Los Angeles Covid-19 pandemic reveals city’s racial and class divide

Dr Nicole Van Groningen is exhausted. Hospitalist and assistant professor at Cedars-Sinai Medical Center in Los Angeles, Van Groningen has been on the front line in the fight against Covid-19 for 11 months, and as Los Angeles comes out of its worst increase in cases since the start of the pandemic, she spent the last two weeks of January in the overwhelmed intensive care unit of the hospital. Even though cases have started to stabilize, morale is grim.

“Everyone’s nervous, it’s a feeling of constantly preparing for things to get worse. And the ICU patients have been so sick for so long, ”she said with a soft sigh. It is the end of January, and the region is recording an average of more than 40,000 cases per week. The hospital’s ICU exceeded maximum capacity by 33%. “They get worse and they don’t bounce back like we usually see them. We are used to having the skills that we can use to improve most people. We know we are doing all we can, but it takes a psychological toll when we cannot heal these people.

Dr Van Groningen’s description of the fight against Covid is frightening. Patients arrive scared, anxiously waiting to see if their symptoms will eventually go away or if they will rise enough to go to the ICU, where the chances of survival are much lower. “Our patients arrive terrified. They are really scared when they first arrive at the hospital and have difficulty breathing, we treat them after giving them oxygen, ”she says. “Sometimes even with that, they start to progress and again out of breath. Once you mention taking them to the intensive care unit, you understand how scared they are. “

A few kilometers away, the death toll of the virus is barely visible. Just days before my conversation with Dr Van Gronigen, I parked near the entrance to Runyon Canyon Park, a popular hiking spot overlooking the city from the Hollywood Hills. It is calm, even peaceful. A teenage couple exit a Jeep, unmasked and standing side by side as they prepare to hit the track. If there is a sense of normalcy during the devastating Covid-19 health crisis, that would be it.

Across the country, the pandemic has revealed deep divisions in our communities, with black and Latin populations contracting the disease and dying twice as many as whites, according to the Centers for Disease Control and Prevention. Nowhere is this more clear than in Los Angeles, where, according to its zip code, the most recent wave of the coronavirus outbreak was either a slightly suppressed talking point during Zoom calls – something to look forward to that dinners and vacations resume – or the brutal plague that destroyed families and communities. Ten of the wealthiest neighborhoods in Los Angeles County combined, representing about 323,000 people, have about 700 fewer confirmed coronavirus cases than the city of Compton alone (95,000 inhabitants).

It is far from a coincidence. The wealthiest, whitest cities are less populated, have less crowding, and have more residents who can work from home and travel by car, crucial to infection rates. Meanwhile, those who live in poorer the communities are more dependent on public transport and have been forced to leave their homes for work, bringing the virus back to their families. After two brutal months of infections and deaths during the holiday season, Los Angeles is recovering, with confirmed cases, hospitalizations and deaths continuing to fall from their heights in late December and early January. But as the city slowly returns, the disproportionate toll is clear.

Seeing daily Covid stats and hearing horror anecdotes on the frontlines from the ICUs is disorienting. While a Los Angeles resident died every 10 minutes from the virus during the peak of the outbreak, residents could still clamor in malls for the holidays. Los Angeles County’s reestablished home security order did not begin until three days after Black Friday. As cases skyrocketed, the county took preventative measures, ending al fresco dining and closing businesses like barbershops in late November, and residents were urged to avoid leaving the house when ‘they weren’t essential. Still, Los Angeles never really reinstated a lockdown.

A stark contrast to the very early forties, where traffic was non-existent and the city seemed empty, during Los Angeles’ deadliest times, malls, jewelry stores, bookstores and most other types of establishments retail stores were open to limited capacity. The city and state also had to support a badly injured economy, with California having the third highest unemployment rate in the country in December, according to the Bureau of Labor Statistics, and it faced continued pressure from businesses that were in difficulty for months. Restaurants across the state have sued California Governor Gavin Newsom over dining restrictions, and Newsom faces a small but notable recall effort Republicans in California in light of the state’s response to the virus.

The limited capacity openings only added an additional sense of normalcy, and what resulted was a confusing message to Angelinos as to what was expected and what was allowed.

South Los Angeles’s Martin Luther King Jr. Community Hospital is surrounded by predominantly black and Latin neighborhoods like Watts, best known for the Watts Riots of 1965, and it has become a symbol of how the coronavirus struck disproportionately these communities. The relatively small 131-bed hospital has largely exceeded capacity since December and, as MLKCH CEO Dr Elaine Batchlor says, her hospital has served more Covid-positive patients than hospitals four times its size. Even though the surge subsided significantly in February, the hospital’s intensive care unit remains 100% full.

The community served by MLKCH was particularly vulnerable to a pandemic. Access to health care is more limited and underlying health problems are more common. Diabetics, for example, are one of the highest risk groups for severe cases of Covid, and South Los Angeles has rates of diabetes three times higher than any other part of the state, Batchlor says, and diabetic amputations and injuries are the hospital’s number one surgery. “A lot of our patients are on the front lines, and if they continue to spread and are immediately exposed to it, they live in overcrowded housing, they go home and give it to the rest of the family. We see whole families getting sick, losing important family members.

The hospital outfitted its gift shop to treat more patients, doubled rooms, converted an entire floor into an intensive care unit, and set up five triage tents outside the hospital, where patients are treated and accommodated until there is room inside the hospital.

As Batchlor says, the areas served by her hospital have long been the most likely to face a health emergency, and she hopes the pandemic will underscore the need for better resources for poor communities across the country in the future. “Even before the arrival of Covid, we had a public health crisis in our community, and it is an epidemic of poorly treated chronic diseases. [Covid] then attacked a vulnerable population and hit them much harder than others, ”Batchlor says. “In the long term, we need to create better access and quality health care for underserved communities. We are all connected. I hope the pandemic has shown us that we are all in pain.

Batchlor and Van Groningen see both sides of the story of Covid in Los Angeles every day. After treating the county’s sickest patients, they return home to Westchester and Santa Monica, where incomes are higher and cases are lower. On several occasions, Batchlor would come home to see her neighbors hosting social events and not following mandatory city protocols, which she said felt “demoralizing.”

“It’s really frustrating and sad that people don’t take it seriously enough and aren’t willing to make the small sacrifices needed to keep other members of the community safe,” she said. “And it makes me angry when I think about how hard we are working to treat those affected by covid. Earlier in the pandemic, when I saw people come out without a mask, I would say something. I quit because it happened so many times.

Van Groningen comes and goes from work to Santa Monica beach, where, especially on weekends, she says, it’s hard to discern a difference from a pre-covid world. Without mask is not creepy but it’s still noticeable, she says, and she still sees enough people probably from different households getting too close for comfort. Finding a way between reducing cases, supporting the economy and deteriorating mental health of residents almost a year after the start of a pandemic is a difficult task, she says, but giving up the first one is dangerous . As many epidemiologists and health experts told Los Angeles Times, fatigue and a decrease in social distancing practices have been a frequently cited factor in the increase in the number of cases during the holiday season. And yet Van Groningen is optimistic.

“I like to think we haven’t given up,” she says. “From my experiences with friends and people I’m close to, I want to say that most people are still trying to do the right thing. But there is a disconnect. I think sometimes people don’t know what the right thing is.