Burden of virus affected by race
Minority groups are hardest-hit
As many as 215,000 more people than usual died in the United States during the first seven months of 2020, suggesting that the number of lives lost to the coronavirus is significantly higher than the official toll. And half the dead were Blacks, Hispanics, American Indians and Asian Americans.
The new figures from the Centers for Disease Control and Prevention highlight a stark disparity: Deaths among minority groups during the crisis have risen far more than they have among whites.
As of the end of July, the official death toll in the U.S. from covid-19 was about 150,000. It has since surpassed 175,000.
But public health authorities have long known that some coronavirus deaths, especially early on, were mistakenly attributed to other causes, and that the crisis may have led indirectly to the loss of many other lives by preventing or discouraging people with
other serious ailments from seeking treatment.
A count of deaths from all causes during the seven-month period yields what experts believe is a fuller — and more alarming — picture of the disaster and its racial dimensions.
People of color make up just under 40% of the U.S. population but accounted for approximately 52% of all the “excess deaths” above normal through July, according to an analysis by The Associated Press and The Marshall Project, a nonprofit news organization covering the criminal justice system.
“The toll of the pandemic shows just how pervasive structural racism is,” said Olugbenga Ajilore, senior economist at the Center for American Progress, a public policy organization in Washington.
Earlier data on cases, hospitalizations and deaths revealed the toll on Blacks, Hispanics and American Indians, a disparity attributed to unequal access to health care and economic opportunities. But the increases in total deaths by race were not reported until now; nor was the disproportionate burden on Asian Americans.
With this new data, Asian Americans join Blacks and Hispanics among the hardest-hit communities, with deaths in each group up at least 30% this year compared with the average over the past five years, the analysis found. Deaths among American Indians rose more than 20%, though that is probably a severe undercount because of a lack of data. Deaths among whites were up 9%.
The toll on Asian Americans has received far less attention, perhaps in part because the numbers who have died — about 14,000 more than normal this year — have been far lower than among several other groups. Still, the 35% increase in Asian American deaths is the second-highest, behind Hispanic Americans.
In an average year, somewhere around 1.7 million people die in the United States between January and the end of July. This year the figure was about 1.9 million, according to the CDC.
DEATHS FROM OTHER CAUSES
Of the possible 215,000 additional deaths above normal through July — a total that has since risen to as many as 235,000 — most were officially attributed to coronavirus infections. The rest were blamed on other causes, including heart disease, high blood pressure and other types of respiratory diseases.
The CDC has not yet provided a breakdown by race and ethnicity of the deaths from other causes. The newly released data is considered provisional and subject to change as more information comes in. Certain categories of deaths — suicides or drug overdoses, for example — often involve lengthy investigations before a cause is assigned.
The outbreak’s disproportionate effect on minority-group communities is not limited to a specific region of the country.
The virus first hit urban areas on the East and West coasts. But according to University of Minnesota researcher Carrie Henning-Smith, disparities have also been seen as the disease spread across the country to Southern and Western states with large rural populations.
For example, Arizona reported almost 60% more American Indian deaths so far this year compared with previous years, and New Mexico recorded over 40% more.
Between the two states, over 1,100 more American Indians have died than normal.
Only about half of the Asian American deaths have been officially linked to covid-19, lower than for all other groups. Jarvis Chen, a lecturer at Harvard University’s public health school, said Asian Americans may not be getting tested at the same rate as other groups, for reasons that are unclear, and that could result in some virus deaths being attributed to something else.
Dr. Namratha Kandula of Northwestern University echoed that theory. She also cautioned against generalizing about the underlying health of Asian Americans as a whole, noting that they are a diverse group from many different nations and cultures.
“It’s not enough to clump them all together because it does not tell the whole story,” she said.
Racial disparities in deaths predate covid-19, and many forces combine to produce them:
■ Some minority-group communities are more likely to have lower incomes and to share living space with larger families, increasing the risk of transmission.
■ They have higher rates of health problems, including diabetes, obesity and lung ailments, the result of living in places where healthier foods are harder to get and the environment is polluted.
■ They are more often uninsured and tend to live farther from hospitals.
■ They are disproportionately incarcerated, which has been linked to long-term effects on health.
■ Experts point to a long history of discrimination that causes distrust of the health care system.
■ And people of color are more likely to fill essential roles that require them to keep going to work during the pandemic.
Dr. Sobiya Ansari, who works predominantly with Black immigrant cancer patients in New York City, worries when they miss or postpone radiation or screenings. Already, the city has seen double the number of Black deaths this year compared with previous years.
“If a storm hits and you’re safe inside your house, you’re safe,” she said. “Then there is a population of people that don’t even have umbrellas. The storm hits, and they’re just really swept away.”
NEW SCHOOL GUIDELINES
The Centers for Disease Control and Prevention on Friday updated its guidance for reopening schools to include advice on what to do with students who come down with covid-19.
The guidelines are largely common-sense, though noteworthy after a week in which several large colleges have reversed plans for in-person learning and after several school districts sent students home after outbreaks.
Sick children should be isolated, areas where they’ve been disinfected, and health officials and close contacts should be notified, the CDC said. Maintaining a goal of keeping schools open, the CDC laid out a possible hybrid strategy that could include temporary building closures or halting certain activities like sports or assemblies “to allow time for local health officials to gain a better understanding of the covid-19 situation and help the school determine appropriate next steps.”
CDC Director Robert Redfield said on a call with reporters Friday that it’s important for schools to “have a well thought-out step-by-step approach” and emphasized, as President Donald Trump has, that students should get back to in-person learning as soon as possible.
When making any decisions about closing buildings or suspending activities, local health officials should take into account the number of covid-19 cases in the area, not just in the school, the CDC said.
Redfield highlighted a CDC study released Friday that showed low secondary transmission of covid-19 in child-care facilities in Rhode Island. Of 666 facilities that were open the last two weeks in July, state officials identified four where someone at the center passed the virus on to someone else there.
The study attributed the low spread to a limit on class sizes and mask-wearing by adults at the facilities.
However, since many children don’t present symptoms, the study concedes that some cases probably went undetected. It also notes the virus had a significant impact on the facilities, which had the capacity to care for almost 19,000 children. During those two weeks, 101 possible covid-19 cases were identified, leading to the quarantine of 687 children and 166 staff members.
SETBACKS AT SCHOOLS
Meanwhile, schools in at least 10 states have had students and staff test positive for the virus since they began opening. The outbreaks have occurred in a variety of settings: marching bands, high school football teams, elementary classrooms, high schools.
A Colorado high school shut down for two weeks after two students tested positive. Football teams in Utah canceled practices and games after several players came down with the virus. The entire football team and marching band in a small Alabama town were placed under quarantine because of exposure to the virus, the second time the team had to be quarantined this summer.
Michigan is reporting 14 outbreaks at schools. Mississippi started the week with about 2,000 students and 600 teachers in quarantine; the state has had 245 cases of coronavirus in teachers and about 200 in students since districts began returning to school in late July.
The K-12 clusters have mirrored the situation at colleges and universities that have had to shut down in-person learning and switch to virtual classes, albeit for different reasons.
Many of the college outbreaks have been traced back to fraternity and sorority gatherings, crowded bars and a lack of masks and social distancing. Students around the country have been suspended for violating bans on campus parties and gatherings.
High school students have been flouting mask and social distancing rules as well. At a high school football stadium Thursday in Utah, the athletic director stopped the game, grabbed the public-address microphone and told the crowd that play would not continue until fans complied with mask and social-distancing requirements.
Information for this article was contributed by Mike Stobbe, Larry Fenn, Marshall Ritzel, Tammy Webber, Kimberlee Kruesi, Jocelyn Noveck and Dave Kolpack of The Associated Press, along with Anna Flagg and Damini Sharma of The Marshall Project; and by Anna Edney of Bloomberg News. The Marshall Project explores the true toll of the coronavirus pandemic on communities of color.