Johanna Bernal spends mornings greeting pet birds that sing from cages in the courtyard of her housing complex in Sherman Heights.
“I see the birds, and I whistle to them everyday and they whistle back,” Bernal said.
Bernal talks to the birds a lot now. She's a single mother and had to leave her job two months ago to have a baby. Now she’s taking care of three children.
Bernal immigrated to the U.S. about two decades ago from Mexico, and since then she’s worked as a janitor. But now her income is low. She used to work multiple jobs to pay bills, but many of them fell through with coronavirus. And she didn’t get a stimulus check from the IRS, because she’s undocumented.
“I have been talking to a counselor about all the stress because it is not easy as an immigrant,” Bernal said. “It's really stressful. It's like if [landlords] aren’t evicting us from our homes, we need to pay after. And if we start paying the rent, we have to find a way to that extra money later to pay our bills.”
Bernal hopes to work again in June. Many of her family and friends are still working in areas like the service industry. It’s scary, she says, because they are easily exposed to coronavirus.
“I heard about my co-workers that they have to bring their own masks to work. It’s sad that they have to do the work for their own safety and for the safety of others,” Bernal said.
Contact tracing in underserved diverse communities key to controlling outbreak
Now that San Diego is opening up again, county officials will increase testing and start contact tracing to prevent outbreaks. This is where they hire workers who can find infected people and their contacts. And ask them to quarantine to avoid spreading the virus.
Contact tracing everywhere is key to controlling this pandemic. But people in those at-risk communities may be afraid to give up information.
“I actually have family that if they get sick, they don't go to the hospital because they ask you for your Social Security number. They think if you don't have it, they're going to send ICE (Immigration and Customs Enforcement) to [deport] them,” Bernal said.
Latinos make up just one-third of the county's population. But they account for 60% of positive coronavirus cases. That same disparity is playing out nationally. So cities like San Diego are seeing how critical it is to address the issue of trust and fear in communities of color.
San Diego County Supervisor Nathan Fletcher said the county will be hiring around 500 contact tracers, who are ethnically diverse and speak multiple languages.
“One of the most overarching criteria that we need when we hire contact tracers is that we need individuals who are going to be trusted by the community,” Fletcher said.
He said the hiring process will happen through a normal human resources screening. He said the distrust between some communities and the government is something the county is aware of.
“We saw this with the census, where individuals became fearful for a good reason. We worked really on our census outreach to make sure it was trust with community members.”
But another project is underway that could help the county further. It’s one that will reach out directly to people from those communities and train them to be contact tracers.
Hala Madanat is a sociologist and director of the San Diego State University School of Public Health.
“When you're part of the community, you understand the community. That's the whole point of why this is a unique arm of the contact-tracing workforce,” Madanat said.
About a month ago, Madanat said the school contacted the San Diego County with an idea: Train up a group of community health workers from Arabic-speaking, Spanish-speaking and African American communities.
“The fact that the people that are being hired are from within the community means they understand their challenges. They can feel for them. They can understand what needs they may have,” she said.
The school has a contract with the San Diego Health and Human Services Agency (HHSA) for nearly $3 million over six months to train up around 100 people to support the county's disease investigation efforts.
Madanat said when people see a familiar face they trust, they’ll be more likely to accept an explanation of what it means to get sick and to infect others with coronavirus.
“Those barriers are easily overcome when you have a real discussion with people about the potential implications, and you’re transparent.”
There’s no catch-all solution for generations of inequity and distrust
In low income and diverse communities like Barrio Logan, coronavirus is just one of many stressors. Roberto Alcantar, is chief strategy officer of the nonprofit community group The Chicano Federation, which works in hispanic communities.
“Folks right now; they’re concerned about keeping a roof over their heads. They’re concerned about where their next meal is going to come.”
In other words, he said, anyone who tries to convince someone to quarantine and take another economic hit, will find it difficult.
“Lack of access to affordable housing, which then forces multiple families to live under one roof. You're really creating a very dangerous situation for our community,” Alcantar said.
And Christy Lopez, a professor of law at Georgetown University, said it will also be critical that the government doesn’t use any data for purposes other than providing health care services.
She said the government has a long history of using data for surveillance, and that has many people reluctant to share their information.
“If gathered, it has to be completely hands-off to law enforcement. It's really only being collected for a public health purpose,” Lopez said.
“We have to give people the confidence that they can give their information to public health and it won't be used by law enforcement. Even if they're documented and they know it won't come back to them, they're worried about how it'll affect those around them.”
She said for many of these communities, contracting the virus itself can be disastrous.
“If you don't have sick leave if you don't have money saved in the bank, that can be devastating. Not only might you lose your job, but that means you might lose your apartment. You may have to change your home,” Lopez said.
“So we have to be very mindful of the impact of those false positives and even the real positives.”
Alcantar said building trust also means giving people the resources they need to be healthy and feel safe. He said hiring people from the community is critical for contact tracing, but he said people may not trust the guidance, because for years basic needs haven’t been met.
So, additionally, he said government leaders need to provide more economic support to allow these communities to weather the storm.
