Dr. Don Garcia discusses the impact of COVID-19 on the Latino community

Dr. Don Garcia is the Medical Director at Clínica Monseñor Oscar Romero, a Federally Qualified Health Center that operates two clinics in Los Angeles and primarily serves Latino and immigrant populations. In this Q&A, Garcia discusses the health disparities faced by the Latino community during the COVID-19 pandemic, inequities in the vaccine rollout, and potential solutions to improve the state and local response to the virus.

 

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Emily Boerger: Can you tell me a little bit about Clinica Romero? What is your mission and who do you serve?

Dr. Don Garcia: “Oscar Romero started in the 1980s when there was the unrest in El Salvador that caused the migration and the safe harboring of many of the El Salvadorans…and it started out as a social rights, immigration rights, human rights, legal rights organization. And then in the mid-1990s, they started turning to health care and health services and they had a free health clinic. In the early 2000s, it became a Federally Qualified Health Center.

So, their mission and role has been to champion the compassionate care for immigrants, undocumented, marginalized, homeless, communities of color that have not been traditionally made part of the mainstream of health care services in this country.”

EB: What specific problems is the Latino community facing when it comes to COVID-19? In what ways is the community disproportionately impacted?

DG: “In Los Angeles, the Latino population is 49%, but the deaths are represented by the Latino population of 52%. So that is significant, and that story hasn’t been put out there. Number two: 60% of the positivity rate is in the Latino population. Number three: 60% of the hospitalizations are within the Latino population, but only 25% of all tests are performed on the Latino population.

More specifically, what are we finding at Oscar Romero? We’ve done close to 3000 tests, but consistently since March of last year, our positivity rate does not match what the county is reporting overall. The general population [is seeing a positivity rate] of 9 to 15%. We’ve been seeing a rate consistently between 30 to 40%, averaging 35%. That is alarming. That is what is not being told by the public health department and by the media. That is what is killing this community that is at major risk.

And why are we at major risk? Because there is an inequity and insecurity that arises from transportation and arises from employment. Without transportation, you cannot get to the mega vaccine sites. If you do, you have to go through public transportation, you’re exposing yourself to infectious risk, you may have to take three to four bus transfers, and it may take two to three hours to get there.

What do I mean by job insecurity? Many of our Latino families are frontline workers who are doing the blue-collar maintenance, dishwashing, cashiers, restaurant, hotel services, skilled nursing facilities, and hospitals. They’re out there in the front, but they’re not like you and I, where they have paid time off and they can leave work and get paid for it as a sick day or as a day to get vaccinated. More importantly, is that we also have a technology insecurity.

If you have a hurricane or a tornado, FEMA comes into the community, has a press conference and delivers the word nationally, regionally, locally, and brings the resources in order to calm the disaster. Why is that not happening here? This is a biological disaster that is killing a larger number of individuals that you would see with the fires we have in California, or the hurricanes in Louisiana, or the tornadoes in the Midwest. It just befuddles me, the inequity that is occurring.”

EB: You alluded to this already, but is part of the problem the way that data is being reported? If you just look at an entire county, the numbers might not seem so bad. But is the solution to dive deeper into the data to find the hotspots, and then use that information to allocate resources?

DG: “Yes. I mean, if I was a policymaker, I would say, ‘well that’s fine and dandy, but what is really happening in the eye of the storm?’ People are missing that there is an eye of the storm…And unfortunately, I happen to be in the eye of the storm. And no one else is crying out and pleading to say, ‘this is not the story that’s occurring at the actual burning site. We are burning to death here and nobody seems to be focusing on us.’ They’re focusing on Dodger Stadium. They’re focusing on the Forum, Cal State Pomona, Cal State Northridge, and Cal State Los Angeles. The fires are not there. I’m not saying that those are not solutions, but it’s not a solution for the people that are being burned.

There is a health inequity in this country and a systemic racial inequity for participation in the health care system… I think that those are vital elements that really need to have some type of public policy review and discussion and there needs to be solutions as soon as possible.”

EB: With that in mind, what actions would you like to see from the county or the state to help address these inequities? What concrete actions would make the biggest difference in the near term?

DG: “We can make it better by leveling the playing field. And what I mean by that is there has to be more fair and equitable allocation of our vaccines to the hotspots and not to the non-hotspots. The hotspots are not getting the doses that are being required.

We also need to be included; we need to be brought into those decision-maker backrooms. And we need to have transparency. We need to be given the most up to date information, and not be given the information a month later…In other words, we need to be there when the information is evolving and causing a major decision to be made on the spot immediately.

So, we need to have better, inclusive collaboration with the local departments of public health, with the state department of public health, with the governor’s office, and with the Washington decision-makers.”

EB: How many vaccines has Oscar Romero received? And how many people do you serve?

DG: “We have 12,000 member lives and we’re surrounded by a community of over a million Latinos. We received one shipment of 100 vaccines only. And then [last] week, another 100…And we are the hardest hit population of the pandemic with infection, morbidity and mortality, and positivity. It has no sense… Something is upside down here. There’s no reason that I can understand why you would not send the boots on the ground, the buckets of water, the vaccines, to where the fire is burning the individuals and where the infection is brewing.”

This interview has been edited for clarity and length.