SAN RAFAEL — Before California’s summer surge took hold, Marin County offered one of the starkest illustrations of the virus’s disparate impact: During the first week of June, just as reopening had begun, Latino residents accounted for 90 percent of all new cases in the county despite making up just 16 percent of the population.
But Marin also stands out for the steps it took to address COVID-19’s spread in the predominantly Latino Canal District of San Rafael, one of just two ethnically diverse census tracts in the county.
After flooding the neighborhood with testing, training local Spanish speakers as contact tracers and covering the streets with signs and materials in Spanish about how to protect against the deadly virus, Marin County saw the number of new coronavirus cases among Latinos drop to a little over 30 percent by late October.
Omar Carrera, who has spent years working in Canal, remembers the first weeks of the pandemic. At the time, he wasn’t optimistic about the county’s approach.
“It lacked understanding of how deep the poverty is in this community,” said Carrera, executive director of the nonprofit Canal Alliance, which has served the neighborhood for nearly three decades and provided more than $1 million in coronavirus aid. “Anything they created wouldn’t translate to success immediately. It required a lot of troubleshooting and fixing.”
The driver of the outbreak in the neighborhood dotted with palm trees, auto body shops and low-slung apartment complexes was clear, he said: Essential workers were contracting COVID-19 on the job and spreading the virus back home in Canal, where 81 percent of residents are Latino, and multiple families often live together in one apartment.
“It was a perfect environment for the virus to grow fast,” said Carrera.
Marin County Health Officer Matt Willis doesn’t disagree. He recalls seeing a pattern as early as May.
“I remember conversations with other health officers saying, ‘Are you seeing what I’m seeing?’ ” he said. “Each day, I get a list of new cases, and you are seeing the same last names over and over again, in clusters representing families. And the majority of the names on those lists were people who were living together.”
When Marin began easing lockdown orders in June, allowing outdoor dining to return to downtown San Rafael, the share of cases among the county’s Latino residents was peaking. Weeks later, indoor dining and hair salons opened, but the county pushed back plans to open hotels, short-term rentals and gyms, citing a spike in cases.
By July, the county had launched what came to be known as the Canal Outbreak Response plan, working with the city of San Rafael, the Canal Alliance, Marin Community Clinics, Kaiser and others.
Within three weeks, a permanent testing site at Marin Community Clinics, in a Canal shopping center, had opened. About 600 “Why I Mask” posters featuring local residents were plastered throughout the streets. Another pop-up testing site was set up at Canal Alliance.
UCSF was brought in to train five Spanish-speaking contact tracers. That helped the county meet its goal of calling 80% of residents who tested positive within 48 hours of their result.
Volunteers with Canal Alliance said they also went door to door, encouraging residents not be afraid of being tested and telling them about available resources.
Jorge and Vicky Tenorio, parents of two daughters and a son, said the Canal Alliance made the difference for them when Vicky, who works as a babysitter for a family in San Anselmo, tested positive for the virus earlier this year. The group helped with groceries and rent while Vicky quarantined in a hotel.
“We had no information at all” prior to the positive test, said Jorge Tenorio. “Everything was new to us.”
By October, about 60% of people living in Canal had been tested, surpassing the initial goal of testing half of the neighborhood. The weekly case rate for Latinos countywide went from 60 cases per 10,000 residents in July to a low point of 4 cases in the last week of October before rising again during the winter surge.
Carrera acknowledges that the county’s efforts to ramp up testing and contact tracing in Canal were a breakthrough. But he stresses that the underlying problems that made the neighborhood vulnerable remain. As of late February, 2,111 residents — about 16 percent of Canal’s total population — had tested positive for COVID.
“Unfortunately, what we have learned in these 12 months has not been enough to understand that what is needed is a profound change in public health,” Carrera said.
