The coronavirus pandemic is still taking a disproportionate toll on people of color and low-income people, according to San Mateo County’s new public health equity officer, Shireen Malekafzali.
Malekafzali was previously senior manager for health policy, planning and equity in the county and began the new role Nov. 15.
One of the most glaring inequities is the prevalence of the disease among Hispanic and Latino residents in the county. Based on the most recent figures available, Latino and Hispanic residents make up 47% of the confirmed COVID-19 cases even though they make up only 24% of the county population.
The new position is focused on bringing a number of the county’s existing equity efforts together, focusing on listening to the most impacted communities — such as communities of color and low-income communities, among others, Malekafzali said in an email.
It involves focusing on testing, contact tracing, and making resources available to people who test positive for COVID-19, she said.
“We see our impacted communities as our teachers and even if our intentions are good, if the impact or experience isn’t effective, we need to learn and adjust,” she said.
There are many efforts underway focused on helping people safely quarantine and isolate, to increase access to testing and improving health education, but one challenge will be to increase the focus on equity and accountability within those efforts, she said. The county has many staff in lots of divisions, and creating a health equity lens for every effort “will be an undertaking,” she said. “But we are all committed and up for the task.”
Working with community leaders to be thoughtful and authentic takes time, even while the needs in the community are very urgent, she said.
“Managing the urgency with a thoughtful approach will be important,” she added.
How is San Mateo County performing on equity goals?
The county’s two main priorities for reducing the spread and the unequal distribution of the virus are to first bolster communication, build trust, and increase engagement and participation in efforts to protect people from getting the virus; and second, to focus interventions in at-risk communities.
The county reports specific metrics for how it’s doing on these goals, which can be accessed at is.gd/covidequityplan.
For the first priority, the county reported that it exceeded its goals for the number of canvassing events hosted and the number of visitors to online COVID-19 resources, but fell short of the monthly 4.5 million media impressions it sought to achieve (reaching 3 million in November).
It also aimed to distribute 2,400 masks per month, but distributed 2,328 in November. It also was falling short of its efforts to contact 500 businesses by the end of the year, with specific quotas for those operated by English, Spanish and Chinese-language owners. It had so far contacted 244 businesses, about 40% of which had Spanish-speaking owners.
The county exceeded its goal of hosting at least six interactive panels, discussions or forums by the end of the year with a count of nine.
For the second priority, hosting targeted interventions in at-risk neighborhoods, the results were more successful. The county was well in excess of its goal to provide a little over 300 tests per 100,000 people at 843 tests per 100,000 people the last week of November.
The county also sought to perform at least 16 neighborhood testing events per month and hosted 81 in November. The most recent reports show that people who tested positive for COVID-19 were contacted by contact tracers within one day 82% of the time, and a third of contact tracers were bilingual, slightly under the 40% goal.
County health workers also exceeded the goals set for helping people who test positive for COVID-19 but may have a hard time isolating safely. They have a team of case managers, all of whom are bilingual, working to connect people with housing, food, health coverage or other county support programs, like rent assistance, landlord assistance or immigrant relief funds. In November, the case managers made 622 referrals to service agencies helping meet these needs, well in excess of the stated goal of more than 250. The two cities with the largest number of referrals were Redwood City and East Palo Alto, according to the report.
Another important strategy, the county reports, is tracking hospital capacity and keeping it available to those who need it, which has become a significant challenge amidst the current surge of COVID-19 cases. As of Monday, Dec. 21, there were 70 staffed and available beds for acute care and only four ICU beds available, with 133 COVID-19 patients hospitalized, according to county data.
Email Kate Bradshaw at kbradshaw@almanacnews.com
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