A hospital worker places a "COVID Patient" sticker on a body
bag holding a deceased patient at Providence Holy Cross Medical
Center in the Mission Hills section of Los Angeles, in this
January 9, 2021 file photo. (AP Photo/Jae C. Hong, File)
As U.S. COVID-19 death toll nears 600,000,
racial gaps persist
By Carla K. Johnson, Olga R. Rodriguez, and Angeliki Kastanis
The Associated Press
Jerry Ramos spent his final days in a California hospital,
hooked to an oxygen machine with blood clots in his lungs from
COVID-19, his three-year-old daughter in his thoughts.
"I have to be here to watch my princess grow up," the
Mexican-American restaurant worker wrote on Facebook. "My heart
feels broken into pieces."
Ramos didnít live to see it. He died February 15 at age 32,
becoming not just one of the nearly 600,000 Americans who have
now perished in the coronavirus outbreak, but another example of
the outbreakís strikingly uneven and ever-shifting toll on the
nationís racial and ethnic groups.
The approaching 600,000 mark, as tracked by Johns Hopkins
University, https://coronavirus.jhu.edu/map.html, is greater
than the population of Baltimore or Milwaukee. It is about equal
to the number of Americans who died of cancer in 2019. And as
bad as that is, the true toll is believed to be significantly
President Joe Biden acknowledged the milestone Monday during
his visit to Europe, saying that while new cases and deaths are
dropping dramatically in the U.S., "thereís still too many lives
being lost," and "now is not the time to let our guard down."
On the way to the latest round-number milestone, the virus
has proved adept at exploiting inequalities in the U.S.,
according to an Associated Press data analysis.
In the first wave of fatalities, in April 2020, Black people
were slammed, dying at rates higher than those of other ethnic
or racial groups as the virus rampaged through the urban
Northeast and heavily African-American cities like Detroit and
Last summer, during a second surge, Hispanics were hit the
hardest, suffering an outsize share of deaths, driven by
infections in Texas and Florida. By winter, during the third and
most lethal stage, the virus had gripped the entire nation, and
racial gaps in weekly death rates had narrowed so much that
whites were the worst off, followed closely by Hispanics.
Now, even as the outbreak ebbs and more people get
vaccinated, a racial gap appears to be emerging again, with
Black Americans dying at higher rates than other groups.
Overall, Black and Hispanic Americans have less access to
medical care and are in poorer health, with higher rates of
conditions such as diabetes and high blood pressure. They are
also more likely to have jobs deemed essential, less able to
work from home, and more likely to live in crowded,
multigenerational households, where working family members are
apt to expose others to the virus.
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 close to the groupsí share
of the U.S. population ó Black people at 12%, Hispanics 18%,
whites 60%, and Asians 6% ó but adjusting for age yields a
clearer picture of the unequal burden.
Because Blacks and Hispanics are younger on average than
whites, it would stand to reason that they would be less likely
to die from a disease that has been brutal to the elderly. But
thatís not what is happening.
Instead, the Centers for Disease Control and Prevention
(CDC), adjusting for population age differences, estimates that
Native Americans, Latinos, and Blacks are two to three times
more likely than white people to die of COVID-19.
Also, The AP analysis found that Latinos are dying at much
younger ages than other groups.
Thirty-seven percent of Hispanic deaths were of those under
65, versus 12% for white Americans and 30% for Black people.
Hispanic people between 30 and 39 ó like Ramos ó have died at
five times the rate of white people in the same age group.
Public health experts see these disparities as a loud message
that the nation needs to address deep-rooted inequities.
"If we want to respect the dear price that 600,000 people
have paid, donít return to normal. Return to something that is
better than what was," said Dr. Clyde Yancy, vice dean for
diversity and inclusion at Northwestern Universityís medical
school in Chicago.
He added: "It will be an epic fail if we simply go back to
whatever we call normal."
Ramos had asthma and diabetes and had quit his job as a chef
at Red Lobster before the pandemic because of diabetes-related
trouble with his feet.
He died during the devastating winter surge that hit Latinos
hard, and the rest of his household of seven in Watsonville, an
agricultural city of around 54,000 people about 90 miles south
of San Francisco, also got sick.
That included his toddler daughter; the family matriarch,
70-year-old Mercedes Ramos; and his girlfriend, who was the only
one in the household working and the first to get infected,
bringing home the virus from her job managing a marijuana
dispensary, according to family members.
Mother and son were admitted to the same hospital, their
rooms nearby. They would video chat or call each other every
"He would tell me he loved me very much and that he wanted me
to get better and that he was doing fine, but he was telling me
that so I wouldnít worry," Mercedes Ramos said in Spanish, her
voice breaking. She has since returned to her job picking
Gaps in vaccination rates in the U.S. also persist, with
Blacks and Hispanics lagging behind, said Samantha Artiga of the
Kaiser Family Foundation, a nonpartisan health-policy research
Experts say several factors could be at work, including deep
distrust of the medical establishment among Black Americans
because of a history of discriminatory treatment, and fears of
deportation among Latinos, as well as a language barrier in many
The U.S. was averaging about 870,000 injections per day in
early June, down sharply from a high of about 3.3 million a day
on average in mid-April, according to the CDC.
Initial vaccine eligibility policies, set by states, favored
older Americans, a group more likely to be white. Now, everyone
age 12 and older are eligible, but obstacles remain, such as
concerns about missing work because of side effects from the
"Eligibility certainly does not equal access," Artiga said.
"Losing a day or two of wages can have real consequences for
your family. People are facing tough decisions like that."
The APís analysis of the outbreakís racial and ethnic
patterns was based on National Center for Health Statistics data
on COVID-19 deaths and 2019 Census Bureau population estimates.
Itís less clear who is dying now, but the still-incomplete
data suggests a gap has emerged again. In Michigan, Black people
are 14% of the population but accounted for 25% of the 1,064
deaths reported in the past four weeks, according to the most
recent available state data. Similar gaps were seen in Florida
"For people of color like myself, weíve had deep personal
experiences during the pandemic" of caring for loved ones and
sometimes losing them, said Yolanda Ogbolu, a nurse researcher
at the University of Maryland, Baltimore.
Ogbolu, who is Black, made herself an advocate for two
relatives during their COVID-19 hospital stays: her 50-year-old
police officer brother ó she persuaded his doctors to treat him
with the drug remdesivir ó and her 59-year-old repairman uncle.
She called the hospital daily during his 100-day stay.
Both survived. But Ogbolu wonders whether they would have
lived if they hadnít had a nurse in the family.
"What happens when people donít have that person to push for
them? What happens when you donít even speak the language?"
Ogbolu said. "What happens when they donít know how to navigate
the health system or what questions to ask?"