Jerry Ramos spent his final days in a California hospital
, hooked up to an oxygen machine, blood clots in his lungs from COVID-19
, and his 3-year-old daughter on his mind.
“I have to be here to watch
my princess grow up,” the Mexican American restaurant worker wrote on Facebook
, adding, “My heart feels broken into pieces.”
Ramos did not live to see it; he died on February 15 at the age of 32, becoming not only one of the nearly 600,000 Americans who have died as a result of the coronavirus
outbreak, but also another example of the outbreak's strikingly uneven and ever-shifting toll on the nation's racial and ethnic groups.
According to Johns Hopkins University
, the approaching 600,000 figure is larger than the populations of Baltimore and Milwaukee
, and roughly equal to the number of Americans who died of cancer
in 2019. However, the true toll is thought to be much higher.
President Joe Biden
acknowledged the milestone during a visit to Europe
on Monday, saying that while new cases and deaths in the United States
are declining dramatically, "too many lives are still being lost," and "now is not the time to let our guard down."
According to an Associated Press
data analysis, on its way to the latest round-number milestone, the virus has demonstrated proficiency in exploiting inequalities in the United States.
In the first wave of fatalities, which occurred in April
2020, Black people
were disproportionately affected, dying at a higher rate than other ethnic or racial groups as the virus ravaged the urban Northeast and heavily African American
cities such as Detroit
and New Orleans.
Last summer, during the second surge, Hispanics were hit the hardest, accounting for a disproportionate share of deaths caused by infections in Texas
. By winter, during the third and most lethal stage, the virus had gripped the entire country, and racial disparities in weekly death rates had narrowed to the point where whites were the worst off, followed closely by Hispanics.
Even as the outbreak recedes and more people are immunized, a racial divide appears to be resurfacing, with Black Americans dying at a higher rate than other groups.
Overall, Black and Hispanic Americans have less access to medical care and 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 more likely to infect others.
Black people account for 15% of all COVID-19 deaths where race is known, while Hispanics account for 19%, whites account for 61%, and Asian Americans
account for 4%. These figures are close to the groups' share of the U.S. population — Black people account for 12%, Hispanics 18%, whites 60%, and Asians 6% — but adjusting for age provides a clearer picture of the unequal burden.
and Hispanics are, on average, younger than whites, it would seem that they would be less likely to die from a disease that has been particularly cruel to the elderly, but this is not the case.
Instead, after accounting for population age differences, the Centers for Disease Control and Prevention
estimates that Native Americans
, Latinos, and Blacks are two to three times more likely than whites to die from COVID-19.
Furthermore, according to the AP analysis, Latinos die at a much younger age than other groups.
Thirty-seven percent of Hispanic deaths occurred in people under the age of 65, compared to 12% for white Americans and 30% for Black people, and Hispanic people aged 30 to 39, like Ramos, died at five times the rate of white people in the same age group.
These disparities, according to public health
experts, send a clear message that the country needs to address long-standing inequities.
“If we want to honor the high price that 600,000 people paid, we must return to something better than what was,” said Dr. Clyde Yancy, vice dean of diversity
and inclusion at Northwestern University’s medical school in Chicago
“It will be an epic fail if we simply return to what we call normal,” he added.
Ramos had asthma and diabetes, and he had left his job as a chef at Red Lobster
prior to the pandemic
due to diabetes-related foot problems.
He died during the devastating winter surge that disproportionately affected Latinos, and the rest of his seven-person household in Watsonville, an agricultural city of about 54,000 people about 90 miles south of San Francisco
, became ill as well.
This included his toddler daughter, the family matriarch, Mercedes Ramos, 70, and his girlfriend, who was the only working member of the household and the first to become infected, bringing the virus home from her job managing a marijuana
dispensary, according to family members.
Every day, the mother and son would video chat or call each other from their respective rooms in the same hospital.
“He would tell me he loved me a lot and that he wanted me to get better and that he was fine
, but he was telling me that so I wouldn’t worry,” Mercedes Ramos said in Spanish, her voice breaking. She has since returned to her job picking strawberries.
disparities persist in the United States, with Blacks and Hispanics lagging behind, according to Samantha Artiga of the Kaiser Family Foundation, a nonpartisan health-policy research
Experts believe that a number of factors are at play, including Black Americans' deep distrust of the medical establishment due to a history
of discriminatory treatment, Latinos' fears of deportation, and, in many cases, a language barrier.
According to the CDC
, the United States was averaging about 870,000 injections per day in early June, a significant decrease from a high of about 3.3 million per day in mid-April.
Initially, state-set vaccine
eligibility policies favored older Americans, who were 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 vaccine side effects.
“Eligibility does not necessarily imply access,” Artiga said, adding that “losing a day or two of wages can have real consequences for your family, and people are faced with difficult decisions like that.”
The Associated Press examined the outbreak's racial and ethnic patterns using National Center for Health Statistics data on COVID-19 deaths and 2019 Census Bureau population estimates.
It's unclear who is dying now, but the still-incomplete data suggests a gap has resurfaced. In Michigan
, Black people make up 14% of the population but account for 25% of the 1,064 deaths reported in the previous four weeks, according to the most recent available state data. Similar gaps were seen in Florida and Pennsylvania
“For people of color like myself, we’ve had deep personal experiences during the pandemic,” said Yolanda Ogbolu, a nurse
researcher at the University of Maryland
Ogbolu, who is Black, became an advocate for two relatives during their COVID-19 hospital stays: her 50-year-old police
officer brother (who she convinced doctors to treat with the drug remdesivir) and her 59-year-old repairman uncle (who she called the hospital every day during his 100-day stay).
Both survived, but Ogbolu wonders if they would have survived if their family didn't have a nurse.
“What happens when people don’t have that person to advocate for them? What happens when you don’t even speak the language?” Ogbolu asked, adding, “What happens when they don’t know how to navigate the health system or what questions to ask?”