Impact of COVID-19:

1 of 3 Los Angeles residents have been infected with COVID-19, according to the Los Angeles Department of Health Services. To make matters worse, the infection rate for residents in Clínica Romero's service area is alarmingly higher than the Los Angeles County rate. Scientific modeling highlights that the region will continue to be a coronavirus hotspot, straining the local healthcare system.

The CDC lists the following key factors in the high transmission of COVID-19: resistance to face coverings, fatigue, colder weather, poverty, people living in close quarters. Clinica Romero's Alvarado & Marengo clinics are both located within Los Angeles Planning Area 4 (SPA 4)—one of the most densely populated and impoverished areas of the city. Some community members in the service area have reported waiting hours to be seen by a healthcare worker and then waiting again for an available hospital bed. Ambulances in our service area no longer transport people with little chance of survival. ICU capacity is nearly at its limit. COVID-19 has created dire circumstances in the service area, especially gripping the vulnerable at-risk populations.

Clínica Romero serves over 10,000 unduplicated patients annually. Our patients are predominantly low-income, 100% live at or below the Federal Poverty Level. Roughly 7% of our patients experience homelessness and over 40% of patients do not qualify for health insurance due to their immigration status (the highest percentage of undocumented clients of any clinic in Los Angeles). 96% of our patients are Latinos. According to the CDC, disproportionate numbers of Latino Americans are dying from COVID-19. Twenty-five percent of the deaths from coronavirus have been Latinos, in spite of the fact that Latinos only make up 18% of the population. Many Latinos are contracting COVID-19, because they are the essential workers, leaving their houses every single day to work in service industries. The other reason is health care coverage and pre-existing conditions. There are still too many Latinos who don't have health insurance coverage and that means they don't have access to primary care services that provide preventive services. This often results in undiagnosed or uncontrolled chronic diseases such as diabetes and heart disease, which puts individuals at higher risk of suffering dire consequences if they contract COVID-19. The impact of the pandemic on the Latino population has been catastrophic.

In response to the COVID-19 global pandemic, Clínica Romero provided some remarkable services to the community in 2020:

• Over 24,000 telehealth/teledentistry visits delivered to Clínica Romero patients.

• Roughly 14,000 individuals and families received outreach and education information workshops and materials on topics such as COVID-19 prevention and awareness.

• 2,400 hot meals were distributed to those experiencing homelessness and facing food insecurity.

• Over 900 food vouchers and cash aid assistance distributed to low-income immigrant families who were economically affected by COVID-19.

• 1,300 individuals experiencing homelessness and street vendors received educational materials and PPE including masks, face shields, and hand sanitizers.

• Both Clínica Romero locations are fully staffed and administered same day onsite COVID-19 testing

Implementation of Telehealth:

Clínica Romero initiated primary care telehealth services in March 2020, in direct response to COVID-19, targeting both existing and new patients. Due to the COVID-19 pandemic, we have experienced an increase in utilization of our telehealth services by patients and saw continued growth throughout the year. Between April 2020 to December 2020, Clínica Romero delivered over 24,000 telehealth visits. Presently, Clínica Romero delivers over 3,000 telehealth visits per month and increased demand for telehealth services continues to rise.

The vast majority of Clínica Romero telehealth services are delivered via phone calls given the digital divide experienced by our patient population. Many of our patients face compounded barriers and challenges that limit their options to only phone calls. The two leading obstacles are securing a phone/connection device followed by a lack of digital literacy. Clínica Romero Promotoras (Community Health Workers) have been mobilized to provide outreach and education to patients and community members. Their work focuses on informing patients about the availability of telehealth services, instructions for how to make an appointment, and outlining simple steps that will allow patients to connect to their doctors.

Thanks to funds provided by LA2050, Clínica Romero has started offering video telehealth services to new and existing patients. This program is available to patients who have moderate to high digital literacy skills (in order to download necessary applications such as Health Zoom), have an internet connection, and a smart device that allows them to access services. Fewer patients have taken advantage of this expanded option but we are working diligently to improve access to video telehealth services for our patients.

“My name is Natalia Lozada and I have been a Clínica Romero patient for 5 years.

The pandemic has taken a lot from me, including the ability for me to visit Clínica Romero and see my doctor in person. I just learned how to use technology on my cell phone so when I was told that I could see my doctor for a digital health visit, I thought it would be too difficult for me. But Clínica Romero offered me so much support. The promotoras, nurses, and doctors were very patient with me and guided me on logging into my visit. I learned how to use the MyChart application and now I can schedule my appointments and have a video call with my doctor. I really liked the video service because I can see my doctor and it's very much like being able to see her in person. I truly appreciate this new way of communicating and staying in touch with my doctor so I can stay healthy.

I appreciate Clínica Romero so much for providing this service and making me feel special. I invite other community members to try telehealth! I am proof that with support, we can connect ourselves to our doctors."

What's next for Clínica Romero:

Clínica Romero is committed to providing the highest quality care to its patients despite the challenges presented by the COVID-19 pandemic.

As of February 2021, Clínica Romero is now a vaccination site in Los Angeles and have begun the administration of the vaccine to our patients at two clinic sites:

Marengo Clinic located at 2032 Marengo St. Los Angeles, CA 90033

Alvarado Clinic located at 123 S. Alvarado St. Los Angeles, CA 90057

We are also in the development stage of becoming a Monoclonal Antibody (mAb) Infusion Center that will provide COVID-19 treatment option to some of the most vulnerable individuals in Los Angeles. Early evidence suggests that mAb treatment can reduce the amount of the SARS-CoV-2 virus in a person's body.

The past year has been challenging and exhausting for everyone, including us. But in the spirit of Msr. Oscar A. Romero, we will continue to fight against health access injustice and provide high quality care to our patients. We are thankful for partners like LA2050, who have invested in Clínica Romero during one of the most critical times in our organization's 38-year history. This grant has allowed us to advance the care that we provide during COVID-19 and make Los Angeles a healthier, more equitable place to LIVE!

Visit www.clinicaromero.com to learn more about our services or follow us on Instagram (@clinica_romero) and Twitter (@ClinicaRomero) to keep up with our work in Los Angeles.