Tanzina Vega: I'm Tanzina Vega and you're listening to The Takeaway. As millions of Americans scramble to get their chance at a COVID-19 vaccine, the State of California remains a hotspot of Coronavirus infections with more than three million residents infected with the virus. While the state has managed to slow the death toll, Latino residents remain some of the worst affected. In fact, data shows that some Latino neighborhoods have roughly five times as many cases of COVID-19 than richer, wider communities, and the death rate among Latinos in LA has surpassed that of all other racial and ethnic groups. Here to help us understand why is Brittny Mejia, Metro reporter with the LA Times. Brittny, thanks for joining us.

Brittny Mejia: Thanks so much for having me.

Tanzina: How has the Latino community been dealing with COVID-19 in terms of the number of cases right now?

Brittny: Yes, it's been pretty dramatic. The differences between the groups of people who are getting COVID here, especially if you look just on a more local level here in Los Angeles County, it's been a 1,000% increase in Latino COVID-19 deaths since November here in LA County. It's a same situation that's playing out across the state. You have dense housing, crowding living conditions, a higher proportion of essential workers who can't work from home. This is all contributing to what's going on right now.

Tanzina: You made that link in your reporting between housing conditions for Latinos in Los Angeles and COVID. Give us a little sense of what you meant there.

Brittny: Yes. It's interesting. I just actually reported a story about a father and his four adult children who shared a one-bedroom apartment in South LA. That's one of the areas, one of the neighborhoods that is where one in five homes is overcrowded. This is a situation where rent is too expensive, this family couldn't move out, the children couldn't move out on their own. A lot of them were essential workers. They were caught in this condition where they couldn't stay home, they slowly each started to get COVID. The dad was the last one who got it, they tried to protect him. They'd wore masks inside, but he shared the living room with his two sons and he eventually got it and he actually passed away.

Tanzina: Brittny, I'm sad to hear that you actually have some experience dealing with this first hand within your own family. Would you tell us a little bit about what your family is facing being Latinos in that community with COVID-19?

Brittny: Yes. It's honestly been so surreal, I think through this pandemic, to see this same situation playing out in my own family. There's been at least 10 family members who have tested positive for COVID over the last year. My uncle actually here in LA County is currently in the ICU on a ventilator because he got COVID, and so seeing it on that level, I often see the same stories, like my family story reflected in the stories I'm telling.

Tanzina: What about the fact that I know here in New York, in particular, and across the country I'm sure, some of this is true that a lot of Black and brown workers are also essential workers. Is that playing into why the Latino population in Los Angeles is being so disproportionately affected by this?

Brittny: Oh, yes, definitely. If you look at who are essential workers, at least here, when you look at LA County, 55% of Latinos work in these jobs and 48% of Black residents do, compared with 35% of white residents. You do see that difference, you do see that there is a greater increase in Black and brown residents who are going out and doing this essential work.

Tanzina: Brittny, what about undocumented workers? We know that there are many undocumented workers, particularly in California, who are working in the agriculture industry there. How is that community faring?

Brittny: It's, again, it's the same impact, it's hitting really hard. I feel like there's maybe a little bit more skepticism about reaching out to the government or reaching out for help in those cases because I have also seen that in my own reporting, where those who are undocumented are a little bit more reticent to actually seek out that help, to go get tested. In some cases, it really is someone can't afford to miss that work, someone can't afford to go in and take the time off and stay at home and quarantine, and it really is you're making a choice between, you obviously don't want to get everybody sick but you also have to pay your rent. A lot of these community members are faced with a really difficult choice.

Tanzina: What is Gavin Newsom and or other state officials doing? What are they doing to help curb this? We know that the rates of infection and deaths are somewhat going on the decline in LA but this is a pretty big problem for this particular community.

Brittny: Right. It's been interesting seeing what's happening at the local level and how this is being addressed because even county health officials here have called it horrifying and have been basically calling for the government to do more to help essential workers and those living in dense, overcrowded conditions. I'm often hearing it from epidemiologists that that is who needs to be targeted is those who are in these multi-generational houses. I think that that needs to be the priority.

It's been interesting seeing on a local level councilmen, saying we need to go door to door, we need to focus on this community, talking to them about vaccines and not just hoping that they'll get an email or they'll go on Twitter and see this information, we need to actually do this targeting in these communities.

Tanzina: We're going to be talking a lot more about vaccine rollout and distribution across the country, but I'm curious, Brittny, what does vaccine distribution look like in LA right now, because we're seeing racial and ethnic disparities in some of the cities around the country that are beginning to release this data?

Brittny: Right. It's been interesting here. I think last weekend, I did a story looking at Keck USC doing vaccinations, and they were vaccinating the family members who are 65 and older of hospital housekeepers, and this whole effort was being done because they saw lagging rates of vaccinations among housekeepers, who are predominantly Latino. I think from there, they were like, "Okay, we need to change the way that we're doing this and we do need to have this equity going on if we have 25% only of hospital housekeepers getting vaccinated."

It's been interesting seeing because you have at the same time, my colleague, Julia Wick, told a story where people are waiting in standby lines all day to get a vaccination, and these are people who can afford to miss work. Often, I don't think that there are Latinos or Black residents who are standing in line all day waiting to get an extra dose if they can get one.

Tanzina: There's almost an interesting tension, really almost a sad tension here between you mentioned house cleaners and housekeepers, I'm sure there are many home health aides and care professionals who are also people of color who need to be vaccinated and we're still seeing that the rates of those vaccinations is very low compared to white wealthier residents of the area. Is that right?

Brittny: Yes. At this point, yes, that is what it seems like. I am going to be curious how there is going to be that move to equity. After 65 and older and these other residents, it's been interesting because councilmen here in LA County have expressed their feeling that these vaccinations need to be routed to community clinics in these communities, like in these communities of color. It's interesting seeing that because a lot of them are saying, I just spoke with a councilman Gil Cedillo, who's saying, my residents, in some cases, they don't have a car, they don't drive, and how are they going to take the bus to Dodger Stadium and hike up a hill to get vaccinated, and he was basically like the approach here needs to change.

Tanzina: I think there are a lot of places that are saying the same thing Brittny. Brittny Mejia is a metro reporter for The Los Angeles Times. Brittny, thanks so much for joining me.

Brittny: Thanks so much for having me.

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Chaz: This is Chaz from Sonoma, California. I'm 70 years old. Our county rollout of vaccines has been a complete fiasco culminating in the cancellation of appointments that we have been made today. Why? Because we're 65 and older, not 75 and older, it just makes one shake their head at the incompetence. We all knew the vaccines were coming, why didn't they get this organization stuff set up? Anyway, I'm disgusted, and I'm waiting to get an appointment still.

Tanzina: We just heard how Latino communities in LA have been disproportionately affected by COVID-19 as the pandemic continues to reveal inequities in health across the US. Now it looks like the rollout of the vaccine itself is reflecting similar problems. So far, of the 17 states that have reported vaccine distribution data by race and ethnicity, communities of color are receiving the vaccine at lower rates than their white peers. I'm joined by Rachel Hardeman, of the University of Minnesota School of Public Health to talk about this. Rachel, thanks for joining me.

Rachel Hardeman: Thanks for having me.

Tanzina: Why only 17 states so far having released this data? Shouldn't we be getting this data from every state?

Rachel: That's a great question and we absolutely should be getting this data from every state but right now, not every state is collecting this data and able to report it out. I think that's part of the significant problem here is that we don't have a vaccine surveillance system in place at the state level, or even nationally at this point, to really be tracking what's happening.

Tanzina: Rachel, the big takeaway here, no pun intended, is really, I think that from what we see in the data that's being reflected, and you can definitely tell us what you're seeing here, is that overall, Black and brown communities, Black and Latino communities have had a disproportionate effect in rates of infection and deaths, and yet they're less likely to get vaccines, at least from this preliminary data than their white counterparts.

Rachel: That's exactly right. We know, and we've heard for months now that Black and brown communities are disproportionately impacted by COVID-19. Now we're seeing the exact same pattern when it comes to vaccine distribution and vaccine uptake. Some states are reporting that white people are actually two to three times more likely to be vaccinated in comparison to their Black counterparts in the same communities.

Tanzina: Let's talk about some of the reasons why that is, Rachel. Of course, we know that we're talking about cities like Philadelphia, we're talking about Miami-Dade County, we're talking about here in New York City and even in Washington DC, where the percentage of people of color who are being vaccinated are significantly less than those of their white counterparts. Why? Do we have any early indicators as to why? We just heard Brittny Mejia from The LA Times, talking about maybe transportation to get to vaccine sites is less, but why else? Because I can tell you I'm trying to get vaccine appointments for my parents and it is not easy, Rachel.

Rachel: It is not easy. I had the same struggle a couple of weeks ago for my parents as well. I have to say, I think that we have to be clear that at the root of this issue is systemic and structural inequity and structural racism that we're seeing is the reasons why Black and brown communities are getting COVID at higher rates, and it's the same reasons why they're not getting access to vaccine.

In some cities and in some communities, it's an issue of location. We just heard the story in LA about vaccines centers being set up in places that are inaccessible to all people. They can't get there or they can't take the time off of work to get there. We also have to think about the issues around vaccine hesitancy are certainly there as well. We haven't really seen any significant efforts yet to really combat those issues in addition to the access issues.

Tanzina: The access issues, and we're going to talk about this more in the next segment coming up, but the access issues to me, at least here in New York City, were stunning, Rachel. A number of websites, a number of different places to try and sign up, set up accounts, and this is for people particularly the elderly, that can't be an easy thing to do.

Rachel: That's exactly right. I think we need to think beyond emails and we need to think beyond online signups for vaccines, we need to meet people where they're at. We need to go to their workplaces. We need to go to their neighborhoods and to their homes and really reach out in old-school public health fashion to be able to engage community and have discussions and get them vaccinated.

Tanzina: Rachel, we identified the issue here. People of color are being infected and dying at higher rates, and yet they're less likely at least right now, to have been vaccinated than their white counterparts are. Do we know if there are states that are beginning to try and address this issue?

Rachel: I'm not sure of specific states yet that are trying to address this issue. I think that there are different community organizations and leaders within different communities that are really working hard to address this issue. In Philly, Dr. Ala Stanford is doing some incredible work with her group to address the issue of vaccine rates in Black communities in Philly. I think we're going to see as the alarm has been sounded over the past few days, in particular, we're going to see more efforts both at the state and I think at the local level and the national level to really address this issue.

Tanzina: Speaking of the national level, the Biden administration did announce a health equity task force. Would this be maybe one of their first things they're attempting to tackle here?

Rachel: Absolutely. I would think so. I've heard Dr. Nunez Smith in the past couple of days mentioned that particularly the data collection piece will be an important priority in her work in leading that group to really ensure that both equity is at the forefront of all of the aspects of what they roll out, but that, in particular, data collection happens in a timely and efficient manner.

Tanzina: Rachel, what does an equitable rollout of COVID 19 look like or what should it look like? Because I think one of the issues here, at least in New York, is that there are multiple websites, there's a lot of confusion. First of all, we're asking people to sign up at multiple places. Really, it's a question of people who have the time to spend on a website, refreshing it for nine hours straight. The people who have the time to be able to take off of their work and potentially wait on the line and they seem to be gaming the system a little bit. What does equitable COVID-19 vaccine distribution look like particularly for communities of color?

Rachel: I think that's an excellent question. I think Minnesota where I live is a perfect example of what you have to be thinking about first is that, in a state like Minnesota, we've prioritized Minnesotans over the age of 65, but here, what that means is that we are targeting more white Minnesotans because nearly a quarter of white Minnesotans are over the age of 65, but only 6% of Black Minnesotans are over the age of 65. Right from the start, we have failed to take an equity lens. I think each state needs to certainly look at their demographics, both overall but also their demographics with respect to who has been disproportionately impacted by COVID, and start from there.

Then I think the second part has to be that we need to expand our definition of high-risk or vulnerable categories to really make sure that essential workers are part of that. We know that Black and brown communities and Black and brown people are overrepresented as essential workers in grocery stores and food production, public transit, janitorial work, and we need to explicitly target those groups as well as within those groups, targeting folks based on both where they live. If they live in multi-generational housing as well as by race. I think it's okay to identify race and ethnicity as a specific criterion to determine priority for vaccination.

Tanzina: Rachel, a lot of the COVID-19 responses at least that we've been covering this over the course of the past year, there's been a lot of tension between how the federal government, at least under the Trump administration was dealing with the states. Then there were state officials having tension with local officials on different rollout capabilities or testing capabilities, or even directive on what should and shouldn't be closed. Do you suspect that those tensions with the Biden administration's new focus on some sort of health equity will minimize somewhat? Will there will be some standardization, I guess, across how we start to look at this? Because it feels like these political battles are playing out and at the end of the day, people are being left behind.

Rachel: That's exactly right. Politics, from the start has played a significant role in how COVID-19 has been handled. Of course, I can't speak for the Biden administration, but I do expect and hope that a lot of that will shift as we center the folks who are the most marginalized and the most impacted by this disease and in our efforts to change things.

Tanzina: Rachel Hardeman is a Blue Cross Endowed Professor of Health and Racial Equity at the University of Minnesota School of Public Health. Rachel, thank you so much for joining us.

Rachel: Thanks for having me.

Charles: This is Charles from Dallas, Texas commenting on our experience with COVID shots. Initially, we were dismayed by the line of cars that resulted in a 45-minute bottleneck at the entrance to the parking lot. Inside the facility, the process was a model of organization and efficiency. At each step of the process, we were met by engaging, cheerful, knowledgeable helpers who explained instructions clearly, told us what to expect at the next step. It was actually an inspiring community-building experience.

Mary Lee Hafley: This is Mary Lee Hafley in Fort Worth, Texas. My husband is 76. I am 72. He is in three high-risk categories in addition to being 76 and we both live in a high-risk zip code. I registered my husband and I on December 30th, still nothing.

Suzy: Hey, this is Suzy from Bend, Oregon. I work in crisis mental health with the public for the County. I had the privilege of receiving my first dose of the Moderna vaccine on December 31st, and just had my second dose of the vaccine last week on the 28th. I would say that my experience has been great. Our County seems to be well-organized and doing a good job of getting the vaccine out to the public.

I wish we could have a little more consistency across the state. My parents live in Umatilla County and they're older on one has compromised health, and they don't know when they're going to get the vaccine. It's unfortunate that your experience with this, accessing it and with the process seems to be really location dependent.

Paul: Hi, my name is Paul. I live in Levittown, Pennsylvania. I have been trying to get an appointment for a COVID-19 vaccination and it's impossible. I have applied with hospitals, doctor's office, pharmacies, the County, the city, nothing is giving me anything. I'm 74 years old. I need to get vaccinated to go back to work. Every night I see people on TV getting vaccinated. This is the most frustrating thing.

Orrin: Hi, my name is Orrin and I've been trying to arrange a vaccine for my 83 year old aunt who lives in New Mexico. She has diabetes and some other medical conditions. I haven't succeeded in doing that yet. It seems like everything has to be done online. I think it's just a matter of supply, but it's impossible to tell why I haven't been able to do it because you can't actually contact a person, you can only go through the various menus and options on their website.

Robin: I work with adults with special needs. My job called me and asked if I wanted a vaccination. I said, yes, please. The next week I was given a time and address in Carlsbad. There were no lines. Everybody was masked. It was proper distancing. I had no problems. My name is Robin and I'm from Oceanside. 

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