COVID-19 has killed black residents of Los Angeles County at a “significantly higher” rate than patients of any other race, the county’s public health director said Monday.

Dr. Barbara Ferrer, the county’s public health director, revealed the finding during a daily briefing in which she addressed the rising number of deaths among residents at skilled nursing facilities, communities seeing higher mortality rates overall, the need to expand testing before easing social distancing and hundreds of cases among the homeless population and from inside shelters, jails, prisons and health care facilities.

L.A. County remains the epicenter of the viral outbreak in California with nearly 47% of all the state’s reported infections as of Monday. It holds just a quarter of the state’s population.

The number of infections and virus-related fatalities continues to climb: 942 patients have died and 20,417 people have tested positive as of Monday, according to data from the county Department of Public Health.

But the death rate for certain groups is vastly outpacing that of others. African Americans face a mortality rate of 13.2 per 100,000 people — a rate that falls considerable lower for other groups, according to Ferrer. Latinos hold a mortality rate of 9.8 per 100,000 people, 7.9 for Asians and 5.7 for whites, she said.

Health officials are also raising alarms over the higher death rate seen among poorer populations.

“When you look at this data by community poverty levels, we see that people who live in areas with high rates of poverty had three times the rate of deaths for COVID-19,” Ferrer said. “This data is deeply disturbing and it speaks to the need for immediate action in communities with disproportionately high rates of death.”

That would include improving access to testing and medical services in general, Ferrer said, as well as “more accurate, culturally appropriate information about COVID-19.”

A total of 423 cases in institutional settings — from jails and shelters to nursing facilities and treatment centers — make up an estimated 45% of all virus-related fatalities, according to county health data. Most of those deaths are tied to skilled nursing facilities, Ferrer said.

Just over the weekend, health officials launched investigations into another 19 institutions where cases of the virus were reported, Ferrer said. Currently, 312 remain under investigation.

Nursing homes continue to be the facilities hardest hit by the potentially deadly virus, with their residents often being older and having underlying health conditions making them particularly vulnerable.

It mirrors a trend seen around the nation, but nursing home residents are dying from the virus at an alarming rate in L.A. County. Ferrer said the residents account for most of the fatalities tied to institutional settings.

That climbing death toll prompted an apology on Monday from Ferrer, who said officials could’ve taken more steps to protect senior residents but did not have the information to do so. She said the virus has been allowed to spread “even where everybody has been doing their very best to implement infection control measures.

“Early on in this pandemic, we were all unaware that COVID-19 could be spread by people who are infected, but did not have any symptoms,” Ferrer said. “So I apologize on behalf of all of us, for not knowing enough at the start of this epidemic, to take additional steps in our congregate living facilities to make sure that we were doing everything possible to protect residents and staff.”

Ferrer said the county’s Department of Public Health and Department of Health Services are now working together to provide testing for all residents and staff at skilled nursing facilities.

Widely expanded testing is one of the key goals county health officials last week outlined as necessary before businesses can reopen or any other COVID-19 restrictions are rolled back.

On Monday, county officials reported another 29 COVID-19 deaths in just the last 24 hours, with 25 of those who died over age 65. Ferrer said 18 of those over 65 had underlying health conditions.

“These numbers represent our family members, friends, neighbors and essential front-line workers who have died from COVID-19,” Ferrer said. “Please know we share your heartache.”

Nearly 10% of all people who tested positive in L.A. County are health workers and first responders. Ferrer said they make up 1,968 of the 20,417 positive cases. The majority of health workers infected are nurses, who account for 43% of these cases, Ferrer said.

A national shortage of personal protective gear — particularly N95 respiratory masks used to filter out airborne particles other face coverings can’t — has led to nurses protesting health care facilities around the county. Some rallied outside Providence St. John’s Health Center earlier this month after the hospital suspended ten nurses who refused to treat COVID-19 patients without N95 masks.

“We didn’t feel safe going into COVID-19 patient rooms without an N95 respirator because the patients were coughing directly in our face,” Jack Cline, one of the suspended nurses, told KTLA.

The suspended St. John’s nurses returned to work last week after being supplied with N95s, the National Nurses United union told the Associated Press.

Since March 28, a total of 11 health care workers have died of the virus, Ferrer said Monday.

Most of them worked in skilled nursing facilities, she said, addressing the families of medical workers who have lost their lives to the virus.

“Your loved ones dedicated themselves to helping others, and in doing so, they saved many lives,” Ferrer said. “To all the health care workers across L.A. County, we owe you all our deepest appreciation … you are our heroes.”

Since last week, the number of medical workers who tested positive rose by nearly 37%, according to county data.

Ferrer said this is due in part to increased testing, especially among staff of skilled nursing facilities. The county also last week expanded testing availability to all health care workers, including those without symptoms.

Among those infected have been physicians, caregivers, medical assistants and first responders.

Meanwhile, shelters and jails continue to also see more cases of the virus as officials expand testing. Twelve homeless shelters are under investigation after being linked to 68 cases of the virus, Ferrer said. Health officials confirmed a total of 118 cases among people believed to be homeless.

Inside jail facilities throughout the county, 142 have been infected with COVID-19, according to health officials. That includes 71 cases among inmates and another 71 among staff. In addition to those infections, another 101 cases have been reported in the state prison population within L.A. County — 81 among those incarcerated and 20 staff.

The Los Angeles County Sheriff’s Department reported that 61 staff members tested positive for the virus, according to Ferrer. At the Los Angeles County Fire Department, another 22 tested positive.

Noting that 92% of all the patients who died of the virus had underlying health conditions, Ferrer addressed this population directly, speaking particularly to those with a history of asthma, COPD and cancer: “Please do your very best to stay home … avoid contact with all others as much as possible.”

Over the weekend, warmer temperatures prompted warnings from Mayor Eric Garcetti and other local leaders, who feared crowding on beaches and other violations of social distancing guidelines. Some beaches filled up more than others, but L.A. County kept its coastline and recreational areas closed to the public — even as neighboring Ventura and Orange counties rolled back restrictions.

On Friday, L.A. County officials said easing local restrictions, from opening parks and beaches to allowing sales at stores and bars, requires first achieving certain goals in the fight against the virus.

That includes widely expanding testing and the county’s ability to trace the virus, ensuring protections for vulnerable populations, maintaining physical distancing and making sure health care facilities have enough capacity for COVID-19 patients.

“We don’t want to undo all the good we’ve done and accomplished so far,” L.A. County Board of Supervisor Kathryn Barger said Friday. “We are not yet on the other side of this pandemic and we don’t want to prematurely ease restrictions that can overwhelm our hospitals and unnecessarily put lives at risk.”