As Latino households across the country are pummeled by the virus outbreak, staff from Neighborhood Health, a chain of medical clinics in northern Virginia, have stepped up testing efforts in areas where that community is hardest-hit.
Of the health center's 30,000 patients, 50% are Latino immigrants hailing from Central America. They are predominantly low-income and uninsured. And though they make up half of the patient population, Latinos represent nearly 90% of those who have tested positive for COVID-19 at the group's clinics.
On one day earlier this month, the medical team's endeavors took them to a small parking lot near Four Mile Run park in the city of Alexandria. A large blue tent set up at the entrance of the lot marks one of five makeshift coronavirus testing sites.
"The next walk-up patient can come up," says Jessica Alvarenga, a medical assistant administering tests at the booth, over a walkie-talkie.
Meanwhile, mask-clad people on foot form two lines while carloads of patients pull in for their respective drive-through appointments.
"The testing rates in some minority communities across the country is much lower," says Dr. Basim Khan, primary care physician and executive director of Neighborhood Health. "So, not only are they getting more disproportionately impacted, but you're also seeing that the response is not as robust as it needs to be."
Latinos make up about 18% of the U.S. population. But when the Centers for Disease Control and Prevention recently analyzed provisional COVID-19 deaths and racial and ethnic data in areas where more than 100 people had died, it found Latinos made up about 27% of coronavirus deaths.
Khan hopes to change that narrative for his patients whose homes line the border of Arlington County and Alexandria, an area called Arlandria. An influx of Salvadoran immigrants in the 1980s earned it the nickname "Chirilagua," after the city on the Pacific coast of El Salvador.
Neighborhood Health has tested more than 800 patients for COVID-19 so far. Khan says members of the Latino community struggle to isolate themselves even after they've tested positive. They often work low-paying jobs deemed "essential" — sometimes with no protective gear.
And language barriers and questions over immigration status can make it harder for Latinos to access the health care systems or unemployment benefits that could provide relief.
"Because they have this illness, they're obviously not able to work and they're struggling to keep food on the table," Khan says. "It's been a really stressful and challenging situation for a lot of our patients who have tested positive."
Virginia Gov. Ralph Northam announced that the state will begin "phase one" of reopening on May 15.
But, for some, it's not so easy to move forward.
Silsa Ortiz de Catalan, 47, is among the Neighborhood Health patients who live in crowded conditions at home. Catalan contracted coronavirus in late March and spread the disease to her entire family of four. Catalan, her husband and two adult sons share a one-bedroom apartment.
"I was working without gloves and without a mask," she says in Spanish, her words interpreted by a Neighborhood Health worker.
"I started to feel like I had a fever and I started shaking, but I didn't pay too much attention, so I kept working," Catalan says. Her bones and throat were aching, but she worked through the pain for several days at a well-known craft store.
The Guatemala native says her latest COVID-19 test came back negative, indicating she's recovered, but she has another problem: After being out of work for five weeks, how is she going to pay the past-due rent for May?
According to a recent Washington Post-Ipsos survey, 20% of Latinos say they've been laid off or furloughed since the outbreak began — compared to 11% of whites and 12% of workers of other races. African Americans and Latinos are also dying of COVID-19 at the highest rates.
When a patient's positive test result comes in from the lab, medical staff at Neighborhood Health reach out to the patient to discuss symptoms and determine the level of monitoring needed. For those with more acute symptoms, the doctor will recommend the delivery of a pulse oximeter to the patient to check oxygen levels on their own.
Meanwhile, another group of workers at the clinic conducts contact tracing with patients that test positive. They also provide the families with food.
As businesses across the country reopen, Khan is urging government officials to focus on the communities most impacted with more aggressive testing.
"First of all, it's just the right thing to do. But second is it reduces the likelihood of broader spread," he says. "We're as good as our weakest link."
DON GONYEA, HOST:
And finally today, if you're anything like me, you miss seeing live music - at a club, a concert hall, wherever. It's just not the same streaming songs into your headphones. Now, imagine being an independent working musician who depends on live shows as a way to promote their music and to make a living. To discuss this new world that we're all coping with, we called up two musicians who both have put out new material in recent weeks and who would be on tour at this time if it weren't for the coronavirus. First, we are joined by Lilly Hiatt, a singer-songwriter based in Nashville. Her brand new LP is called "Walking Proof." Lilly, Hello.
LILLY HIATT: Hey. How's it going?
GONYEA: Good. Good. And also joining in is Caleb Caudle. He's a singer-songwriter. He's also in Nashville. His just-released album is titled "Better Hurry Up." Welcome, Caleb.
CALEB CAUDLE: Hey. Thanks for having me.
GONYEA: So right now, musicians, really, across the world are unable to tour and promote their new records, music they're putting out. Lilly, tell us why this is such a blow to the way musicians at your level - you guys aren't playing big arenas and all that, but musicians at your level - why is it such a blow to how you operate and make money?
HIATT: It's such a blow because it's the way that we continuously propel our musical ride is by going from city to city. And people hear the show, and they might talk to a friend or they might do, like, an Instagram story with us playing and where it starts to spread. And, you know, we don't have the luxury of being blasted on AAA radio constantly or, like, million-dollar marketing campaigns behind us and stuff. Though we have great support, it's like, we're indie. And there's an element of DIY to that. And a big part of that is touring. So that's where I've made the majority of my income my whole career. So it's kind of like our jobs are gone right now.
GONYEA: Caleb, same question to you, your take on what it means to your ability to do what you do.
CAUDLE: The only thing that I would add was I feel like most of my job - and I'm sure Lilly feels the same way - is, like, spent at the merch table after the show is played, just meeting fans and, you know, connecting with them on a more personal level and them going through what your songs mean to them and how it's all connected. And that's a really special moment. And, you know, it's something I really miss.
GONYEA: I, like a lot of people, spend too much time on Twitter. But I do follow a lot of musicians. And one thing I've noticed over the past month or so is musicians - and I think I've seen each of you do this - giving a shoutout to other musicians who have a new release out. So along that vein, I'd like to do a little bit of that in this interview. So normally what we do when we talk to artists like yourselves is we plan in advance what songs we're going to ask you about and get your comments and all that. But I want to turn that over to each of you for a moment. You guys certainly know each other's music. So, Lilly, is there a song on Caleb's record you'd like us to play right now?
HIATT: Yes. I would like you to play bigger oceans bigger oceans.
GONYEA: "Bigger Oceans."
(SOUNDBITE OF SONG, "BIGGER OCEANS")
CAUDLE: (Singing) Times get hard. Times get rough. Guard your heart when the going gets tough. The light will blind you till your eyes adjust. Prisoner of time, a night in jail. Free your mind, Nightingale. Through the sky, lover set sail. I don't know how you do it, but somehow you keep on moving. And you're on to bigger oceans, I can tell.
GONYEA: Lilly, the composer is right here. Any questions for him or thoughts for him on that song?
HIATT: Well, firstly, I wanted to know who the woman is singing on it with you and also why it was decided as the last song.
CAUDLE: Well, that is Courtney Marie Andrews...
CAUDLE: ...On that one doing a great job. And it just felt so dreamy that, when I heard it, I just knew it needed to close the record. And it's a really hopeful song. And I wanted to leave the listener with some hope as they walked away from the record.
HIATT: I love that.
GONYEA: It's one of those songs too, when we hear it now in this new world, it takes on a different meaning.
CAUDLE: Absolutely. Yeah, I wrote it for my wife when she was leaving her job to just come on the road with me. So yeah, it's one I hold very dear.
HIATT: It sent me off with such a hopeful feeling. I love a good sea song. And I think the cadence and the groove of it rocks like the ocean. And I love the lyrics. And I really think it shows what you do best.
GONYEA: Caleb, same drill for you. Pick a song off the new Lily Hiatt album.
CAUDLE: It was really hard for me to decide, but I went ultimately with "P-Town" because I remember hearing it and just thinking, like, this is Lily, like, totally herself. And that was just really inspiring for me. So I love the little details in it. And, Lily, you have such a great way of creating a setting and making people feel like they're there. So yeah, I love the song.
HIATT: Thank you.
GONYEA: Let's hear it.
(SOUNDBITE OF SONG, "P-TOWN")
HIATT: (Singing) Looking at pictures of us in Portland, Ore. I still can't figure out why we didn't have fun. (Unintelligible). You said mine doesn't at all. You know us passionate girls, we all got our clothes (ph). I grabbed a coffee, and I gave Paul a buzz. I said I don't think I'm who he thought I was. And we (unintelligible) walk on the bridge. Don't you just hate when people say it is what it is?
GONYEA: So, Lilly, how long have you been carrying that line around in your head? I hate when people say it is what it is (laughter).
HIATT: (Laughter) Well, probably about like four to six years, for whenever the time in my life was where I seemed to be hearing it a lot.
GONYEA: Any other questions for Lilly about this song or a lyric or whatever?
CAUDLE: No, no more questions, I don't think. But I really love how you kind of introduce a character named Paul just kind of like as an afterthought. I really love that.
CAUDLE: Well, thank you Caleb.
GONYEA: To finish up, and you can both answer this. You can go first, Lilly. What are you looking forward to the most once we get beyond all of this, whatever that means, whenever that is?
HIATT: I'm looking forward to standing between a crowd and my drummer and having amps blast my ears and feeling that visceral, like, guttural vibration that comes from a rock 'n' roll show with a bunch of people.
CAUDLE: For me, it's, you know, like obviously, I want to go hug my family and my friends and then get back to the rock 'n' roll shows and go down roads I've never been down before because I live for that.
HIATT: Clearly, I want to hug my people too, you know. We'll throw that in there.
GONYEA: We've been talking to musicians Lily Hiatt and Caleb Caudle. Both have new records out. Lilly's record is called "Walking Proof." Caleb's is "Better Hurry Up." Lilly, Caleb, thank you both so much for joining us today.
HIATT: Thank you so much.
CAUDLE: Yeah. Thanks, Don. Transcript provided by NPR, Copyright NPR.