The Pfizer and Moderna vaccines had begun shipping to California in mid-December, and arrived in Los Angeles when the risk of getting COVID-19 there had never been higher. While New Yorkers drank hot toddies next to heat lamps, outdoor dining in L.A. was suspended despite consistently beautiful weather, and gyms and schools were closed. County officials had begged residents not to gather for Thanksgiving or for Christmas, but there was still a post-holiday surge. By the end of December, more than twenty per cent of COVID-19 tests in L.A. County were coming back positive, and there were more than twenty thousand new infections every day. By New Year’s Eve, the L.A. County Department of Health was warning on Twitter that people were dying of the coronavirus there at a rate of one every ten minutes. (Its account urged the public to “Please stay home tonight” at least sixty times that day.) By January the county hospitals were running low on oxygen and dialysis machines, and morgues had reached capacity. From the first recorded case last year, it had taken Los Angeles until December 11th to hit five hundred thousand cases of COVID-19. It took only one more month for that number to double.
Despite this emergency, the vaccine rollout in Los Angeles, the most populous county in the country, was slow to get going. As of January 6th, the county had administered just thirty-eight per cent of the doses it had received. When, a week later, the state of California expanded eligibility from health-care workers and nursing-home residents to people over sixty-five, there was a shortage of shots, many of which had been reserved for people receiving their second doses. Two cities in the county, Pasadena and Long Beach, have their own health departments and therefore maintained control over their own distribution of vaccines. Long Beach, a port city with a population the size of Oakland, had opted to get shots into arms as quickly as possible, counting on projections of supply for second doses instead of reserving them in the freezer. The city’s progressive mayor, Robert Garcia, had lost his mother, who was a health-care worker, and his stepfather to the virus over the summer. His willingness to risk the possibility of running out of vaccines proved an effective strategy: by the third week of January, when the rest of the county had just started giving vaccines to people over the age of sixty-five, Long Beach had expanded eligibility from health-care workers and the elderly to food workers, with teachers following the next week. The vaccine rollout seemed oddly experimental in its approach, with different jurisdictions across California and the country choosing different groups for eligibility. Why, in the heart of the epidemic, did things seem to be so disorganized?
In December, I was staying at a friend’s place in the neighborhood Echo Park, a few blocks from Dodger Stadium, which was serving as a drive-through COVID-19 testing site. Every day, the lines of cars snaking down Vin Scully Avenue seemed to be getting longer. It was an otherwise peaceful part of town, and I was surprised when, one evening, I came home to find my street blocked off for a protest opposing the pandemic-related restrictions on businesses and the mask mandate. Earlier that day, I had seen a handful of people at the bottom of the hill waving signs that said things like “COVID=SCAM.” Now a rowdy and unmasked group of twenty or thirty people was gathered on what seemed to be an insignificant side street. It was confusing, but 2020 had been the kind of year when it no longer seemed strange to run into a mob of conspiracy theorists at any given moment. I walked through them with my mask on, trying not to make eye contact, but caught the attention of a blond, bearded man wearing a MAGA hat, with a can of beer in his hand. “Look, Antifa’s here!” he shouted as I passed. “You can tell by her lesbian haircut.” We exchanged some insults, then I continued walking toward my driveway, baffled, annoyed, and trailed by protesters eager to record confrontations on their phones.
A couple of days later, when I took in the mail, I realized the reason they had chosen our block. In the mailbox was a printed letter of apology about the protest, signed by a neighbor named Barbara—Barbara Ferrer, the silver-haired director of the Los Angeles County Department of Public Health, who appeared on television nearly every day with updates about the city’s increasingly dire situation. By the following Saturday, the news was so bad that she fought back tears during a briefing. “Over eight thousand people who were beloved members of their families are not coming back,” she said.
The number of deaths did not dissuade the protesters, who came back to our neighborhood the following Sunday, and the Sunday after that. Their campaign did not seem to be to win hearts and minds. They stood outside Ferrer’s home and chanted “Open up L.A.,” into a megaphone. They harassed the drivers filling up at the gas station down the street, yelling at them to “take off those face diapers.” When my mother and I walked past them one afternoon with our masks on, they baa-ed at us like sheep. The neighbors began a counteroffensive. One posted window signs that said “WEAR A MASK.” Another, on the last Sunday before Christmas, blasted jazz music and the soundtrack to “A Charlie Brown Christmas” to drown out the chants.
Soon after, the anti-maskers mobbed Erewhon, the expensive health-food grocery chain recently described in the New York Times as “the unofficial hangout of the young, beautiful, and bored.” (One protester told the Los Angeles Times that he’d thought that the grocery store, whose staff had tried to bar his cohort from entering, would have been more sympathetic given its countercultural origins.) In January, another of their number, a salon owner from Beverly Hills named Gina Bisignano, was indicted on seven counts for her participation in the January 6th invasion of the Capitol. Bisignano had been the subject of a video on YouTube (“COVID-Denying Karen Goes On Homophobic Rant”), recorded in November at a protest on my street. As the city and county health authorities began opening mass-vaccination sites, the anti-maskers turned their attention to opposing the vaccine, planning a protest on the Facebook page “Shop Mask Free Los Angeles,” where they posted videos of heated confrontations with such arch-oppressors as the hapless manager of a Ralphs grocery store.
On January 15th, Dodger Stadium, which had been converted from a testing site to a mass-vaccination site, was inaugurated with visits from Los Angeles’s mayor, Eric Garcetti, and California’s governor, Gavin Newsom. When Newsom toured the destruction of the wildfires over the fall, he had worn a rugged khaki-colored jacket with a white silhouette of the state grizzly bear and the number “40” (he is the state’s fortieth governor) emblazoned on the sleeves; to visit the stadium, he wore a navy track jacket with the white bear over the breast. The Times reported on a day, two weeks later, when the wait time to get a vaccine was several hours, with recipients, among them the seventy-three-year-old Arnold Schwarzenegger, queuing in their cars. Eric Garcetti, the mayor, who had spent several days working at the site as a volunteer, informed the Times that the city had spent sixty thousand dollars on traffic cones. When a couple of self-identified staffers wrote in the comments of the Times article that they had not, as had been reported, received Subway sandwiches or Krispy Kreme donuts, and that they were being overworked, they inadvertently occasioned a tabloid-worthy celebrity temper tantrum from Sean Penn, a co-founder of the Community Organized Relief Effort, the nonprofit that had been contracted to help run the site. (“In every cell of my body is a vitriol for the way your actions reflect so harmfully upon your brothers and sisters in arms,” Penn wrote in an e-mail to staffers that was leaked to the press.) Despite these kinks, the site was delivering more than seven thousand vaccinations a day. The protesters made it their target on January 28th, waving signs that said things like “TAKE YOUR MASK OFF AND SMELL THE BULLSHIT” and “TELL BILL GATES TO GO VACCINATE HIMSELF.” They yelled at the seniors waiting in their cars for their vaccines, informing them that they were lab rats. “If you think about it, what they’re doing right here is a mass, mass, massive, massive indoctrination,” one of them told the L.A. Times.
The following Saturday, I visited Dodger Stadium to see if the demonstrators had returned. As I walked up Academy Road, I had that special Los Angeles feeling of being a lone pedestrian with the gaze of an entire traffic jam on me. I saw Range Rovers and Teslas waiting in line, elders with their children and elders by themselves, a camper van. The anti-maskers weren’t around; after their gathering the previous week, their Facebook page had gone dormant. (The reprieve was temporary: they returned to Dodger Stadium at the end of February.) At the entrance of one of the vast parking lots, volunteers in vests directed the traffic. I turned into Elysian Park and climbed a hill with a view of the stadium. Down below, the cars inching their way through the vast maze of traffic cones glittered in the sun.
Los Angeles County had focussed its initial vaccine rollout on mass-vaccination sites known as mega-PODs (the acronym stands for Points of Distribution), like the one at Dodger Stadium. The five sites included the parking lots beneath the deserted roller coasters of Six Flags Magic Mountain, in Valencia; the Forum, the multi-purpose arena in Inglewood; and a complex in Pomona, where in a normal year L.A. County holds its fair. By February, the county leadership was realizing that these sites were not effectively reaching the hardest hit populations. Despite a state task force devoted to equity, the imbalances that had characterized the effects of the pandemic since it began were playing out once again.
The Clínica Monseñor Oscar A. Romero was founded in 1983 by a coalition of refugees who fled the civil war in El Salvador. Named for a canonized Salvadoran archbishop who was assassinated while giving mass, it serves a primarily low-income population that is ninety-five per cent Latino. By the clinic’s own estimates, about a third of its twelve thousand patients are undocumented immigrants. Clínica Romero has two branches, one in the neighborhood of Boyle Heights and the other in Pico-Union, both among the most densely populated areas of the city. This winter, these neighborhoods were the epicenter of an epicenter: at the Boyle Heights clinic, the rate of positive tests at the surge’s peak hovered between thirty and forty per cent.
One morning in mid-February, I met with the clinic’s executive director, a Salvadoran refugee named Carlos Vaquerano, in the back garden of the Boyle Heights clinic. Soon after the F.D.A. approved the Pfizer and Moderna vaccines in mid-December, Vaquerano and his colleagues had received permission from the state and county authorities to be a vaccine-distribution center. “Like many others, we were hoping we would get a fair amount of vaccines,” Vaquerano told me. “And the surprise was we didn’t.” When, in mid-January, the state expanded eligibility to people over sixty-five, Clínica Romero awaited a promised shipment of one to two hundred vaccines for its thousand or so elderly patients. A month passed. When I met Vaquerano, the clinic had received and administered its first shipment of a hundred Moderna vaccines only a few days before.
Whereas the mass-vaccination sites relied on vaccine seekers to make appointments online, the staff of Clínica Romero had called patients and sent appointment reminders via text message. They used a grant to pay for transportation for patients who could not get to the clinic on their own. If eligible people showed up without an appointment and there were extra vaccines, they would receive a shot, too.
I visited the clinic again a few days later, when it had received its second shipment of a hundred vaccines. Outside, four or five patients waited in the shade. A member of the clinic’s staff pre-registered patients in Spanish, speaking to an elderly man in a Dodgers cap and a woman with a woven purse that said “Guatemala.” A security guard set up folding chairs for patients with mobility issues. I chatted with a woman named Rosa who sat down in a chair and rested her cane against it. She told me in Spanish that she had been receiving her primary care at Clínica Romero since 1996, and the clinic had been the first place she called to ask about getting the vaccine. She had also tried to inquire at some pharmacies, she added, but nobody had picked up the phone.
As Don Garcia, the medical director of the clinic, explained, Dodger Stadium, the closest mega-POD, is a drive-up site, and many of the people he works with don’t have cars. They cannot afford to spend hours waiting in line, and might not understand how to make an appointment because they don’t speak English, or they are illiterate, or they don’t have the technology. They might be reluctant to give their information to a public-health database because of their immigration status. I thought of my parents, who had gotten their first dose of the Pfizer vaccine at a drive-through vaccination site at the Pomona Fairplex, a forty-five-minute drive from where they were staying with my brother, in the city of Altadena. The majority of hospitalizations in Los Angeles were people of Latino heritage, who died at a rate almost three times that of white people. “When you have a forest fire in California, you take the water to the fire,” Garcia told me. “In this situation, why is the water not being brought to the fire, which is in the Latino community? Why do we have to go to the water, which is the mega vaccine sites?”
When I spoke with him, Garcia had recently met with the leadership of the L.A. County Department of Public Health, who told him that the delays had been a question of tight supply. “That’s not the question being asked,” he said. “The question is why is this health center only receiving one hundred vaccines when we have twelve thousand patients and are surrounded by a million Latinos?” In part in response to these problems, in mid-February Los Angeles expanded its vaccine network to almost four hundred sites that now include mobile clinics and neighborhood pharmacies. In March, California allocated forty percent of available vaccines to residents of disadvantaged areas. But the delays had resulted in incalculable losses. Garcia spoke of a generation of grandparents, and recalled the decimation of the native Mexican population by the pathogens brought by the Spanish to the Americas in the sixteenth century. “This country just went through this whole Black Lives Matter movement six months ago, and we’ve already forgotten—that was a question of social justice. This is similar, but in a biological environment. There’s something that’s upside down. There’s something that’s lacking in reasoning.”
Clínica Romero is a Federally Qualified Health Center, part of a national network of clinics that receive federal funds to work with populations in medically underserved areas. The program has its origins in legislation passed during Lyndon B. Johnson’s War on Poverty, in the mid-sixties. Many of the centers provide vision, dental, and mental-health services, and substance-abuse treatment as well as primary medical care, and many of them have their roots in social activism. Nationwide, two-thirds of the populations served by such clinics fall below the federal poverty line; sixty per cent of their patients are from racial and ethnic minorities. Given their outsized role, the Biden Administration announced in February that the federal government would begin directly shipping vaccines to at least one center in each state, with plans to expand later on.
The Kedren Community Health Center, in South Los Angeles, another federally funded clinic, was founded by a group of Black psychiatrists in 1965, the same year as the Watts rebellion. Today, it provides mental-health services in predominantly Black and Latino neighborhoods in South Central L.A. The center also offers primary medical care, health-insurance enrollment assistance, and a food bank. In contrast to Clínica Romero, Kedren has been receiving an allotment of six thousand vaccines a week from the state. Jerry Abraham, a thirty-seven-year-old doctor who has become the clinic’s director of vaccines, told me that the only reason his clinic received more vaccines while other community health centers were ignored was their persistence. “They forgot about us, so I refused to give up,” Abraham told me. “We literally banged on doors at the Department of Public Health.” Kedren has also supplemented the vaccines it is allotted by becoming one of the Department of Public Health’s catchalls for unused doses from nursing homes and other facilities that ended up with a surplus.
Governor Newsom, again dressed in his track jacket, recently paid a visit to the maze of white tents that comprise Kedren’s vaccination site, and Abraham has been praised in both the national and international news for the urgency with which he campaigned to bring vaccines to L.A.’s Black residents, and has also been invited to testify before congress. The attention piled on him by the national and international media has not altered the fact that, as of February 19th, twenty-four per cent of African-Americans over the age of sixty-five in Los Angeles had received their vaccine, compared to forty-three per cent of white residents in the same age bracket.
Outside Kedren on a recent February day, parking spots were difficult to find, and a festive mood pervaded—banners proclaiming “COVID VACCINE HERE” hung on the front gates, a dance remix of a Tracy Chapman song played through loudspeakers, and security guards monitored a tight entrance. Volunteers greeted senior citizens and led them into waiting areas. A fruit vender had set up a cart to cater to the crowd; another vender grilled corn around the corner. Two lines led into the gates. The one to the left consisted of eligible people who had made appointments through the county’s Web site. The line to the right was made up of so-called vaccine chasers, the people who, sitting in camping chairs with picnic blankets—one had brought a propane space heater, and another worked remotely from a MacBook Air—begin lining up early each morning in the hopes of receiving an expiring vaccine at the end of the day.
Kedren will vaccinate senior citizens on a walk-up basis, and people over sixty-five are allowed to skip both lines and go straight inside—a small act of defiance against the state’s online appointment system, which digitally savvy populations had already learned to manipulate. Owing to one early mistake, links the county sent to health-care workers could be passed around and reused; owing to another, a series of codes distributed to community organizations in underserved areas quickly found their way into the hands of the young and fit. In theory, everyone with an appointment in line on the left at Kedren was a health-care worker. Apparently, Los Angeles has lots of young, white health workers who dress in athleisure on their days off.
“Anybody can lie and be a health-care worker, anybody can be a digital native and somehow skip the line and cut grandma, anybody can be a tech hipster, and I have no control because I’m forced by the state to take those appointments if I want more vaccines, right?” Abraham told me. “So we created a workaround: any senior that shows up gets through, because that’s the priority, and that’s the most vulnerable.”
I asked Abraham about vaccine hesitancy. News coverage of the issue had seemed to disproportionately focus on Black people, despite many indications, including the mostly white anti-vaxxers at Dodger Stadium, that it was not limited to a particular demographic. “Black and brown health-care workers have been coming here since the day we offered the vaccine, and how do they come here? With their sleeves rolled up and ready to get the shot,” he said. “When we engaged, when we educated, they were vaccinated.”
Abraham, dressed in a white lab coat, blue scrubs, and black patent-leather clogs, whirred through his domain like a spinning top. In one tent, senior citizens sat in folding chairs placed six feet apart while medical volunteers, including students from Charles R. Drew University, the historically Black med school in Willowbrook, inoculated and monitored them; in another tent, three staffers sat at a folding table filling syringes. Those getting vaccinated via appointment were herded into yet another area, a steadily moving line.
The government provided the vaccines, Abraham told me, but the clinic was paying for things like gloves and Band-Aids from its own funds. “We’re bleeding the organization to do it, but that’s better than dying of COVID,” he said. “For us, this is our family dying, our nurses dying, our patients and our community and our neighbors dying. It was never an option to stay on the sidelines and wait and say, ‘Well, when they ask…’ ”
The next afternoon, I spoke on the phone with Barbara Ferrer, the director of the L.A. County Department of Public Health, and the object of the protests in my neighborhood in December. (“I’m so sorry,” she said repeatedly, as I reassured her none of it was her fault.) Ferrer told me that starting the vaccine rollout with the drive-up sites had made sense when health-care workers were eligible, as most of them had cars. “The large sites can do high volume, but they don’t necessarily get the vaccines to people who need them the most,” she admitted. As the county had expanded its network of vaccination sites, the problem had once again become one of supply. The county had capacity to deliver six hundred thousand doses a week, but as of March 6th was only receiving about half of that number.
In the United States this year, everyone who wants a vaccine against the coronavirus will, in theory, be able to get one. The scope of the effort offers a glimpse of what health-care could look like if universality really were its goal. Its failures to reach certain populations thus far are yet another reminder of how our system neglects so many. Robert Garcia, the mayor of Long Beach, who has been celebrated for his city’s efficient vaccine rollout, told me that administering hundreds of thousands of vaccines and tests this year has transformed city governments across the country. “Cities like Long Beach have essentially become citywide clinics,” he said. “What we do now, more than anything else, our bread and butter is, we do health care,” he said. “That’s something we have transitioned to and I think is going to be the case for a while.” Garcia hoped that Americans would learn from the pandemic. “We have a unique opportunity to get folks health care without worrying about whether they are documented or undocumented, whether they have insurance or whether they don’t have insurance, and whether they can pay for it or not. It’s free, it’s no questions asked, and we’re going to get you as healthy as we can. I think this awful pandemic is going to strengthen the argument around access to health care and how cities can play a role in it,” he said.
By the end of the surge, more than twenty thousand residents of Los Angeles had died of COVID-19. By March, businesses had reopened, and the county was on track to administer nearly two million doses of the vaccine. One sunny Friday, I stopped by the South Park Recreation Center, where a pop-up vaccine site had been organized by Curren Price, a city councilman who represents a predominantly Black and Latino district where more than nine hundred people have died of the coronavirus since the pandemic began. The mobile site offered three hundred doses a day for three days, and would return three weeks later with second doses. It was a simple affair: a trailer parked in a corner of the park, some traffic cones to indicate where to wait in line, and two firemen sitting at a folding table administering the Pfizer vaccine from a cooler. A former valet driver who had been furloughed from the Beverly Hills Hotel last year was managing the site. Instead of listing appointments on the county’s Web site, where they might have been taken by the people Abraham referred to as “tech hipsters,” the pop-up clinic had been advertised through the councilman’s office and word of mouth. It was early afternoon, and a consistent trickle of elderly people arrived, all of them Black or Latino, most of them accompanied by younger family members who carefully guided them by the arm. After getting their shots, they sat in the shade of a tree so that they could be monitored for an allergic reaction. One took out her embroidery and began to stitch.
An eighty-four-year-old retired electrician wearing a red-and-black checked lumberjack shirt, bifocals, and a hat that identified him as a Vietnam veteran remarked on how easy it was: a friend had called, and he had walked the four blocks from his home. I had the sense, rare in this pandemic, that I was witnessing something working as it should.
