A slight fever woke Jorge around 10 p.m. May 2 in his southeast Baltimore home. He tried not to pay it much thought and went back to bed. By 1 a.m. his fever was raging. His mind started to race. “What if I have coronavirus?" he thought. Panic quickly settled in for the uninsured 47-year-old.
Jorge’s blood pressure spiked, and he worried if he did not calm down, a heart attack could kill him. His wife and daughters in Honduras depend on his income.
While the coronavirus can affect anyone, social, economic, and health disparities are among the reasons Latino and black populations are becoming sick and sometimes dying at disproportionate rates, not just in Baltimore but across the country, experts say.
“COVID-19 has highlighted inequalities in our society,” said Dr. Kathleen Page, an infectious disease expert and associate professor at the Johns Hopkins University School of Medicine.
Hispanic people have the highest rate of infection of any race or ethnic group in Maryland. As of Tuesday, 7,274 Hispanic residents had tested positive for the coronavirus — or more than one of every 100 people, according to a calculation based on Census Bureau data. Nearly a third of the newly confirmed cases, 217, were Hispanic residents who were diagnosed with the disease.
In Baltimore, 12% of coronavirus patients whose ethnicity is known are Hispanic, while they make up 5% of the population. The disparity is even more pronounced in the recent number of hospitalizations at Johns Hopkins Hospitals in Baltimore.
Hispanic patients account for 36% of admitted COVID-19 patients at Johns Hopkins Hospital and 38% at Johns Hopkins Bayview Medical Center as of May 7, according to Hopkins data obtained by The Baltimore Sun.
Although Jorge wears a mask and gloves at his job as an auto technician in Parkville, he thinks he could have been exposed while buying lunch or riding to work with co-workers. Jorge asked The Baltimore Sun to use his first name only because of safety concerns, as he is undocumented.
Over the next few days, Jorge began searching the internet for answers. Without a doctor’s order and identification, he could not get tested. He knew his last resort would be the hospital.
Page said Hispanic COVID-19 patients at Hopkins hospitals oftentimes are presenting late to care because they don’t have a safety net and many are uninsured.
Latinos and Hispanics have the highest uninsured rates of any racial or ethnic group in the country, according to the U.S. Census Bureau in 2017.
Only 16% of Latinos and 20% of African Americans are able to work from home; they’re often working in jobs where social distancing is not possible, according to an analysis of U.S. Bureau of Labor Statistics data by the Economic Policy Institute.
Latinos often work low-wage jobs and live in shared households with multiple family members or roommates, which can lead to increased spread, said Page.
Those in the U.S. without authorization may fear going to a hospital could get them deported. Not eligible for public benefits and left out of economic relief packages, undocumented immigrants are especially vulnerable, said Angelo Solera, a longtime leader in the Latino community and health care advocate.
In Baltimore’s Highlandtown neighborhood, home to a large immigrant population, Cinco de Mayo grocery store owner Evaristo Guzman takes precautions. He makes sure customers wear masks and limits the number of people in the store.
Guzman worries some of his customers are at higher risk of coronavirus because they might not know how hard the virus is hitting this area.
“I think that in the Hispanic community, they are blinded to the severity of the situation,” said Guzman. “I think our government should become more involved and concerned.”
The number of cases in the 21224 ZIP code, which includes Canton, Highlandtown and parts of Dundalk, has doubled in less than two weeks, according to city data.
Even in non-pandemic times, the Latino immigrant community isn’t counted fully in many areas. Health experts say that without consistent data, it’s hard to recognize and address disparities.
“Infectious diseases highlight that we’re all connected. And so, ignoring or neglecting one thing is likely going to have an impact on the rest of us as well,” said Page.
Even as the virus spread, there was no data publicly available about coronavirus cases among Hispanics at the city level until The Baltimore Sun submitted inquiries. On May 4, the city began reporting data by ethnicity. It now shows about 12% of confirmed coronavirus patients ― 403 out of 3353 ― are known to be Hispanic. City officials acknowledge this is an undercount because 41% of cases are missing ethnicity data.
According to 2019 Census data estimates, Hispanics make up about 5% of Baltimore’s population.
“Accurate, timely data is important to have, as it helps guide the City’s response to COVID-19,” according to a statement from the city health department, which obtains its data from the state.
Johns Hopkins did not release data broken down by ethnicity for its two Baltimore hospitals, but it was provided to The Sun by a nurse who said the information was too important to keep from the public.
“I believe it would be negligent if this data was not shared with public health agencies to alert the Latinx population of the presence of COVID-19 within their community," said the nurse in the Johns Hopkins Healthcare system.
When The Baltimore Sun presented the numbers to Hopkins and asked for additional information, the hospital did not respond.
Data that is public shows that Hispanics make up 23% of all COVID-19 inpatient cases across the five Hopkins institutions in Maryland, according to data summaries from the Johns Hopkins Institute for Clinical and Translational research.
Other hospitals in the city referred questions about hospitalizations to the state health department.
Today, Maryland’s survey shows that 21% of those infected whose ethnicity was known were Hispanic, though they make up about 10% of the state’s population, according to public data by Maryland Department of Health.
Gov. Larry Hogan has said there are significant data gaps because private labs that do the most testing aren’t required to report on race and ethnicity.
The state health department did not make someone available to talk about COVID-19 trends among the Hispanic population and referred to a statement from its Office of Minority Health and Health Disparities: “As the virus continues to spread, higher rates of infection and fatality are linked to existing health disparities that affect minority communities, and particularly Black Americans.”
While the numbers are incomplete, the impact on the Hispanic community is clear.
Councilman Zeke Cohen, who represents much of the city’s Spanish-speaking community, said there’s a lot of anxiety as immigrants worry over access to food and medical care.
“I think our immigrant community is extremely resilient but in many cases has a lot of challenges,” said Cohen.
Cohen appears on Spanish-language radio stations with the help of a translator. He collaborates with churches and volunteer groups to deliver meals to those in need and distribute fliers about COVID-19 to open businesses.
The Baltimore Mayor’s Office for Immigrant Affairs has translated COVID-19 information to seven languages and sends a weekly email newsletter. The agency has also partnered with a Spanish-language news source and doctors from Hopkins’ Centro Sol to answer questions about the coronavirus on Facebook.
Food distribution sites in the city are open to anyone, said agency director Catalina Rodriguez.
Johns Hopkins launched a new pilot program last week to “promote the most effective care for vulnerable Spanish-speaking inpatients diagnosed with COVID-19,” according to Hopkins.
Statewide, the health department’s Office of Minority Health and Health Disparities is increasing testing in “minority communities” and partnering with other agencies to increase access to hospital beds and ventilators, according to a statement.
For now, Jorge feels better and is taking extra precautions. His brother, who is an American citizen, got his primary care doctor on the phone and determined Jorge did not have all the COVID-19 symptoms to get tested, said Jorge. He hopes this was just a false alarm.
Baltimore Sun reporter Phil Davis contributed to this article.