Desert Sun: Targeted COVID-19 testing is needed in eastern Coachella Valley, Ruiz says
By: Nicole Hayden, Palm Springs Desert Sun
Published: 4:20 p.m. PT April 29, 2020
In the center of Coachella, two medical clinics sit side by side. One is for families, Clinica Medica Familia, and another is for industrial injuries, Superior Industrial Clinics.
Elva Trevino is a nurse manager on the industrial side. She typically sees workers local to the eastern Coachella Valley come in from the fields and packing or manufacturing plants with work-related injuries. A woman sat in the waiting room on Monday with large gash on her knee, bleeding through her jeans. Trevino is used to this.
She isn’t accustomed to navigating the health care system amid a global pandemic, and she is worried about providing care for COVID-19 to the residents that her clinic serves.
“There absolutely isn’t equal testing access across communities,” Trevino said. “I have tried to make testing appointments for my patients and couldn’t.”
The Desert Sun requested the number of residents tested in each city and unincorporated community in the Coachella Valley but Riverside County health officials denied the request. They said the information was not available — even though patients must provide their home address when making an appointment for a test.
At first, the barrier to making an appointment was limited testing resources across Riverside County. Now more testing is available, but Trevino cites lack of transportation, lack of awareness and lack of availability as reasons for continued disparate access — testing is often open during times that essential farmworkers are in the fields, she said.
As COVID-19 cases rise in the Coachella Valley, communities in the eastern part of the region continue to have the highest reported rates of infection. As of Wednesday, Thermal, Mecca and Coachella, respectively, lead with the highest rates, according to Riverside County public health data.
The higher rates don’t necessarily mean the highest number of cases. It does, however, mean — when compared to a particular community’s population size — the total number of cases represents an undue burden.
An unincorporated community just south of Coachella, Thermal has an infection rate (8.1) that is five times higher than the overall rate among Coachella Valley cities and unincorporated communities. The overall rate of cases is 1.6 per 1,000 residents.
Mecca, an unincorporated community just north of the Salton Sea, has double the overall valley rate (3.2). The city of Coachella is just under double the overall rate (2.7).
The higher rates are likely due to a myriad of causes. The eastern Coachella Valley is home to many essential workers. Area residents live in smaller homes where isolating family members from potentially exposed individuals is near impossible. These same communities also experience household overcrowding at higher rates. While just 6% of Coachella Valley households are overcrowded, that trend spikes in the predominantly Latino unincorporated areas — to 26% in Mecca and 13% in Thermal.
Additionally, residents may not have access to online COVID-19 marketing materials from local governments.
Two testing sites in Thermal also could be a contributing factor in its high rate of confirmed cases, since more tests are conducted there.
Experts say the eastern Coachella Valley needs more targeted testing because of the increased risk of spread in the community. Essential workers do not have the ability to stay home, and underlying health risks are already present in the population, they say.
Ruiz pushes for more testing in east valley
U.S. Rep. Raul Ruiz, D-Palm Desert, said he would like to see an immediate, targeted community outreach project that specifically addresses those most at risk for contracting COVID-19 and those who have barriers to accessing the county’s drive-through testing.
Beyond that, Ruiz said ideally he would like to see every household tested for coronavirus in east valley hot spots like Mecca. He is calling on Riverside County to take more responsibility for communities that have been overlooked.
“If there is a focused effort to pilot a project to test all households in Mecca for coronavirus and to do antibody testing than we can make safeguards in this contained community to start putting people back to work,” Ruiz said.
Riverside University Health System Public Health Director Kim Saruwatari said during a Wednesday press conference that the county is one of the leaders per-capita in testing in the state and country. Saruwatari said the county is working to bring additional testing sites to Mecca, San Gorgonio Pass and San Jacinto Valley.
“These are areas where we believe there is still a great need,” she said.
Ruiz said the eastern valley should be a priority focus because it is already a medically underserved area with higher rates of asthma, COPD and diabetes — all are underlying health conditions that exasperate severe symptoms of coronavirus.
In the eastern Coachella Valley, childhood asthma incidence is three times or more than the rest of California, according to David Lo, and associate dean of research at University of California, Riverside.
Testing is especially needed to reduce spread of the virus among high-risk families, Ruiz said.
“If you are quarantined or isolated in a house with multiple rooms, then you can isolate individuals within a home,” Ruiz said. “However, in a farmworking community with workers who still have to show up to work every day, they are more likely to infect their family because they don’t have space in their trailer or small house to divide the family.”
Additionally, Ruiz said the communities are part of the essential workforce of agriculture and packing houses, and they don’t always have the privilege to wash their hands often during work or practice adequate social distancing. Companies lack oversight, Ruiz said, to ensure that workers have what they need to keep themselves safe, such as personal protective equipment and distance between others.
Ruiz pointed to the recent outbreak at SunDate, a data packaging facility in Coachella, where the state’s Division of Occupational Health and Safety is now investigating an employee’s coronavirus-related death. Twenty employees at the facility have tested positive.
Riverside County public health officials have said they intend to work with facility operators to test more employees.
‘Some people can’t take time off work’
There are currently a handful of sites where individuals can get tested in the eastern Coachella Valley. However, due to lack of information, some people aren’t aware of these options — or they can’t get to the clinics due to time or transportation constraints.
Coachella Valley Unified School District, which spans from the eastern Coachella Valley, east to Chiriaco Summit, and south to Salton City, estimates about 40% of its students lack reliable access to internet at home, Superintendent of Schools Maria Gandera said.
“Some people can’t take time off of work to get testing or don’t have transportation,” Ruiz said. “Then there is the awareness aspect in terms of people who don’t have the information or awareness of where and when testing occurs.”
Riverside County is conducting tests daily at the Indio Fairgrounds. But Trevino said workers often don’t leave the fields until 4 p.m. — three hours after the county testing site closes.
Ruiz said that testing should be offered at varied times throughout the day.
Ruiz also said testing should be available at the community clinics that are embedded into neighborhoods, so people don’t have to travel far. From Mecca, it’s about a 25-minute drive to the Indio Fairgrounds.
For those who do need to travel to get tested, though, a carpool should be set up to provide that transportation in a safe, socially-distanced way, Ruiz said.
“It is going to get really hot soon, too, so people who don’t have a car to sit in at the drive-up testing sites or who don’t have A/C in their car should have an area where they can sit while they wait to get tested that is cool,” he said.
Communication of resources is a harder feat, however. Ruiz said there have been advertisements about testing on both Spanish and English radio and TV, and online advertisements, but it doesn’t seem to be enough.
“Often people find out about things through word of mouth,” Ruiz said.
For Mecca resident Steve Herrera, that lack of information led him to travel throughout the valley trying to get tested. He ended up at a pop-up testing site on Tuesday in Cathedral City, run by Borrego Health, a Federally Qualified Health Center that operates multiple clinics throughout the valley. Two are in Thermal, and one closely borders Mecca.
“My sister told me that it was easier to get tested there and my doctor wanted me to be tested because I have had a cough and trouble breathing for the past month,” Herrera said. “But you know, right now, everyone is scared because they don’t really know what to do or where to go. Having testing in places like Mecca or Thermal would help.”
Currently all three Borrego Health clinics in the eastern Coachella Valley have the capability of testing, though that was not known to many in the community. Most people have continued to try to book an appointment through the county at the Indio Fairgrounds which is open from 6:30 a.m. to 1 p.m., or have tried to seek appointments at other clinics in the western Coachella Valley, Trevino and Hererra both said.
Most testing at the Borrego Health clinics is done by appointment, though there are some exceptions, said Mark Connelly, Borrego Health chief operating officer. Borrego Health plans to start doing outreach to educate community members about testing options.
“Because of the limited availability of test kits, the provider has discretion whether a patient should be tested or not,” Connelly said. “It is best for a patient to call the clinic directly to schedule an appointment and to receive the latest information regarding the availability of testing and clinic specific testing procedures.”
Borrego is offering testing at Centro Medico Coachella in Thermal from 7 a.m. to 5 p.m., Centro Medico Oasis in Thermal from 8 a.m. to 6 p.m., Martha’s Village Clinic in Indio on Monday, Wednesday and Friday from 8 a.m. to 5 p.m. and at 85365 Dillon Road near Spotlight 29 Casino on Friday and Saturday from 7 a.m. to 11 a.m.
To expand the availability of testing, Ruiz’s office worked with the Coachella Valley Volunteers in Medicine to set up testing Wednesday from 3:30 to 6 p.m. at the Mecca Catholic Church.
Ruiz said he hopes to expand that effort.