MICHEL MARTIN, HOST:
We're going to start with another look at how and why COVID-19 is affecting some people in some communities much more severely than others. And our focus today is the Latino community in what has become the epicenter of the pandemic in the U.S. in recent months, Los Angeles.
According to public health officials in LA County, which includes the city of Los Angeles, as of late last month, COVID-related deaths among Latinos there had soared by almost 1,000% since November. Latinos in LA also have a mortality rate from COVID that is much higher than that of any other demographic group. And despite a recent decline in case numbers and increased access to vaccines, infection rates among Latinos are still well above their pre-surge levels.
We wanted to know more about why and how this is happening, as we said, so we've called Dr. Efrain Talamantes. He is a primary care doctor and the chief operating officer of AltaMed Health Services in Boyle Heights. That is a majority-Latino neighborhood in East Los Angeles.
Dr. Talamantes, welcome. Thank you so much for joining us.
EFRAIN TALAMANTES: Thank you so much for the opportunity.
MARTIN: Why do you think there's been such a spike among Latinos in LA County? I mean, why do you think your - the patients that you serve have been so hard-hit?
TALAMANTES: Well, one is that our communities have never had a choice. They've been the first in line to take on the toughest jobs, have the least of access to health care services, often not protected by their employers because, you know, they take on jobs that don't pay as much. And all our patients, for the most part, live in multigenerational households. And that also impacts - so when someone goes out to work, and they come home, they spread it to their family. And it's, you know, like wildfire - just spreads everywhere.
And a lot of the communities that we serve are very much - you know, a lot of the housing complexes are very close to each other. And the stories we hear is, you know, neighbors just walking around, and all of a sudden, they had their protection, you know, for a second may have let down their guard, and someone passes it to someone else. And that's the beginning of, you know, really these surges and the losses in families. I mean, the number of death certificates we're filling out of people - not just passing away at home, but in hospitals - has been very alarming.
MARTIN: Without compromising anybody's privacy, can you just maybe describe one or two of the situations that you've seen?
TALAMANTES: Definitely. The number of call volumes usually approximate, you know, let's say about 5,000 for all the patients we serve, about 300,000 here in Southern California. But as we were seeing things surge, our call volumes were approximating 20,000 any given day. We weren't able to keep up with the amount of patients with symptoms that were coming to see us, testing. We were testing, you know, high numbers - in the several thousands per week. And we saw the test positivity shoot up from about 8% before the surge to about 40%.
But as the vaccines have rolled out, you know, early in December, we keep telling people they're coming, they're coming. And it's been a real challenge, not only for our patients, but even our workforce. Many of them reflect the community. They are from the community. And for us not to be able to vaccinate them until recently is another example where, you know, we've been ready. Our patients are ready. But we keep telling people it's coming.
And there's a lot of doubt. I think the doubt is, are we really going to get the help we need, given that we've been through the worst?
MARTIN: Well, how about that? I was going to ask you about that - that, you know, LA County has rolled out mass vaccination efforts - like, there's one at Dodger Stadium.
TALAMANTES: Yeah.
MARTIN: Can people get to those? Is that helping at all?
TALAMANTES: Well, you know, the communities we serve - I mean, in community health centers where we're located - we're in some of the most underserved areas in the country - they don't have access to transportation. Obviously, there's some fear around getting the transportation that - even though we've done our best to assure people that public transportation is safe, people still are challenged by that.
And when they do come with us, they're asking us all the questions. And once we answer their questions, they'll say, doc, I'm ready. You know, I'm ready for the vaccine. And I'll say, well, you've got to get online, and you've got to sign up. And here, let me help you. And it's like, well, who's going to take me there? You know, my family - they work. They have multiple jobs.
Those are the real barriers, is that if we don't come to our patients where they work, where they live and where they spend their time, then we're going to miss a lot of people. And these are the same people, again, that have been devastated by this pandemic.
MARTIN: So can't - why can't you vaccinate them where you are...
TALAMANTES: Well, you know...
MARTIN: ...I mean, at your place?
TALAMANTES: Yeah. We've actually been preparing, like I shared, since the first surge for this day. And we invested in the refrigeration. We came up with various scenarios as how to do this in our clinics, how to get out to the community. But it's been a real challenge to get the federal government and the state to coincide on their push to get vaccines to community health centers and community providers.
I mean, many of us have been vaccinating families for decades, and we've built trust, and they want to come to us. But the amount of vaccine that has been shared with us has been minimal. And we see that as not only continued exacerbation of inequities, but really that the structure, the health care structure, really does favor those that have greater access to health care systems that may be better positioned - that, you know, are commercial, that are not underinsured or uninsured.
So we've been doing a lot of coalition building and working together with community, our partners around these issues. But it's falling on deaf ears. We continue to hear, yeah, it's coming. Just wait your turn.
MARTIN: But before we let you go, you know, I wanted to ask you about the whole question of what - apart from the vaccines, like, what should happen now in terms of the whole picture of dealing with this? I mean, the state of California lifted its statewide stay-at-home order last week, but LA County is still grappling with the consequences of this huge surge these past couple of months.
I don't want to put this on you to figure out the whole picture, but the fact is, those are a related phenomenon. And so if you feel comfortable saying, do you have an opinion about this? I mean, do you think lifting those restrictions is the right thing to do or not?
TALAMANTES: When we lift these restrictions, I mean, the people that have to go out are the same people that have been the hardest hit. And they're going to bring the COVID and - or any other variant now that we're worried about back home. And so unless we do more in the community, there's going to be a huge challenge as we look at what's to come. And so we can't let down our guard.
MARTIN: That was Dr. Efrain Talamantes. He is a primary care physician. He's the chief operating officer of AltaMed Health Services, and that is in Los Angeles.
Dr. Talamantes, thank you so much for your hard work. And thank you so much for talking with us today.
TALAMANTES: Of course. Thank you so much. Transcript provided by NPR, Copyright NPR.