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The family business, the matriarch, and a $4,145 close call: The cost of COVID-19 is much worse for some American families

Jun 30, 2021, 19:25 IST
Business Insider
Skye Gould/Insider

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Leslie's family poses for a photograph in Dalton, Georgia, at a quinceañera in 2019. Leslie
  • Leslie, 22, and her family were hit hard by the coronavirus pandemic.
  • Her dad was hospitalized, her grandmother died, and her mom's business went under.
  • Their story is one of too many left by a pandemic that disproportionately hit communities of color.

In Marietta, Georgia, Leslie watched the pandemic unfold up close.

Her dad, Ricardo, came home for the weekend in late June 2020. Ricardo helped build the framing for new Zaxby's locations and often worked out of state. The current gig for the fast-food chain was in Florida.

Georgia Gov. Brian Kemp had extended the state's public-health emergency at the end of May 2020 while allowing clubs and bars to reopen. It preceded a surge in cases.

That weekend, one of Ricardo's coworkers who'd carpooled with him to Georgia went to a club. On the two-hour drive back to Florida, the worker was coughing.

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Within a few days, Ricardo called Yolanda, his wife and Leslie's mom, and said he had a fever. He worked while sick for the rest of the week, feeling as if he couldn't leave the job.

"And then he came home, and he was, honestly, in denial that he had COVID," Leslie said.

(We're not using the family members' last names at their request, but their identities are known to Insider.)

They all got free testing at a nearby park on July 2.

Ricardo's fever didn't go away, and he spent the next few days in bed. On July 4, he had a coughing fit and panic attack. He was yelling for help and struggling to breathe. Fireworks went off while the paramedics took Leslie's dad away in an ambulance.

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That night, the family got their results back from the health department. All were negative except for Ricardo.

Leslie's family is close. Ricardo, 48, met Yolanda, 46, in their hometown of González, Mexico. Leslie, the older of two siblings, age 22, acts as quarterback, scheduling appointments and translating. They talk to their extended family members around the clock, sharing their homes with grandma Adelina in shifts.

In the span of a month, the virus would take a lot, including the family business and the family matriarch. Almost a year later, Ricardo still can't lift heavy objects.

Health disparities in the US have been laid bare

The family's experience mirrors what thousands have faced during the pandemic.

Read more: Inside Cityblock's meteoric rise: How a Google spinoff built a $1 billion business and convinced Silicon Valley to bet on healthcare for the sickest patients

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People of color can be more at risk of getting sick because of where they live, like a crowded house, or where they work. They may work essential jobs in construction or service, unable to avoid the virus. And the US healthcare system has a long history of racial disparities.

"This crisis has unveiled the inequities that are really baked into our system and how structural racism contributes to worse health outcomes for people of color," Dr. Laurie Zephyrin, a healthcare delivery reform expert at The Commonwealth Fund, said.

People who identify as Hispanic or Latino account for more than a quarter of COVID-19 cases, far great than their share of the population, federal data shows. Throughout the crisis, Black people have been twice as likely to die from the virus than white people. For Indigenous Americans, it's over three times as high.

Read more: This doctor is helping Biden prepare for a White House victory. Her focus on a $238 billion problem could shape healthcare's future.

Mixed messages and misdiagnoses

Before Ricardo was admitted to the hospital, Yolanda put his phone and charger in his jacket pocket, in a plastic bag. So he could write short texts, like "Hi I'm okay," Leslie said.

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The messages were as much a source of fear as comfort.

A couple of days after Ricardo received a plasma transfer to help combat the infection, he said he couldn't breathe and no one would listen. Yolanda cried to Leslie, saying that Ricardo was dying.

"That happened a lot," Leslie said. "Like my dad legit felt like it was it. And he would text my mom and say 'I love you. Please tell my kids I love them.'"

For his 28-day stay, Leslie said the hospital called just once. Instead, information came from Leslie's efforts, dialing memorized numbers while her mom tried to decipher the texts of a very sick person.

A nurse dons personal protective equipment to attend to a patients in a COVID-19 intensive care unit. PATRICK T. FALLON/AFP via Getty Images

The doctors thought he had pneumonia, but it turned out to be a pulmonary edema, a condition marked by excess fluid in the lungs. They treated him for diabetes, with insulin and a diet, even though he didn't have diabetes, a test would later show, Leslie said. The chances for a misdiagnosis increase when you're not white.

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Ricardo started to deteriorate. About five days into his hospital stay, he was transferred to the ICU.

It's difficult to measure the economic toll of COVID-19

Meanwhile, the expenses were adding up.

Leslie saw bills for physical therapy, $1,479; pharmacy, $7,190; and ICU, $71,554, she said. The family doesn't have health insurance, and no one explained that a lot of the costs would be forgiven.

It ended up being $4,145, discounted down from $216,850, after relief provided by the CARES Act, Leslie said. They set up a payment plan to slowly pay it back. Leslie said it felt doable.

Ricard's medical bill was adding up, and the family didn't know discounts were incoming. Leslie

Yolanda had COVID-19, a test from July 7 confirmed. The home she shared with Leslie and her siblings, Ricardo Jr., 19, and Giselle, 12, started to feel like a scene from the film "Contagion." Everyone kept to their rooms. Leslie would cook and leave meals at everyone's door, knocking on the wall once she was six feet away.

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To keep up, she withdrew from a couple of classes she was taking that summer at Georgia State University, extending her time there by another semester and $1,400.

Yolanda and her sister Irma ran a boutique. Without parties, there wasn't much demand for dresses and alterations. They applied for a loan through the Paycheck Protection Program, but since they didn't really have employees, the government gave them just $1,400. Behind on rent, they gave it straight to the landlord, who gave them until the end of July to leave.

PPP didn't prioritize underserved markets, such as businesses owned by women or people of color, despite its intent, according to a review of the loans by the Office of the Inspector General. More than 71% of the money went to white-owned businesses.

July was not an easy month for Leslie's family to empty out a whole store.

Despite a big sale, they were left with a lot of merchandise and nowhere to keep it, Leslie said. Colorful quinceañera dresses were tucked away in an abandoned storage unit and the shed behind their house. Now they're running alterations out of Irma's house, as they did before the business started, in 2016.

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Then the head of the family died

Respiratory therapy was starting to help Ricardo when Yolanda's mom died.

Adelina, mother of 13 children, passed away on July 16 in González from the coronavirus. She'd returned to Mexio with family, and stopped to visit Ricardo while he was sick.

Adelina brought a picture of her husband, who passed away in 1985, to one of their children's weddings in Arkansas. Leslie
When she learned of her grandmother's death, Leslie packed her bags, thinking she would help with the arrangements.

She had imagined her grandma's wake before, with scores of family and friends celebrating for 24 hours, a Mexican tradition. But no arrangements would be made.

"The morgue came, literally bagged her, put her in the coffin, and buried her," Leslie said. "All in the matter of an hour, she was in the ground."

The doctor told Leslie not to tell Ricardo the news because he was just starting to get a little better. He found out three days later from Facebook anyway.

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Leslie broadcast the family's nine days of prayer on Facebook from the driveway, and Ricardo joined in. She said it was almost like they were all together.

Leslie and her grandma Adelina pose for a photograph on her 83rd birthday in Marietta, Georgia. Most of her kids and grandkids traveled to Georgia to surprise her that year. Leslie

The family is recovering and might take the vaccines

Ricardo returned home on July 31. He was 45 pounds lighter, with a beard and an oxygen tank.

The family bought him a walker and a shower chair, and they celebrated tiny victories. He walked two steps, then four, then five. Then he walked to the front door and sat on the rocking chair.

Ricardo went back to work over the winter months. They recently went to the beach for his birthday. Leslie got a job as a bilingual nanny in July.

Ricardo and Ricardo Jr. are soon getting their second dose of the vaccine. The family has been nervous to get vaccinated because people around them were saying scary things about the shots. But so far her dad and brother have reacted well, she said.

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Georgia's vaccine rollout has been one of the slowest because of an uneven rollout, communication issues, tech problems, and more.

Leslie said, "I'm thinking we're going to get it."

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