Jerry Ramos spent his final days in a California hospital, in thoughts his 3-year-old daughter was connected to an oxygen machine with blood clots in her lungs from COVID-19.
The 600,000 mark, tracked by Johns Hopkins University, exceeds the population of Baltimore or Milwaukee. This equals the number of Americans who died of cancer in 2019. And as bad as it is, the actual toll is believed to be quite high.
On its way to the latest round-number milestone, the virus has proved adept at exploiting inequalities in the US, according to an Associated Press data analysis.
In the first wave of fatalities, in April 2020, black people were slammed, dying at higher rates than other ethnic or racial groups as the virus spread to the urban Northeast and heavily African American cities such as Detroit and New Orleans .
Last summer, during a second surge, Hispanics were hit hardest in Texas and Florida, suffering a large proportion of infection-induced deaths. By winter, during the third and deadliest phase, the virus had engulfed the entire country, and the racial gap in the weekly death rate had narrowed enough that whites were the worst, followed by Hispanics.
Now, even as the outbreak ebbs and more people are vaccinated, a racial gap is emerging again, with black Americans dying at higher rates than other groups.
Black people account for 15% of all COVID-19 deaths where race is known, while Hispanics represent 19%, whites 61% and Asian Americans 4%. Those figures are closer to the share of groups in the US population—blacks at 12%, Hispanics at 18%, whites at 60% and Asians at 6%—but adjusting for age paints a clearer picture of the disparate burden.
Because blacks and Hispanics are on average smaller than whites, it would stand to reason that they would be less likely to die from the cruel disease for the elderly. But this is not happening.
Instead, the Centers for Disease Control and Prevention, adjusting for population age differences, estimates that Native Americans, Latinos and blacks are two to three times more likely to die from COVID-19 than white people.
Furthermore, the AP analysis found that Latinos are dying at a much younger age than other groups.
Thirty-seven percent of Hispanic deaths were of people under the age of 65, up 12% for white Americans and 30% for black people. Hispanics between 30 and 39 – such as Ramos – died at five times the rate of white people in the same age group.
Public health experts see these inequalities as a strong message that the nation needs to address the deep inequalities.
“If we want to honor the expensive price that 600,000 people have paid, don’t return to normalcy. Whatever it is,” said Dr. Clyde Yancy, vice dean of diversity and inclusion at Northwestern University’s medical school in Chicago. Better get back to that.”
He added: “It will be an epic fail if we go back to what we normally call normal.”
Ramos had asthma and diabetes and quit his job as a chef at Red Lobster before the pandemic due to diabetes-related trouble with his feet.
He died during a disastrous winter boom that hit Latinos hard, and the rest of his family of seven also became ill in Watsonville, an agricultural town of about 54,000 people about 90 miles south of San Francisco.
Including his younger daughter; the head of the family, 70-year-old Mercedes Ramos; And his girlfriend, who was the only one working at home and was first infected, brought the virus home from her job managing a marijuana dispensary, according to family members.
The mother and son were admitted to the same hospital, their rooms were nearby. They used to video chat or call each other every day.
“He would tell me that he loved me so much and that he wanted me to get better and he was doing fine, but he was telling me that so I wouldn’t worry,” said Mercedes Ramos in Spanish, his voice was breaking. She has since returned to her work picking strawberries.
Samantha Ertiga of the Kaiser Family Foundation, a non-partisan health-policy research organization, said gaps in vaccination rates in the US also remain, with blacks and Hispanics lagging behind.
Experts say a number of factors may be at work, including a deep distrust of the medical establishment among black Americans due to a history of discriminatory treatment, and fears of deportation among Latinos, as well as the language barrier in many cases.
According to the CDC, the US averaged about 870,000 injections per day in early June, down from an average of about 3.3 million daily injections in mid-April.
Early vaccine eligibility policies, set by states, favor older Americans, a group more likely to be white. Now, everyone over the age of 12 is eligible, but obstacles remain, such as concerns about missing work due to side effects from the shot.
“Eligibility certainly doesn’t equal access,” Ertiga said. “Losing a day or two of wages can have real consequences for your family. People are facing such tough decisions.”
The AP’s analysis of the outbreak’s racial and ethnic patterns was based on the National Center for Health Statistics data on COVID-19 deaths and 2019 Census Bureau population estimates.
It is less clear who is dying now, but still incomplete data suggests that a gap has re-emerged. In Michigan, black people make up 14% of the population, but have accounted for 25% of the 1,064 deaths in the past four weeks, according to the most recently available state data. Similar gaps were observed in Florida and Pennsylvania.
“For people of color like me, we have deeply personal experiences during a pandemic,” said Yolanda Ogbolu, a nurse researcher at the University of Maryland in Baltimore, taking care of loved ones and sometimes losing them.
Ogbolu, who is black, made himself an advocate for two relatives during his COVID-19 hospital stay: his 50-year-old police officer brother – he persuaded his doctors to treat him with the drug remdesivir – and his 59 year old old repairman uncle. She used to call the hospital daily during her 100-day stay.
Both survived. But Ogbolu wonders if there was no nurse in the family, he would have survived.
“What happens when people don’t have that person to push for them? What happens when you don’t even speak the language?” Ogbolu said. “What happens when they don’t know how to navigate the health system or what questions to ask?”