Marin County, just north of San Francisco, is best known nationally as a picturesque gateway to wine country and home to moneyed tech investors and a handful of aging rock stars. The reality, of course, is more complicated.
Those complexities can be found in a San Rafael neighborhood known as the Canal. Its large Latino population has been hit hard by COVID-19. Many residents are immigrants. The Canal's struggles reflect systemic failures and are playing out nationally as Latinx and other communities of color continue to bear the brunt of the deadly virus.
In Marin County, one of the nation's wealthiest, these line workers who stock the shelves, scrub the hardwood floors, wash the Teslas and care for the gardens and children in Tiburon, Mill Valley and San Rafael are bearing the brunt of the coronavirus.
"You know, high-risk, high-poverty essential workers facing multiple challenges that other groups are not," says Omar Carrera who runs the Canal Alliance, a San Rafael non-profit that has supported Latinx immigrant communities here for nearly 30 years.
Like other African American and Latino populations around the country, this community has been disproportionately hard-hit by the coronavirus. Latinos make up about 16 percent of Marin's population, but account for nearly 80% of COVID-19 cases in the county, according to health officials here.
Neighborhood decimated by pandemic
Almost a third of all the county's cases are here in the Canal neighborhood, a small, densely populated section of San Rafael packed with multi-family apartment buildings. One report shows that out of the county's 51 census tracts, the Canal ranks last in opportunity, well-being and education.
Even before the pandemic, many Canal residents were living paycheck-to-paycheck — "survival mode," Carrera says. Then when it hit, the neighborhood was decimated.
"Latinos have been the essential workers for this county before COVID-19, during COVID-19, and probably after," he says. "So poverty, inequities, the jobs that they perform, the (packed) housing conditions - all of that creates the perfect environment for the virus to spread quickly." And it has.
Overall, about 3% of the county's coronavirus tests are coming back positive. In the Canal, the positive rate is averaging 20% and has spiked as high as 40%, says Dr. Matt Willis, Marin County's health director. "The roots of this outbreak go so far beyond our health care interventions and are really rooted in how we've organized our economy," Dr. Willis says. "People who live in the Canal are three times more likely to live in poverty than the rest of Marin County, and are 15 times more likely to share a room with two or more other people."
'It's killing our loved ones'
Efforts to battle COVID-19 mirror the challenges faced nationally in communities like the Canal: fear of jeopardizing legal status, underlying health conditions and long-standing disparities in wealth and health care access.
California health officials are alarmed that Latinos continue to get sick and die from COVID-19 at far higher rates than other groups. Latinos make up 39% of California's population but account for almost 60% of all Coronavirus infections and almost half of all deaths.
"Our communities are in crisis," says Luz Gallegos, the Community Programs Director for TODEC, which works with the Latinx communities in Southern and Central California. "COVID-19 is real, it's not a myth. And it's killing our loved ones."
Gallegos lost an uncle to the virus.
TODEC is hosting a series of workshops to raise awareness of the pandemic among undocumented workers. Last week's workshop on Zoom attracted more than 400 participants.
There's ongoing fear in Latinx communities across the state, she says, about getting tested and seeking help. One of the most asked questions her group gets is "will authorities get my personal information if I get tested?"
The answer is no, Gallegos assures immigrants. But the ongoing "level of fear of being tested is having a profound impact on the communities."
Here in the Canal, just about everyone knows someone who's tested positive. Everyone's afraid they could be next.
"I live with my brother and others, there are five of us," says 18-year-old Zoila Garciawho moved here a year ago from a rural village in Guatemala. She works in a bodega in the Canal. "If someone's positive it's hard to isolate and keep distance with several people in the house," Garcia says.
'Absence of a coherent national strategy'
It's equally difficult, she says, to stop working. "We have bills to pay, and my brother and I have to send money back to our family in Guatemala. If we get sick, it would be catastrophic."
As in many low-income neighborhoods during the pandemic, activists and public health officials here say they've been hampered by a shortage of testing supplies, trained contact tracing staff, additional support and the absence of a coherent national strategy from Washington.
Testing in the Canal, initially, was undermined because the company doing them didn't offer online registration in Spanish and didn't have enough staff who spoke the language. Then when that challenge was resolved, the test results were taking too long to prove useful for public health officials and contact tracers. Contact tracing is only now getting up and running in the Canal, some six months into the pandemic.
"We're trying to ramp it up really quickly because it's definitely a huge gaping hole, especially for this community because they're usually the ones that get forgotten about," says Sarah Ryan, who works as a contact investigator with the Canal Alliance.
Ryan knows the neighborhood: she lives here, speaks Spanish fluently and is married to a Mexican national. Nonetheless, she says cold-calling people to tell them they're positive and need to isolate is tough.
The responses, she says, run the gamut from sadness and frustration to anger and outright denial. "You have to play part social worker, part therapist, you know, and still kind of find a way to steer them through to answer the medical questions," she says. "I had a poor woman who was crying on the phone to me for like an hour because she had lost her father. Her husband is a truck driver and gone for weeks at a time. And she kept telling me, 'Life isn't fair, life isn't fair,' because now she's positive and we're trying to tell her not to go to work. It goes very deep."
The county is working closely with the Alliance to deliver help. "We do our best to connect people with every resource that we can," Ryan says, "food, help for rent, help isolating when they're in the very crowded living situations."
A new antibody testing effort is launching here. There also are now 20 hotel rooms in the Canal available free to people here who've tested positive and need to isolate.
But that's just 20 rooms for hundreds positive cases in the Canal, so far. (More than 1,100 positives to date, although many of those have recovered.)
'We need resources'
"We need a lot more hotel rooms. There's no question," says Dr. Willis, the county's health director. "The question is how does that happen?"
Early in the pandemic, California launched a multi-million-dollar effort to add testing in so-called "testing deserts" – mostly low-income and immigrant communities such as the Canal. The state also boosted data collection and outreach. That helped.
Still, it wasn't nearly enough. When counties asked the state for more help, local officials say, the requests were almost always denied. Like hard-hit essential worker communities across the country, there never seems to be enough money, contact tracers or rooms to isolate the infected.
"Yes, it is late. And, yes, we know, these problems should have been solved months ago," Dr. Willis says. "But we are inheriting a system that is categorically unequipped to manage a problem of this scale and complexity. I'll take, the county will take, what it needs to in terms of, culpability and blame around that. But I think ultimately what we really need is a robust national plan. We're left scrambling at the local level to adapt to these problems."
The Canal Alliance's Carrera says Marin's sharp disparities in wealth and access to health care and housing are now coming home to roost in a stark and ugly way.
"We have a county that is one of the wealthiest counties in the country, and yet you have these inequities that existed for a long time. And that is the lack of policies. We need resources, yes, but also policies to support people that need it the most."
Topping Carrera's post-pandemic wish list: new debates and policies on housing, health, transportation, and education equity. The virus, he says, shows that when you leave any community neglected, "we all suffer."
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