No insurance, no savings, no support: what happens when LA’s least privileged get Covid

Undocumented Filipino caregivers, South LA’s black neighborhoods and garment workers grapple with unequal toll of virus

By: Sam Levin

Lily has no health insurance, no doctor and no savings.

The 57-year-old Los Angeles caregiver contracted coronavirus last month at work and survived after weeks of agony and isolation in her bedroom. Without access to healthcare, she drank boiled ginger and tried basic flu remedies common in her native Philippines. Lily made it, but at least two other Filipino caregivers in the city have succumbed to the virus.

Covid-19 has devastated Los Angeles, infecting people of all incomes and backgrounds, but the suffering has not been equal. The damage has been particularly brutal in communities that have long faced systemic racism and health and economic inequities, including the black essential workers of South LA, the Latinx factory workers now sewing masks and the immigrants of Historic Filipinotown.

In addition to disparities in the number of cases and deaths, victims of the pandemic fear the unequal toll will only become starker as California inches toward reopening – with those who most need help least likely to get it.

“I cannot get the support from the government because I’m undocumented,” said Lily, who asked not to use her full name. She’s not sure how she will recover after quarantining for more than a month with no income or paid sick leave, or how she will continue sending money to her children in the Philippines. “I’m waiting for any assistance. It’s really, really hard.”

How Covid-19 spread

LA county is California’s primary coronavirus hotspot, with more than 34,000 cases and 1,600 deaths. Although LA has not suffered the kinds of hospital surges states like New York saw, the growth in cases in southern California has remained steady, increasing an average of 850 cases per day in the last week.

The numbers are worrying enough that LA is likely to extend lockdown restrictions for three more months.

Experts’ understanding of Covid-19’s movements through LA has evolved. In early April, puzzling reports found that the city’s whitest and wealthiest enclaves had the highest documented infection rates, which helped to fuel a false rumor that black Americans could be more immune. In reality, the data showed that these white communities were getting more tests, foreshadowing that lower-income people of color would have unequal access to Covid-19 healthcare – and worse outcomes.

By mid-April the data indicated that the virus was clearly overwhelming LA’s disadvantaged communities: “Once here and spreading locally, it multiplies inequality,” said Andrew Noymer, a UC Irvine epidemiologist.

Now it’s clear that the people who live in high-poverty areas have nearly four times as many Covid-19 deaths (29 per 100,000 people) compared with LA areas with low poverty rates. Working-class city neighborhoods such as East Hollywood, South LA and Westlake are especially hard hit.

The racial disparities in deaths are also disturbing. For native Hawaiian and Pacific Islanders, the death rate is 89 per 100,000 people; for black residents, it’s 18 per 100,000; It’s 15.5 for Latinx people; 12 for Asian residents; and nine for white people, according to county data. Black and Latinx residents ages 18 to 64 are also dying more frequently than others, according to the LA Times.

“People say, ‘We’re all in this together,’ but that phrase is misleading,” said Janel Bailey, of the LA Black Worker Center, whose uncle died of the coronavirus. “In South LA, we’re all in this together as far as having to advocate for resources. People talk about the peak and curve, but the virus is going to hit very differently for us.”

Those who can’t stay home: ‘No time off, nothing’

The inequities in LA’s case numbers in part reflect whose labor is considered “essential” in the city – and who cannot afford to stay home.

The crisis has been particularly dire among the city’s undocumented Filipino caregivers, who often work multiple jobs in private homes and assisted living facilities, taking care of elderly and disabled people. Westlake, the neighborhood that includes Historic Filipinotown, has four times the Covid-19 death rate seen by the county as a whole.

Because many caregivers find work through agencies and are classified as independent contractors, they typically have minimal job protections and benefits. “I have no paid time off, no sick leave, no health insurance, nothing,” said Emily, a 61-year-old worker who cares for a 91-year-old client and sends her income to her children and grandchildren in the Philippines.

“My kids are worried about me,” Emily said. “They say, ‘Don’t go to work.’ But if I don’t go, then there’s no pay.”

Emily’s fears of Covid-19 escalated dramatically after the virus killed one of her childhood best friends from the Philippines, who also moved to the US and was a retired nurse: “In her last hours, I could only see her through Zoom. It was so heartbreaking.”

“Our caregivers are essential workers but are not really included in any systems that can support them as essential workers,” said Aquilina Soriano Versoza, the director of the Pilipino Workers Center. Caregivers have struggled to get basic personal protective equipment at their jobs, she said, and generally can’t get unemployment if they have lost work.

PWC members who have contracted Covid-19 also often have no safe or easy way to quarantine. In Westlake, more than one-third of housing units are considered overcrowded, according to one recent analysis.

Soriano Versoza said she knew of one shared house with 18 residents, mostly caregivers, where two people had recently contracted the virus. One PWC caregiver had to sleep in his car and a tent after he was presumed to have Covid-19.

Despite the perilous conditions at work and the lack of safety nets if they contract the virus, some without work are desperate for opportunities. .

Yohana, a 46-year-old factory worker who lives in Westlake and makes masks for low wages downtown, said she and others in her family got sick and feared they had the coronavirus. She eventually got a test that showed she was negative but noted that many Garment Worker Center members like her didn’t even want to get tested: “The truth is people are scared. People don’t want to go to the doctor. They don’t want to be left without work. They don’t want their boss to know they’re sick and not give them their job back.”

The gaps in care: ‘The onslaught won’t stop’

In South LA, Covid-19 immediately hit black workers, but the government’s initial strategy didn’t recognize this crisis and public health messaging around the dangers of the virus was not reaching communities that needed to hear it, said Najee Ali, a longtime South LA black activist who has lost two friends to Covid-19.

“When the city of Los Angeles catches a cold, black LA catches pneumonia,” said Ali. “Black people are the essential workers – in grocery stores, the airport, at Amazon, in rideshare companies.”

Don Nichols, 65, was working for Uber and Lyft when he contracted Covid-19. He had started driving a year and a half ago after losing his job at a supply distributor for salons and barbershops. When he got sick in early March with a bad cough and chest pain, his doctor told him it was probably the flu.

He was hospitalized weeks later when he couldn’t breathe, and by the time he got a test showing he had coronavirus, “corona had overtaken his body,” said his brother, Richard Darryl Nichols, 64. “I do think if he had gone to the hospital earlier and they had tested him, he probably would’ve had a better outcome.”

Don was put on a ventilator and died on 29 March, said his brother, who also lost a cousin to Covid-19 in Detroit. Don was healthy for his age and should have lived longer, Richard added.

Longstanding gaps in the healthcare system have exacerbated LA’s Covid-19 inequities, Bailey, of the LA Black Worker Center, said. They helped organize a mobile Covid-19 testing clinic in South LA after it had become clear that some in their neighborhood were falling through the cracks, they said: “It’s an unfortunate indictment on the system.”

While LA county has taken proactive steps to address these problems, including by expanded testing in hard-hit areas and organizing virtual town halls and PSAs, many in neighborhoods like South LA are worried what reopening may look like.

“It’s scary when people talk about going back to normal, because we know how normal got us here,” Bailey said.

LA and state leaders have promised to address gaps in who is receiving aid during the shutdowns. Since undocumented people won’t be getting $1,200 stimulus checks, the California governor has opted to provide $500 to them during the crisis, and LA’s mayor launched a prepaid debit card program that provides $700 to $1,500 for low-income Angelenos.

Lily, the caregiver who survived coronavirus, said she was hoping to get back to work soon and was grateful that state and local leaders were offering some financial support.

A month after contracting Covid-19, she was still waiting for those funds to arrive in the mail.

Read More: https://www.theguardian.com/us-news/2020/may/14/los-angeles-coronavirus-inequality-undocumented-healthcare