Latinos Have The Highest Rate Of Coronavirus Infection In D.C. Why Is That? "We've been seeing situations where whole households are getting sick, and the public health infrastructure is just not responsive to how our communities communicate."
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Latinos Have The Highest Rate Of Coronavirus Infection In D.C. Why Is That?

Maria Morales and her daughter, Flor. Courtesy of/Flor Morales hide caption

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Courtesy of/Flor Morales

Flor Morales' two-year-old son doesn't understand that his grandmother has died. She has tried to explain it to him the best way she knows how, but the boy continues to pound his little fist on the door to the basement unit, where his nana used to live. He yells her name.

Her four year old understands better: she's told him that his grandmother is up in heaven with Jesus. He turns his face upward and blows kisses at the sky.

The seven-year-old girl knows what happened. She's the only one who cries.

On April 7, Maria Morales died of COVID-19 after more than a week of severe illness that left her pale, breathless and unable to eat. The Saturday before her death, her breathing became so labored that her daughter called an ambulance and she was admitted to the hospital, where she died days later. The family believes she contracted the virus from her other daughter, Flor's twin sister, who became sick after one of her work shifts at the Howard University McDonald's.

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Now, Flor's sister lives in the basement unit alone.

"My mother was a strong woman for her children," says Morales, 23, in Spanish. "She was a good example to follow. She was a Christian woman who always told us, 'dying is a journey to go be with Christ.' I think about her saying that a lot now. But we're her children, and we needed her."

Maria Morales is one of at least 30 Latino residents of the District who have passed away from COVID-19. Communities of color in the city continue to be disproportionately affected by the virus — black residents make up 80% of the people who have died from the disease here, despite being just 46% of the population. Latino residents, meanwhile, have the highest incidence of coronavirus infection per capita in the District, at 1,200 per 100,000. (The rate for black residents is 820 residents per 100,000, while it's 175 per 100,000 white residents). However, because testing remains limited, rates of infection might be much higher than that.

Columbia Heights and 16th Street Heights emerged as the two neighborhoods with the highest number of coronavirus cases in D.C. in data released by the city last week. Both neighborhoods have relatively high numbers of Latino or Hispanic residents.

Dr. LaQuandra Nesbitt, director of D.C. Health, told reporters last week that the high incidence of cases in these areas can be at least partly explained by the higher average number of occupants per household compared with other parts of the city, as well as the higher number of essential workers who have to continue to show up to their jobs in-person day after day.

Dr. Carlos Rodriguez-Diaz, an associate professor at the George Washington School of Public Health, agrees.

"Latinos are highly represented among health care workers and emergency providers, and among those who are still working in the actual workplace rather than at home," he says, citing cleaning companies and restaurant and hospitality workers as among those at highest risk. "All of that increases their exposure to the virus."

Rodriguez-Diaz says there is also the baked-in challenge of how many Latino immigrants to the U.S. live: in multi-generational, sometimes multi-family households, everyone pitching in on rent and other expenses to make ends meet. The crowding can make social distancing within a home all but impossible, even if someone gets sick. That, coupled with problems obtaining accurate Spanish-language information about the virus, contributes to a public health disaster in the making.

"Not all [federal] prevention information has been available in Spanish," he says, and the constant updates to recommendations from the Centers for Disease Control mean that there is often a delay in getting the latest information translated to Spanish on the website.

"Linked to that is the fact that there might be a lot of misinformation circulating among the Latino community,"Rodriguez-Diaz says. "News from text messages and WhatsApp videos that are not reliable and not factual are problematic and potentially increase the risk of infection as well."

Catalina Sol, the executive director of La Clínica del Pueblo, a health center that services Spanish-speaking immigrant communities across the region, says she and her staff have not been surprised to see Latino neighborhoods emerge as hotspots for the virus.

"These are the essential workers at restaurants delivering food, they're taking public transit, they're doing their laundry at laundromats, they're going to the grocery store to be able to buy food because sometimes it's more expensive to order online or there's just not as many resources to be able to do that," Sol says. Many of her patients have been left in the position of sole provider for their large families, as layoffs have rocked nearly every industry in the District.

Both Sol and Rodriguez-Diaz mentioned the social determinants of health: things like housing, employment, health insurance access and food access. Those markers tend to be worse for Latino communities, particularly low-income immigrant communities.

"We've been seeing situations where whole households are getting sick, and the public health infrastructure is just not responsive to how out communities communicate," says Megan Macareg of Many Languages One Voice, an organization that advocates for immigrant communities and street vendors in D.C. "So we have people who, the basic meaning of what it is to keep quarantine has not really been getting through."

Sometimes, even when it does get through, people are too desperate for income to stay indoors. That's particularly true for street vendors and others working in the informal economy, who often don't qualify for government relief programs like unemployment.

Last week, street vendor Enrique Arias began going out onto the street to sell flowers and clothing again, as his fear over not making rent started overtaking his fear of catching the virus. "We can't stay locked up forever," he says in Spanish. "How are we going to make rent? We're going to end up in the street."

Arias personally knows several people who have been sickened by or died from the virus, including Maria Morales.

Everybody in the neighborhood knew Maria Morales, her daughter says. She was quiet and religious, known for cooking large meals to share and caring for the neighborhood children. She lived in the same Columbia Heights home for 21 years.

"My mom was like the mother of all the neighbors," says Flor Morales. "When she made food here, people would come, and my mom would give some out. She was always the one who babysat people's kids. Everyone knew her as a Christian woman and they came to her for advice."

Morales says there's been a collective grief in their pocket of Columbia Heights over her mother's sudden death. But the public display of mourning had to be small: only five close family members gathered to identify her mother's body after she died alone in the hospital. They had ten minutes with her body before she was whisked away. Her burial was the same day.

"I've cried, I've been angry with God," Morales says. "Why did he take her from me if I still needed her here?"

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