When Jose Torres was admitted to an intensive care unit in November 2020, his family hoped he wouldn’t be there for long. He and his wife, Teresa, had gone to Scripps Mercy Hospital for other reasons and then tested positive for COVID-19.
The couple’s health had declined in recent years, but they had been resilient. Jose was born in Mexico City and Teresa grew up in San Ysidro. Jose worked for an airline, but eventually he and Teresa set up their own travel agency, which survived a fire.
Now JosÃ© and Teresa have found themselves a few feet from each other, unable to see or communicate with each other. They were in neighboring hospital rooms, separated only by a wall.
Teresa died on December 8. Their daughter, Diana Gimenez, waited days to tell Jose, fearing an emotional setback would worsen her condition. But Jose kept asking questions about Teresa and on December 13, Diana finally broke the news.
“He made a gesture as if he knew it,” she said. “He made a sign with his fingers as if he was climbing a ladder and ‘I’ll follow her.”
He died the same day.
The new coronavirus has torn apart families across the county, but new analysis from Voice of San Diego reveals immigrant families like Jose and Teresa Torres’ have been hit harder than almost any other group.
Immigrants accounted for more than half of all COVID-related deaths in the first year of the pandemic. Foreign-born residents make up 23% of San Diego County’s population, but account for 52% of all COVID-related deaths.
Voice of San Diego reviewed and recorded 4,046 death certificates – one for each COVID-related death between March 22, 2020, the date of the first recorded death, and March 22, 2021.
Of the immigrants killed in the first year of the pandemic in San Diego County, 68% were from Mexico. Filipinos and Iraqis also made up a significant percentage of the population of other countries.
In some ways, the results are surprising. A phenomenon known as the “healthy immigrant effect” indicates that immigrants to the United States are healthier than born residents. People who immigrate, it is believed, tend to be in better shape than those who do not.
“Our current assumption about the health status of immigrants is that immigrants, at least from Mexico, are in fact healthier and have healthier health habits (for example, in the case of diet, smoking , alcohol consumption) “, wrote Sheila CastaÃ±eda, professor of public health. at San Diego State University, in an email.
But CastaÃ±eda also acknowledged that COVID-related issues pose additional complexities. Immigrants, for example, have less access to medical care, she said.
âIt doesn’t surprise me that the majority of deaths were immigrants, as they tend to include essential workers. They didn’t have the luxury of working from home. And there were more chances of having older people who lived in multigenerational homes, âsaid Maria Rosario Araneta, professor of public health at UC San Diego.
Jose and Teresa retired after their travel agency went bankrupt in 2009 – the internet and a recession effectively killed the business – and then moved in with their daughter full-time. They bought a 1,700 square foot townhouse in Bay Terraces in late 2019. Three generations lived together: Jose and Teresa, Diana and her husband, as well as Diana’s daughter, Ivette, and her husband.
Diana, Ivette, and Ivette’s husband all had jobs that kept them apart – in insurance, healthcare, and tech – so they turned the house into an office.
Despite having six people under one roof, Diana described these first months of the pandemic as a joy. They spent time together playing Monopoly and Dominoes and praying with their extended family of aunts and cousins ââon Zoom.
They have been cautious, asking visitors to stay outside and largely limiting their own trips to the grocery store and drugstore. Diana and Ivette wore masks inside the house but sometimes took them off to console Teresa. She suffered from dementia and did not understand why people were hiding their faces.
In the weeks following the death of her parents, Diana returned to her memory to reconstruct who might have come near them. She interviewed people close to her. Then abandoned the problem. It wasn’t going to bring anyone back.
Living in multigenerational housing is more culturally familiar to many immigrants and also more affordable.
âCalifornia has such high house prices and it has forced many low-income and Latino households to live in these very small homes,â said Arturo Bustamante, professor of public health at UC Los Angeles. âAnd we know that kind of framework is helping the virus to spread. “
Voice’s analysis identified 32 residential addresses, like those of Jose and Teresa, where two people died from COVID-19.
Of these 32, three-quarters were immigrant households. Two of these houses were located in the same block at Otay Mesa West. Door to door, they lived 350 feet apart.
It’s unclear exactly what caused the deaths of immigrants at such disproportionate rates in San Diego. Multigenerational housing clearly puts them at greater risk. But several other factors may also be at play.
It was not necessarily immigration status itself that caused the disproportionate death rates, according to Castaneda. Exposure rates, access to care and poverty rates âmay actually play a role,â she wrote.
Poverty appears to be closely linked to death rates.
A Voice analysis of death rates and median income rates showed a significant correlation. For every $ 6,600 increase in household income, the risk of death decreased by 10%.
The level of education, which reflects income, also stands out. Among deceased immigrants, 51% did not have a high school diploma. The same was true for only 10 percent of non-immigrants.
Age does not appear to be the cause of the difference in death rates at all. COVID is deadlier for older people. But the median age of deceased immigrants and non-immigrants was 76.
Other variables, such as language barriers and a tendency towards essential work, may have accumulated as risk factors. At the onset of COVID in particular, there was limited information available in some people’s native languages, Araneta said.
Asian residents, unlike Latinos for example, speak hundreds of different languages. Officials did not have a good idea of ââthe communities to which they should target the information, she said.
âThere were a lot of mixed messages and it became difficult to understand why we had to lock ourselves up or why we had to wear face masks,â Bustamante said. “It was even more difficult for those of us who don’t speak English fluently.”
It is also not known whether the healthy immigrant effect has a long lifespan. Some studies have shown that the longer immigrants stay in the United States, the more their health is likely to deteriorate.
Like many deceased immigrants, JosÃ© had been here for decades. Over the years, he developed diabetes – which increases the risk of death in cases of COVID.
A good 25 percent of San Diegans who died from COVID had diabetes. Eighty percent suffered from a chronic illness that contributed to their death, such as high blood pressure, kidney disease or obesity.
Shortly after Jose and Teresa’s hospitalization, Diana and Ivette also tested positive for COVID-19. Their husbands’ tests came back negative. The couples tried to keep their distance. They were living in different rooms when Teresa and JosÃ© died.
âI couldn’t kiss my husband. My mom couldn’t kiss my dad, âIvette said. âWe had to grieve alone. ”
Grief is still very much these days, but the family takes comfort in the time they spent with JosÃ© and Teresa during the pandemic. They plan to take the ashes back to the couple’s church in Tijuana. But they’re not quite ready to say goodbye.
Meanwhile, the family has watched the vaccines roll out, the world open again, and the death toll drop back into the backdrop of everyday life.
âPeople tend to forget what happened last year,â said Ivette, âexcept for those who have lost loved ones.â