The coronavirus pandemic is an unprecedented challenge for front line healthcare workers across Oakland. But emergency-room nurses aren’t the only ones scrambling to respond. Pediatricians, mental health counselors and specialists like allergists and OB/GYNs are also having to adjust to the new reality of an invisible viral threat.
We spoke with three Oakland physicians and public-health experts about how the pandemic and the shutdown are impacting the communities they care for, and how their clinics are rising to meet the challenge.
“The shelter-in-place order, while necessary for keeping communities safe and flattening the curve, has been taking a toll on Oakland families,” said Katherine D’Harlingue, a pediatrician at La Clínica de la Raza in Fruitvale.
D’Harlingue said her clinic, which primarily serves low-income and immigrant families, has seen an increased need for mental-health services for children and adults. Many Oaklanders were already living in overcrowded housing before the crisis. Clinicians worry that job and income losses, school closures, and demands to stay indoors could cause increases in child abuse, domestic violence, and depression.
D’Harlingue said La Clinica is distributing resource packets about the coronavirus and economic assistance, and making social workers more available. And while the clinic now mostly interacts with patients through “telehealth” video and phone appointments, D’Harlingue said, “We’re still vaccinating babies and seeing kids that are moderately sick and can’t be seen only over the phone.”
Other clinics have also drastically changed the way they communicate with patients, said Dr. Noha Aboelata, CEO of Roots Community Health Center, which serves deep East Oakland. “This is a community that was already facing a lot of food and housing insecurity,” said Aboelata. “We used to be a beacon for people to congregate around meals and popup markets. Now, it’s shifted to appointment times to pick up food and supplies, like diapers and hand sanitizer. We’ve shifted to a lot of home delivery, especially for elders.”
Dr. Michael Lenoir, an allergist and pediatrician who has practiced for 35 years in Oakland and founded the African American Wellness Project, said the COVID-19 crisis’s impacts on Oaklanders will reflect existing longstanding racial inequities. For example, because Black Oaklanders suffer from higher rates of asthma, they may be more vulnerable.
“This just amplifies an issue that’s been present a long time,” Lenoir said. “Health equity for African Americans has long been a disgrace in this country. I don’t know why everyone is surprised.”
Lenoir said pre-existing inequities in how doctors and hospitals care for Black Americans is also likely to play a role in this crisis. “I think what worries me the most is choices in how to treat patients,” he said, referring to research that has shown that Black people often receive lower-quality care than white people.
D’Harlingue said Oakland’s growing Maya community of Guatemalan immigrants may not be getting the information they need to stay safe and get resources. She said more needs to be done to translate information into languages like Mam, such as in a video recently produced by La Clínica.Other population groups will have particular needs during the crisis, the physicians explained. “People released from jail without having really any resources are showing up into a community where there’s a complete economic shutdown,” said Aboelata about hundreds of people recently freed from Santa Rita Jail, many who are from Oakland and were dealing with mental and physical health issues before the crisis. “Trying to re-integrate into a community is really challenging.”
All three doctors agreed that this crisis has only begun. Oakland and the state will need to take action to ensure that the pandemic doesn’t result in an economic crisis that disproportionately harms communities of color, as the Great Recession did. And as we recently reported, we know that other disease crises, like swine flu, tuberculosis, and HIV, have harmed Black, Latinx, and Asian Oaklanders at higher rates.
“The long-term economic effects will be really severe,” said D’Harlingue. “I hope workers’ rights in terms of sick leave will be more widely expanded and made permanent, as well as broader housing equality reforms.”
“This came at a time when we had over four thousand people living on our streets, and we’re seeing significant displacement in our community and predatory practices, including high-priced development and pushing people out,” said Aboelata.
“We need to put together resources now so that when, not if, the next major crisis comes, we’ll be better prepared,” said Lenoir.