SUNDAY, NOVEMBER 22 , 2020. THE WASHINGTON POST EZ RE A
selves from the virus by following
public health protocols.
On Sept. 21, the NMA, the
Black physicians group, an-
nounced it would convene its
own panel of experts outside of
federal health agencies, to vet
data on clinical trials related to
vaccines — essentially a parallel
effort to address what it says are
gaps in the government’s re-
sponse and to counter doubts in
African American communities
about whether the vaccines will
be safe and effective.
“Trust remains a huge prob-
lem,” said Terri Laws, an assistant
professor at the University of
Michigan at Dearborn whose re-
search focuses on health and Af-
rican American studies. “But
we’re not where we were 100
years ago. Black professionals are
stepping up to fill the gap.”Columbia, S.C.
Dennis Bannister, his wife,
Shirley, and their daughter Dem-
etria — Demi — had been ex-
tremely cautious about the coro-
navirus. Shirley, chair of the nurs-
ing department at Midlands
Technical College, had tried to
work from home most days. Demi
diligently sprayed the doorknobs
with disinfectant whenever they
came back from an outing and
was constantly reminding every-
one to be careful.
Halfway through a master’s
program in education, Demi had
been trying to save money for her
own place while living with her
parents. Dennis, who had retired
from his job as an electrical
engineer at a local factory, was
delighted to have her.
She was their only child, and
the three of them were close.
Demi had been a math and sci-
ence whiz with a penchant for the
performing arts and had talked
about becoming a doctor or actor.
Her father was surprised when
she told him she wanted to be a
teacher. But when he volunteered
to teach her third-grade students
chess, he saw how much she
loved it.
“When it was Black History
Month, she put this choir togeth-
er and it seemed like every child
wanted to be in the choir,” he
recalled. “It gave her joy, and she
gave joy.”
Demi came down with a fever
shortly after an in-person meet-
ing before Labor Day with other
teachers and staff. At her family
medical practice, they guessed
she had a bladder infection and
gave her some medication. They
did not test her for the coronavi-
rus, Dennis said. A few days later,
she was admitted to the hospital,
and her infection with the coro-
navirus was confirmed. She died
Sept. 7 without ever seeing her
parents again.
Shirley, who had a history of
diabetes and asthma, became ill
shortly after her daughter’s
death. Dennis said she had been
despondent and told him, “All I
worked for is nothing. My baby’s
gone.”
“She was a fighter, a strong
woman, my wife,” Dennis, who
turned 65 this month, recalled. “I
don’t know if she gave up hope or
what.”
Shirley went to the emergency
room twice because she was hav-
ing trouble breathing. The first
time, he said, doctors declined to
admit her.
The second time, a few days
later, Shirley insisted on an X-ray,
which found pneumonia in her
lungs. To his surprise, Dennis
Bannister said, they sent her
home again without performing
a coronavirus test. “All that delay
time. She was getting sicker,” he
recalled. A few days later, he had
to call 911 when her breathing
deteriorated further. Bannister
was able to see her in the hospital
briefly before she was intubated.
She died Sept. 27.
[email protected]
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[email protected]Lena H. Sun and Magda Jean-Louis
contributed to this report.ty have died, he said; more Mar-
shallese have passed away in
other states, including Arkansas
and Hawaii.New Orleans
The struggle to combat the
virus has focused on different
issues in Black communities.
Reynold Verret, president of
Xavier University of Louisiana,
and Walter M. Kimbrough, presi-
dent of Dillard University, set off
waves of surprise and indigna-
tion in September when they
announced they had volunteered
as test subjects for an experimen-
tal vaccine for the coronavirus.
They also appealed to students,
faculty, staff and alumni of the
historically Black schools to con-
sider the same.
The blowback was immediate
and loud.
“You are putting our children
at risk with these fast-track vac-
cines. They are not lab rats!!!”
one parent fired back on social
media. Another commented,
“How dare you suggest they use
our community to experiment
on.”
But Verret, a scientist with a
background in immunology, said
in an interview that it is impor-
tant for him to participate pre-
cisely because he is a 66-year-old
African American man. Diverse
participation, he said, is critical
to ensuring that vaccine testing is
rigorous and fair so that all popu-
lations can benefit.
“The communities we serve
look to us as examples,” Verret
said.
The men’s decision to share
their participation in the trials is
part of an effort among African
American leaders to address the
mistrust they worry puts commu-
nities of color in greater danger.
That mistrust is grounded in
historical abuses such as the
Tuskegee syphilis trials but has
been exacerbated by missteps in
the pandemic response.
As part of that endeavor, Gil-
christ, Michigan’s lieutenant gov-
ernor, tweeted about his recent
flu shot. And the Rev. Jesse Jack-
son said at a public celebration of
his 79th birthday last month in
Chicago that his wish was that
people of color protect them-tional emergency — it recom-
mends alerts and other key guid-
ance be translated into 17 lan-
guages to reach as much of the
United States population as
p ossible — the Marshallese and
many immigrant communities
still rely on their young to
tell them what they need to know.
When the CDC began posting
information on the coronavirus
in January and February, it was in
English only. It wasn’t until
March 11 that sites in Spanish,
Chinese, Korean and Vietnamese
appeared. Translations of the
covid-19 content into other lan-
guages, such as Marshallese, are
still unavailable.
Frustrated members of minori-
ty groups said many communi-
ties created their own communi-
cation channels — through cul-
tural organizations, church net-
works, and other forums — to
share health information. Na-
tionally, the Asian & Pacific Is-
lander American Health Forum
set up a website to collect transla-
tions but access to timely infor-
mation is hit or miss.
In the Marshallese community,
Yoshikawa explained, “we have a
few who work in the hospital and
schools.”
“They are not doctors, but they
can talk to the doctors and they
can translate and get the infor-
mation to the households so they
can understand,” he said.
While it has been impossible to
get a comprehensive picture of
Asian Americans and the corona-
virus because of the lack of de-
tailed data, reports from Hawaii,
San Francisco and Washington
state suggest Pacific Islanders,
especially the Marshallese, are
being impacted disproportion-
ately among the different Asian
subgroups.
Yoshikawa, who works in cus-
tomer service at Walmart, and his
mother-in-law had such serious
covid cases they were hospital-
ized.
“It was the worst experience of
my life,” he said, describing how
he struggled to breathe as doc-
tors pumped experimental medi-
cines into him to try to save his
life. “I had to fight it and get
myself strong every day.”
At least three in his communi-people translate critical guide-
lines and alerts into his native
language, Marshallese, for their
families. One of roughly 3,
Pacific Islanders in his county —
most from the Marshall Islands
in the vast expanse of ocean
between Hawaii and Southeast
Asia — Yoshikawa said this online
group has been critical to his
community’s struggle against the
virus.
While the Marshallese, who
are allowed to live and work in
the United States but who are not
citizens, make up less than 1 per-
cent of the county’s population,
they represent an eye-popping
30 percent of covid-19 cases. The
community has been vulnerable,
he said, not only because of
language barriers, but because
many work outside the home in
essential jobs and are not eligible
for most federal health programs.
The Marshallese also have star-
tlingly high rates of cancer, likely
linked to the 67 nuclear tests the
United States conducted on or
over the volcanic island chain
between 1946 and 1958.
Despite a Federal Emergency
Management Agency playbook
that emphasizes the importance
of communications during a na-rus.
“They couldn’t give him extra
attention because his test hadn’t
come back,” she recalled. “But he
didn’t last very long.”
Ángel Chavez, 69, died a few
days later of a heart attack. At the
funeral, his youngest son had
such a bad coughing fit, he was
unable to deliver the eulogy.
Rushed to the hospital and put on
oxygen, Juan Francisco Chavez
died soon after at the age of 42.
Her father’s positive coronavi-
rus test did not come back until
after his body had been cremat-
ed, Raquel Chavez said. Numer-
ous other relatives also were in-
fected by then — her older broth-
er, a nephew, two cousins —
though everyone had worn
masks at the funeral. She said she
has been struck by how the virus
can spread faster than test results
can be processed.
“My mother cannot overcome
what happened,” she said. “It was
so quick.”Spokane, Wash.
In Spokane, Wash., Jeffrey Yo-
shikawa said much of the infor-
mation he has about the corona-
virus comes from a Facebook
group where younger, bilingual“If you distill it down to the
root causes,” Fos said, “they are
ones we have known in our coun-
try for years and we’ve just done a
very bad job of addressing it. It’s
some of the same reasons people
are protesting in the streets —
police brutality, job discrimina-
tion, environmental justice. The
coronavirus shows how much
racism there is in health as well.”
Hidalgo County, Tex.
If New York City was the epi-
center of the first wave of the
pandemic, the stretch of Texas
along the Rio Grande Valley near
the U.S.-Mexico border is the
epicenter of the second.
As of this past week, four
counties in this region had tallied
a combined total of 70,000 cases
and more than 3,300 deaths.
Norma Ramirez, the Democratic
chair for Hidalgo County, has said
there is not one person in her
region “who hasn’t been affected
by this horrible virus.”
Vanessa Alvarado, outreach
coordinator for LUPE, a commu-
nity group in Texas founded by
labor activists César Chávez and
Dolores Huerta, said immigra-
tion policy and economic chal-
lenges have exacerbated the Lati-
no communities’ vulnerability. A
Trump administration rule that
took effect Feb. 24 makes it more
difficult for people to get green
cards if they seek government
help such as food stamps and
some types of health and housing
assistance.
That has left many fearful to
seek care even if they are very
sick, she said. And as layoffs have
accelerated and people have
sought cheap living arrange-
ments, it has left families and
friends crammed into small
homes with no space for a “sick
room” to isolate patients. About
27 percent of Hispanic house-
holds span three or more genera-
tions, according to a Pew Re-
search report. That compares
with 16 percent of White house-
holds.
In addition, Alvarado said, so
many are struggling to make
enough money for basic needs
like food and shelter that the
coronavirus has sometimes
seemed a secondary concern.
Even the most vulnerable in her
community — men and women
over the age of 60 with known
health issues — have to go to
work to make ends meet. In
addition to everyday expenses,
some families are now being hit
with huge bills for funerals.
“ ‘Whatever God wants. We
leave it in God’s hands,’ ” Alvara-
do said. “That’s the general atti-
tude because that’s all you have
left.”
Alvarado and other communi-
ty activists said it’s common to
see the virus strike whole house-
holds in the Latino community.
Raquel Chavez, who is origi-
nally from Mexico, lost her fa-
ther and a brother to the virus in
September. It had started with
her mother’s stomachache. After
her mother arrived at a hospital
and they took her vital signs, she
was wheeled into intensive care
and put on a ventilator. She
tested positive for the coronavi-
rus. Then her father came down
with flu-like symptoms. His doc-
tor sent him home with some
cold medicine, and as a precau-
tion, tested him for the coronavi-
SEAN RAYFORD FOR THE WASHINGTON POSTDennis Bannister, seen at home in Columbia, S.C., lost his wife and daughter in September, 20 days apart: “I just pray God will help me find a way to deal with the situation.”
CARLOS OSORIO/ASSOCIATED PRESS
Posters of victims in Detroit. Michigan in April created a task force to tackle racial disparities in the
pandemic. Months later, Black residents accounted for a much smaller share of the caseload.Methodology
The Post used a multivariate logistic regression model to test for survival
or death of diagnosed covid-19 patients. Factors in the model were date,
patient age group, gender, combined race and ethnicity, and presence of
relevant preexisting conditions (co-morbidities). Each of those factors was
found to contribute to the model beyond the 95 percent confidence limit.
Odds ratios were also calculated comparing change over time, older age
groups to the youngest age group, men to women, and other race-ethnicity
groups to White non-Hispanics.
The limitation of the study was missing data on some of the 5.8 million
covid-19 patients collected by local health departments and assembled by
the Centers for Disease Control and Prevention. To address that, models
were tested including and omitting co-morbidities, the factor that was
most often missing. Because information tended to be more complete on
the sickest patients, models were also tested that assumed missing
information on patient survival meant that the patient had not died, that
is, a missing value was treated as “alive” in the classification of “dead” or
“alive.” Because limits on testing impacted the denominator of how many
patients were confirmed to have covid-19, models were also used for
hospitalized patients rather than all patients.
For combined race ethnicity, all White, Black and Asian patients are non-
Hispanic. Hispanic patients can be of any race. Patients are placed
exclusively in one group or the other. There is no double-counting.
This shows the parameters and results for the primary analysis model and
supplemental models that tested for issues with missing data. All findings
are significant beyond p<.0001 except for Native Americans/Alaskan
natives, which are always p<.005.FAMILY PHOTO
Bannister’s daughter, Demi, fell ill after a meeting with fellow
teachers before Labor Day. She was not tested for the virus until
she was hospitalized, and she died Sept. 7.