greatest in East Palo Alto. As of July 10, there were 111 confirmed cases of COVID-19 per 10,000 residents, or about 1% of all residents infected.
More than 49% of the county's confirmed COVID-19 cases are among residents who identify as Latinx or Hispanic. According to data available as of Thursday, July 9, out of 3,846 total cases, 1,901 of them were among Latinx or Hispanic residents.
Yet Latinx or Hispanic residents represent 24% of the population overall in San Mateo County, according to the U.S. Census Bureau.
And in North Fair Oaks, a community of nearly 15,000 people in an unincorporated area between Atherton and Redwood City that is about 70% Hispanic or Latinx, the number of COVID-19 cases reported by the county has remained less than 10 since numbers began to be reported.
Across the U.S., Latinx and Black residents of the United States have been three times as likely to become infected as their white neighbors, and Black and Latinx people have been nearly twice as likely to die from the virus as white people, according to data from the U.S. Centers for Disease Control and Prevention reported by the New York Times.
The Almanac contacted local experts and leaders to dive deeper into the data San Mateo County is reporting and explore why the rates might be so high among Latinx residents.
The San Mateo County Health Department did not provide a clear explanation for why the case count had remained static in North Fair Oaks while it has continued to escalate rapidly in neighboring communities with significant Hispanic or Latinx populations, such as East Palo Alto, where they represent 62% of the population, and Redwood City, where they represent 37% of the population.
East Palo Alto Mayor Regina Wallace Jones did not respond to a request for comment.
Everardo Rodriguez, chairman of the North Fair Oaks Community Council, said he suspected that not many immigrants and Latinx people in North Fair Oaks are getting tested, despite the fact that the county has recently been running a pop-up COVID-19 testing facility in the neighborhood at Everest Public High School, two days a week.
The testing site has been busy, according to San Mateo County Supervisor Warren Slocum and a county worker at the testing center who asked not to be named.
Even though the site has been busy, having to set up an appointment in advance may be deterring members of North Fair Oaks' immigrant community from signing up to get tested for COVID-19, Rodriguez said. The pop-up site discourages walk-up testing requests, and the requirements to sign up online may be a technological barrier for some.
Without being able to sign up in advance, people may not get tested until they are showing serious symptoms of COVID-19, he said.
San Mateo County has contracted with Verily's Project Baseline to administer free COVID-19 testing. It has set up roving testing sites throughout the county that people can access by appointment through the Project Baseline website.
Verily is a subsidiary of Google and requires people to have a Google account and email address to sign up for testing.
As a volunteer interpreter at the testing site, Rodriguez said only one Latinx person showed up without an appointment, and it took about a half hour to help him through the process of signing up to be tested, since he didn't have an email address.
"That's a little crazy, and discouraging, of course," he said.
When asked to confirm the case count in North Fair Oaks, county Health Department spokesperson Diana Rohini Lavigne said that the numbers were the most up to date available and that she did not want to speculate on the data. The county staff members who work with the COVID-19 data were too busy to provide an explanation by this news organization's deadline, she said.
The county was not able to provide information about the demographics of who has been tested at the North Fair Oaks testing site and whether they reflected those of the community.
The health department sees the demographic disparities and is crafting its responses accordingly, said Dr. Louise Rogers, Chief of San Mateo County Health, in a written statement.
"We are aware of the issue of inequitable impact of COVID-19 and how this unprecedented pandemic is exposing known, longstanding underlying inequities in our healthcare system and social determinants of health," she said.
"Low-income, marginalized groups are prioritized for our deepest response as part of our approach to reducing gaps in access, engagement and equitable treatment," she added.
An information gap
While the reason for the relatively low case count in North Fair Oaks may remain without an official explanation, other rising numbers on the county's data dashboard are telling.
"The numbers do speak for themselves," said Slocum in an interview, referring to the disproportionately high rate of COVID-19 cases confirmed among Latinx and Hispanic community members.
He said he observed a large party in the neighborhood over the Fourth of July weekend where he didn't see anybody wearing a mask.
Rodriguez said that one problem is that the community in North Fair Oaks doesn't have an accessible go-to spot for information about the community, even public health information. The county has good information on its website, but not everyone checks it, he said.
As a result, he said, some people in the community had to learn about the mandatory face mask requirements when they were barred from entering grocery stores and other businesses.
Language can be another barrier, he added. About 68% of North Fair Oaks residents speak Spanish at home, according to estimates from the U.S. Census Bureau.
Slocum said he was working with the county to get more culturally specific outreach materials, both regarding COVID-19 and the census this year.
"We're getting much better at targeting messages for specific communities – one size doesn't fit all," he said.
In Menlo Park, the city has not made any specific outreach efforts to the city's Hispanic and Latinx residents beyond disseminating information from the county health officer in Spanish and highlighting the county's COVID-19 testing site in East Palo Alto as a resource for residents, according to Nicole Acker, public information officer in Menlo Park.
During the weeks of June 23 and June 30, the number of COVID-19 cases rose 62% in East Palo Alto, 44% in Redwood City and 11% in Menlo Park.
Rodriguez said he thought the county should have started sooner to develop comprehensive outreach in his community.
"In my view, the county may have started a little late," he said.
Another factor facilitating the spread of COVID-19 in the Latinx and Hispanic community may be overcrowding. Latinx households are about 7.6 times more likely than white households to be overcrowded in California, according to a May report from the Public Policy Institute of California. California's overcrowding rate is also more than double the national average at 8.3%.
Economic factors are also shaping the disparate outcomes in infection rates, according to a study by UCSF and community partners earlier this year, in which widespread COVID-19 tests were conducted with a single census tract of San Francisco's Mission District where 95% of residents are Latinx.
Early results, published in May found that most of the people who tested positive were unable to work from home, earned less than $50,000 per year and lived in households of three to five people or more.
"The results so far suggest that those who are at highest risk for infection are those who cannot easily shelter in place due to job loss, furloughs, or because they are providing the essential services. Among those who tested positive, 90 percent reported being unable to work from home," the report said.
Many Latinx and immigrant residents of San Mateo County have been economically devastated by the pandemic, and many families are in "survival mode," Slocum said.
In several lower-income communities he represents, like Belle Haven, North Fair Oaks and East Palo Alto, "There are a lot of people that are really, really hurting. The county, I think, has done a lot of different tactics and strategies, but the problem is overwhelming," Slocum said, adding, "It's a heartbreaker."
"A lot of these folks are essential workers," Rodriguez said.
"They don't have the luxury of staying home and working from home, and so the fact they have to risk it every day, going out and coming back to their families, that's got to account for ... some of the higher incidence of infection," he said. "They don't have any other place where they can isolate."
San Mateo County's offices of Diversity and Equity, Behavioral Health and Recovery Services and Diversity and Equity Council have set up a Zoom community input session on the topic of race and COVID-19 on Friday, Aug. 7, set from 11 a.m. to 1 p.m. Access the link here.