Virus raging through Hispanic communities
10 county ZIP codes with the highest rates of positive tests are predominantly Latino
As María Sarat rushed to her brother’s apartment in the early morning hours Monday, she knew that neither the prayers of his wife and six children back home in western Guatemala nor the natural medicine she had brewed was working.
Alfonso Sarat, 47, had developed a persistent cough days before and felt so fatigued he had fallen asleep in his car between shifts as a dishwasher and kitchen assistant at two different restaurants. But he couldn’t afford to see a doctor and was fearful of exposing himself as living in the U.S. illegally.
When María saw her brother, she wept, and, shaking, embraced him. He was so pale. The four men with whom he shared a westside apartment were paralyzed, fearful of authorities and deportation. But she called 911.
“If we flat out have nothing left,” she said, “let’s see how God could help.”
The coronavirus is raging through Hispanic communities in the Houston area, data show, and has local leaders worried that public health messaging urging residents to wear masks and maintain social distance has not
reached some of the most vulnerable residents.
Beginning in late May, Harris County Public Health data gathered outside the city of Houston show rapid case growth among Hispanic residents, far outpacing the virus’ spread among other ethnic groups. Between half and 65 percent of all those hospitalized with the virus each week during this period also were Hispanic.
State officials have not released comprehensive racial and ethnic data on COVID-19 cases, but a snapshot from the federal Health Resources and Services Administration of 14,471 Texans tested on July 3 showed Hispanic patients made up 37 percent of those tested and 72 percent of the positive tests.
The city of Houston lacks ethnicity data on most of its cases, but a UTHealth School of Public Health analysis that covers both city and county residents confirms the trend — and that it is accelerating.
Roughly a third of Hispanics being tested for the virus in Harris County are receiving a positive result, according to the study, by far the highest positivity rate of any ethnic group and multiples higher than what public officials have said is a manageable level.
“There’s no question this is spreading right now more quickly in the Hispanic community than in other communities,” said Houston Methodist CEO Dr. Marc Boom. “Let’s be clear — it’s spreading everywhere — but particularly rapidly in Hispanic patients.”
The county’s 10 ZIP codes with the highest rate of positive tests, in fact, are all predominantly Hispanic, according to the UTHealth analysis, which drew data from all Texas Medical Center-affiliated facilities countywide, hospitals and primary care clinics alike.
Two of the five ZIP codes with the highest positivity rates are in southwest Houston’s Gulfton and Sharpstown, not far from Alfonso Sarat’s apartment.
Residents there are not hearing public health messaging aimed at containing the virus’ spread, said Aisha Siddiqui, executive director of Culture of Health - Advancing Together, a nonprofit that serves the area’s Hispanic and immigrant communities. This is a particular risk, she said, given that the area is packed with huge apartment complexes, often with many people living in the same unit.
“You would hardly see a mask in this area. They are not getting the information, they are not taking precautions,” Siddiqui said. Residents living in the U.S. illegally “are getting sick, but they don’t want to talk or go to the hospital.”
Alfonso Sarat, too, had no plans to visit a hospital. So María Sarat bought a pound of corn for homemade chicken soup and made an herbal tea with cinnamon and ginger for her brother, even though her husband was out of work and they relied on food donated from their church.
But now, on Monday, Alfonso Sarat could barely speak. The frightened voice that had summoned her that morning — “What should we do?” — belonged to one of his roommates.
After paramedics arrived, he was taken to Memorial Hermann Southwest Hospital and placed in intensive care with a breathing mask. Clinicians confirmed his diagnosis: COVID-19. He did not seem to be improving, María Sarat said, after getting an update from hospital staff over the phone.
Community leaders say the surge is not a surprise, given that Hispanic residents are more likely than others to work many jobs that can’t be done from home — and many that were deemed “essential” even when stay-home orders were in effect.
“Many of these undocumented workers, they’re front-line, essential workers, working in construction, in bars, as cooks and dishwashers,” City Councilman Robert Gallegos said. “Our city as a whole is less safe when our undocumented neighbors are too afraid to get tested or seek medical help when they most need it.”
Harris County Judge Lina Hidalgo last week echoed that.
“There should be no surprise that our minority community is disproportionately impacted,” she said. “Many of these folks are the folks that call my office saying that their supervisor is making them work when they’re sick, that their supervisor is keeping the business open when they know it should be closed, that they’re not taking adequate precautions in the
workplace as they should.”
Indeed, U.S. Census Bureau data from 2018 show that in Harris County, Hispanics make up 43 percent of residents but account for 81 percent of construction workers, 65 percent of building and grounds workers, 57 percent of repair and maintenance laborers and 50 percent of food industry employees.
Hispanic residents are more likely to be exposed to the virus while earning a living, which compounds public officials’ and health care leaders’ concerns that many have not heard public health messages.
This is particularly true, officials noted, because Hispanic residents have a higher prevalence of conditions including obesity and diabetes, which heighten the risk of COVID-19 patients becoming seriously ill.
Community outreach
City and county officials have responded to the surge of cases among Hispanic residents by launching targeted outreach campaigns. They have long stressed that no one will be asked about immigration status or health insurance at testing sites but have stepped up that messaging with targeted social media initiatives and increased testing in Hispanic neighborhoods.
County Commissioner Adrian Garcia worried during Tuesday’s Commissioners Court meeting, however, that public health officials’ “traditional” efforts had been proven inadequate, citing surging case counts. He called for “creative thinking on how to deal with this infection rate.”
Hidalgo responded by saying she hoped to present an item for the court’s approval in two weeks that would fund a more robust outreach effort.
Hospital leaders, too, have responded to the influx with renewed messaging efforts.
“We definitely have a significant number of patients who are Hispanic who are working front-line jobs — many times more than one front-line job — who economically need to, and we have a significant number of the patients who are essentially Spanish-speaking only,” said Boom, the Methodist CEO. “We’re hearing from some of them that the messages that we all think we’ve been chanting from the rooftops have not been getting through to them as effectively.”
From the tail of the last wave of COVID-19 cases in May to early July, Boom said, Methodist’s share of patients who are Hispanic roughly doubled, from a quarter of patients to more than half.
Memorial Hermann CEO David Callender said he, too, has seen a similar surge in Hispanic patients since early June, particularly at the system’s large hospital in southwest Houston — where Sarat is in intensive care.
Memorial Hermann has distributed numerous posters in Spanish to businesses in neighborhoods around that campus urging visitors to maintain social distancing, wash hands and wear masks.
Public health messages also have not reached the families seeking care at El Centro de Corazón in the East End, CEO Marcie Mir said.
That federally qualified health clinic, which serves predominantly uninsured, low-income and Spanishspeaking patients, has seen a spike in concerns about the virus, conducting 14 times as many COVID-19 tests in the first half of June as were done in all of April.
Most of the clinic’s COVID-19 patients were exposed to the virus at home by family members, Mir said, which is a particular risk when many of her clients live in crowded homes or apartments with several generations present.
“How can we best educate our patients and communities about how to maintain that social distancing and disinfecting?” she said. “I don’t think we’ve done a good enough job in providing that message out to our Hispanic community and other communities that don’t have the ability to self-isolate in one room while the rest of the house can live normally.”
‘Are you OK?’
When the message is missed, it can cost lives.
Arturo Castro hadn’t seen his mother, Idalia Garcia, in weeks when she called in late June to tell him she wasn’t feeling well.
Both had worked at the DAV Thrift Store on Griggs Road, which had shuttered during the spring shutdowns. But when the store reopened, Garcia went back to work. The Laredo native had worked there nearly the entire 30 years she had lived in Houston. Castro’s wife, meanwhile, had just given birth, and he stayed home.
Garcia was an active person who liked dancing, made coffee at night and chatted with friends on the phone, but she had stopped going out, stopped visiting Castro’s four children — and wore a mask at work. Soon, however, she felt ill enough to seek out a COVID-19 test.
As she pulled up in front of Castro’s apartment, she stayed in her seat and cracked the window. The test had come back positive, she said.
She had worked a shift that day and visited a doctor’s office, but she had grown impatient with the long wait and left without being seen. Garcia asked if her son had any medication. He did, but he didn’t think it made sense to give her someone else’s antibiotics.
“I’m going to go home and rest,” she said. “I’m just tired.”
Still, she couldn’t smell or taste, couldn’t get a full breath. He tried to keep her calm. “Nah, don’t worry about it,” he told her about the COVID-19 diagnosis. “That’s not real.”
That night he called to check in. He asked repeatedly, “Are you OK? Do you want to go to the doctor again?” She said she was fine.
When he called the next morning just after 7, she didn’t pick up. After several more tries, Castro drove to her apartment near Griggs and MLK, worried this would be the last time he would see his mother.
The manager of the complex gave him a key, but the door was dead-bolted. The manager let him use a chair to break the window.
In her room, he found the light and TV on, and a cup of coffee on her nightstand. Her phone was in her hand, resting on her chest. She wasn’t moving. At her bedside, he wept.