Covid-19 especially lethal to younger Latinos

THERMAL, Calif. — Her lungs aching with each breath, Blanca Quintero, a 53-year-old cancer survivor, sought care for the coronavirus from physicians almost two hours away in Mexicali, Mexico, because her calls to doctors here went unanswered.

Was she being overlooked in the flurry of the winter surge or simply ignored, another instance of the mistreatment she and other Latino patients have faced as Spanishspeaking immigrants, she wondered.

Was the risk of venturing across the border worth it? Yes.

Even as the virus tried claiming Quintero as a casualty, it infected her son, husband and grandson — infections Quintero believes she carried into their home. At last count, 15 friends and family members have been taken from Quintero’s life by the coronavirus.

“People get to the point of where my uncle was. He waited until he couldn’t breathe any longer,” she said. “That’s when they want to look for help.”

Throughout the pandemic, the coronavirus has disproportionately carved a path through the nation’s Latino neighborhoods, as it has in African American, Native American and Pacific Islander communities. The death rate in those communities of covid-19, the illness caused by the virus, is at least double that of Whites and Asian Americans, federal data shows.

Even more stunning: the deadly efficiency with which the virus has targeted Latinos in their 30s and 40s.

In California, which has the nation’s largest Hispanic population, state figures show that as of Wednesday, Latinos ages 35 to 49 died of the virus at more than 5 1/2 times the rate of White people the same age. The gap was even wider a few months earlier: In December, when Quintero fell ill, Latinos in the prime of life were nearly seven times more likely to die than their White peers, according to the Covid Tracking Project, an independent group that collects case, death and hospitalization data.

Put another way: 35to-49-year-old Latinos represent 41.5 percent of people in that age range in California but account for about 74 percent of deaths.

The staggering loss of life at younger ages, plus higher overall mortality rates, is projected to have caused Latinos’ life expectancy nationally to plummet by about three years during 2020, according to a peer-reviewed study published by the Proceedings of the National Academy of Sciencesin February. The results were calculated using federal data. The authors of that study, who recently updated their findings, report that Latinos’ reduction in life expectancy was more than three times the loss experienced by the White population.

“A younger age at death represents more lost years of life,” said Theresa Andrasfay, the study’s coauthor and a postdoctoral scholar studying health disparities at the University of Southern California. “This shows just how this pandemic is operating a little bit differently than other causes of death.”

The findings proved all the more stunning because for years researchers had recognized that Latinos in the United States lived longer than White people, despite social, political, economic and environmental factors that typically erode health and shorten lives. This advantage had grown since 2006, when the federal government began separately documenting Latinos’ life expectancy.

Now because of the pandemic’s overwhelming loss of life and disproportionate amount of death among younger Latinos, about two-thirds of that advantage has been erased in one year, said the study’s coauthor, Noreen Goldman, a Princeton University demographer who has studied Latino health and socioeconomic disparities in health for years.

“That’s huge,” Goldman said. “One would have thought [that advantage] would have carried over to covid. And we’re not done. What’s going to happen by the end of 2021? My hunch is that there will no longer be an advantage at all.”

The quest to reverse that tide of death can be found in California’s eastern Coachella Valley, where citrus and date groves rise from a desert floor lined with rows of broccoli and lettuce. Each person who answers the door in a mobile home community reflects part of Quintero’s story as a Mexican immigrant negotiating life during the pandemic.

Thirty-five years ago, she settled in the United States as an 18-year-old bride pregnant with a child who would be born with special needs. Quintero, already mother to a toddler, spoke no English and had no clue how to navigate the nation’s complex health-care system.

But with the support of promotoras de salud - community health workers she learned which questions to ask the surgeons and what support services her daughter’s developmental delays required as she worked toward a better life for her family. She washed dishes, cleaned houses, worked in fields and cared for the elderly before going to school and becoming a message therapist and cosmetologist.

Now, Quintero stands on the front lines in the battle against the coronavirus - as a promotora de salud. She knows that battle all too well from her own sixweek bout with covid-19, when she relied on a nebulizer to ease her breathing. Sometimes, she is joined in her work by her daughter Lesly Quintero.

“It was like from one week to the next, people were just getting sick everywhere,” Lesly Quintero said as she walked along Peter Rabbit Road with her mother, promoting a free testing event later that week while emphasizing that coronavirus tests were “por la boca” (for the mouth) because people remained wary of nasal swabs. “Everybody was just having symptoms and testing positive.”

Just then, she overheard her mother admiring an altar devoted to the Virgin of Guadalupe as two tiny dogs barked and chased strangers in the roadway. The shrine - a transformed eight-foot-tall shed brimmed with candles, roses, daisies and gladioli that had yet to bloom. A huge picture of the virgin hung from the back wall.

Pinned to a statue were dollar bills, offerings of gratitude for blessings received.

Blanca Quintero listened as a 48-year-old farmworker, Maria Ines Sanchez, told her that faith spared her family the worst ravages of covid-19. The shrine rotates to a different member of the indigenous Mexican family, who are Purépecha, each Dec. 12, the feast day of the virgin. This year, it landed in the farmworker’s backyard as the coronavirus surged and four people in the house got sick but recovered quickly.

Later, Quintero said it was faith that helps her cope with an incomprehensible amount of death: “Yes, there’s pain and sadness, but to me it means their mission was accomplished.”

Her daughter was the first person in her family to fall ill from the coronavirus. A medical assistant who used to work at a pain management clinic, Lesly Quintero said she contracted the virus from a patient in June and brought it home, where it spread.

“If I had been tested earlier, I could have prevented passing it on to my partner,” she said. She was sick for a month and lost her job after she recovered, so she joined her mother as a promotora de salud with Visión y Compromiso.

“They are the safety net,” said Linda Sprague Martinez, a professor at Boston University’s school of social work who conducts community health research with adolescents and young adults. “They’re able to translate information from institutions to the community in a way that’s meaningful because they know personally mediated racism and how that plays out. They see people. They see neighbors. They see friends.

“Whereas systems don’t see you,” Sprague Martinez said, “they see a number. They see a chart.”

Part of Lesly Quintero’s mission as a medical assistant had been helping Spanish-speaking patients better understand the doctor’s orders, serving as a bridge between marginalized communities and the medical establishment. Covid-19, with its stranglehold on low-income neighborhoods and communities of color, intensified the need for that work.

Then came the winter surge of cases, which overwhelmed California’s hospitals, deepened the virus’s disproportionate impact and spawned a dangerous variant.

“Now, you hear of people dying all the time,” Lesly Quintero said.

There was her colleague’s uncle, a wellknown Catholic priest who worked to ensure that his parishioners did not go hungry during the pandemic.

And her mother’s friend, who lost both parents, a son and a grandchild.

“When communities have very solid social umbrellas, covid is not going to make much headway,” said David Hayes-Bautista, director of the Center for the Study of Latino Health and Culture at the University of California at Los Angeles’ David Geffen School of Medicine. “But when you get communities that have great big, gaping holes - lack of health insurance, lack of providers, have to be out and exposed, low-income - covid is just going to go right through there.”

A federal analysis of the first half of 2020 found a precipitous drop in life expectancy among Black and Latino Americans, with African Americans suffering the steepest decline. Life expectancy for Latino Americans was 79.9 years through the first six months of 2020, for White people it was 78 years and for Black people 72 years, according to federal figures. A year earlier, it was 81.8 years for Latino people, 78.8 for White people and 74.7 for Black people.