While coronavirus cases in Maryland’s most populous jurisdiction have plummeted since May, yawning inequities in who is affected have persisted — and grown wider.

Recent data shows that Montgomery County’s 200,000 Hispanic residents account for more than two-thirds of new infections, even though they are just a fifth of the county’s population. Advocates blame the disparity partly on government failures to provide easy access to testing and medical care in underserved Latino communities, where residents are more likely to face job and living conditions that make it harder to avoid the virus.

Health officials say various steps have been taken to ramp up testing and expand outreach, but residents and advocates say these efforts have fallen short.

A bilingual hotline to refer patients for testing hasn’t been well-staffed, often leaving residents talking to a machine; county-operated testing sites are open only one or two days a week and never on the weekends, making them hard for essential workers to access; an offer to house sick patients in hotels wasn’t well advertised; and a testing site in a predominantly Latino area was moved without adequate notice.

“It wasn’t that they didn’t do anything,” said Maria Gomez, chief executive of Mary’s Center, which operates a community clinic in Silver Spring. “It’s that their measures didn’t work.”

According to county statistics, 4,934 Hispanic residents have tested positive for the novel coronavirus in Montgomery as of Monday, and 135 have died.

In a recent email to the Montgomery County Council, health officer Travis Gayles reported data showing that Hispanic residents accounted for 74 percent of the 3,376 new coronavirus cases reported in the county in June.

That percentage was drastically higher than for other demographics, including non-Hispanic white residents, who represented 13 percent of new cases but account for 43 percent of the county’s population — more than twice that of Hispanic residents.

“The numbers here are absolutely horrific,” County Council member Hans Riemer (D-At Large) said in response to the July 7 email.

“I am at a loss for words,” said County Council member Nancy Navarro (D-District 4), who spearheaded the county’s government-wide racial equity legislation in 2019.

The council Tuesday introduced a new Board of Health regulation that would mandate “free, no appointment, no referral, walk-up testing” at 35 locations, all of which would need to operate eight hours a day, five days a week.

The council’s two Latino members — Navarro and Gabe Albornoz (D-At Large) — said they also want to see the county release a targeted strategy for how to test and treat more Hispanic residents.

“Having press releases in Spanish is just not enough,” Navarro said.

Some lawmakers incorrectly interpreted the 74 percent figure as the test positivity rate among Hispanic residents, and included it as such in the health regulation proposed Tuesday.

But that was inaccurate, Gayles said. Test positivity — for all residents — has steadily declined since April. For Hispanics, it reached a low of 14 percent in June, compared with 1.8 percent for non-Hispanic white residents and 4 percent for black residents.

What the 74 percent figure shows, Gayles said, is that as overall cases in the county have decreased, Hispanic residents have accounted for a growing share of new infections.

Since mid-June, the county’s seven-day average in daily cases has fluctuated between 65 and 90, down from its peak of more than 250 in May. But the percent of cases involving Hispanics has grown. In April, 45 percent of Montgomery’s cases involved Hispanics.

“It’s true that in the small number of new cases, the virus is disproportionately affecting the Latino community,” said Gayles, adding that the scale of the inequity is “alarming.”

“But the notion that we have done nothing and ignored these communities is completely and totally wrong and inaccurate,” he said.

As of Monday, 22,335 Hispanic residents had been tested in Montgomery, accounting for 18 percent of total tests.

Albornoz said the health department should have recognized in March that the virus was going to disproportionately affect Hispanic residents and adopted a more aggressive testing strategy toward that community. Widespread testing is key to understanding the burden of the disease on a certain community, which can help inform what is needed to contain it, experts say.

Latino people are more likely to work as essential workers and to live in the densely populated apartment buildings that can be hotbeds for covid-19, the disease caused by the novel coronavirus. Many are also less likely to access testing, lawmakers said, either because they are uninsured or wary that being tested might pose risks to their immigration status.

The latter concern has intensified since the Trump administration changed the “public charge” rule, which affects who is considered dependent on the federal government for benefits. In parts of Montgomery, advocates say, many noncitizen Latino residents are reluctant even to pick up free food from a local school, much less seek out coronavirus testing, for fear it would eventually jeopardize their ability to seek citizenship or permanent residency.

Montgomery resident Elizabeth de Garcia said that in early April, it took two hospital trips, dozens of phone calls and a tense confrontation with a hospital nurse for one of her brothers to be tested for the virus.

Since then, she said, the process of procuring a test in her majority-Latino community in Montgomery Village has not gotten easier. Many residents of her rental apartment complex, Cider Mill, have exhibited symptoms associated with the virus, she said, but almost none have been tested. Five have died of respiratory illnesses.

“Nothing has changed,” de Garcia said in Spanish through a translator. “We were abandoned.”

Gayles pointed out that in May, the county opened free testing sites that do not require government identification to access. There are five such sites across the county, each open one or two days a week.

But de Garcia, who serves as a hub of information for her family, friends and apartment complex, said she was not aware of any free testing sites in Montgomery. In her community, covid-19 information is passed along primarily by word of mouth, she said. She gets her news from a friend who works for the county government and keeps her eyes peeled for updates from the county’s Facebook page, which occasionally posts information in Spanish.

The closest free testing site she had heard of, she said, is in neighboring Frederick County, 27 miles and a two-hour bus ride from Cider Mill.

“From the very beginning, we should have had a Spanish-
language hotline,” said Albornoz, who heads the council’s health and human services committee. “Our [executive] branch was slow in developing that strategy, so now four months in, we’re not where we’re supposed to be.”

Gayles acknowledged that reaching Spanish-speaking residents through the channels they use is an “ongoing challenge.”

“That falls on us,” he said, but it also falls on community groups to partner with the county.

Gomez, chief executive of Mary’s Center, said some groups have tried. Her community clinic in Silver Spring has been administering tests to its predominantly Latino clientele since March. Of 2,500 patients, 900 have tested positive, including more than 100 pregnant women. The nonprofit has asked the county to help scale up its testing operation, but to no avail.

“There are tremendous resources within the immigrant population, and the county should in the future plan their services with us,” said Gomez. “The lack of coordination really was the missing piece.”

The advocacy group Action in Montgomery held a news conference Tuesday evening, calling on the county to offer testing at predominantly Latino or black churches, such as de Garcia’s St. Rose of Lima Catholic Church.

It would be ideal to have testing sites at institutions that communities know and trust, de Garcia said. But she’s skeptical it will happen.

“When they need us, we are everything for the county,” she said Monday, as she soothed her crying 3-year-old son. “When we need from them, we don’t exist.”