Fatality counts show uneven effects of coronavirus in tri-county

When it comes to who is dying in the pandemic, “COVID-19 has highlighted all the things we’ve known all along,” one expert said.

TRI-COUNTY — As the coronavirus pandemic lingers in the tri-county, it’s exposed disparities in health outcomes, ravaging some communities while leaving others relatively unscathed.

With 22 total fatalities, Presidio County has been hit far harder by the pandemic than either Brewster or Jeff Davis counties. Brewster County has had just eight coronavirus deaths, despite a larger population and almost twice as many cases. Jeff Davis County has had just one death.

In Presidio County, the divide is just as stark, though the data makes it harder to see. Both Judge Cinderela Guevara and Presidio County Health Authority Dr. John Paul “J.P.” Schwartz said they had not received a breakdown of where county deaths were happening. A spokesperson for the Texas Department of State Health Services said they could not provide that data beyond the county level.

But numerous local health officials — including both Dr. Schwartz and Presidio EMS Director Malynda Richardson — said a significant majority of those 22 deaths had been in Presidio. The border city appears to have more cases than the entire rest of the tri-county combined, including Marfa. That fits with findings across the United States, where low-income and non-white communities have been disproportionately impacted by the pandemic. Presidio is around 96% Latino. Around 40% of residents live below the poverty line.

In 2019, The Big Bend Sentinel reported on a study compiled by Episcopal Health Foundation in Houston, which showed a wide disparity in life expectancies across the tri-county. Brewster County residents live for an average of almost 88 years, while people in south Presidio County lived for an average of around 77.

Take the less than two-hour drive from Alpine to Presidio, in other words, and the average life expectancy of residents drops by more than a decade. The study pointed to a number of possible causes for local discrepancies like these, from race and income to the availability of fresh food.

Episcopal hasn’t done a follow-up study specifically comparing life expectancy data to coronavirus fatality rates. But in a new study with the nonprofit Altarum Institute, Episcopal highlighted the heavy burden of COVID on Black and Latino people in Texas.

If Black and Latino people got sick and died from COVID at the same rates as white people, the study found, there would be more than 5,000 fewer deaths and more than 24,000 fewer hospitalizations across the state. And that study was from September. Around 20,000 more Texans have died of COVID since then.

The study put those figures in other terms, too. Excess Black and Latino COVID deaths caused more than $5 billion in lost productivity for the state. The state has also lost more than 550,000 years of life when accounting for the expected lifespans of people who died of COVID.

“These numbers are a glaring reminder of how non-medical factors like economic status and living conditions impact health and how COVID-19 is highlighting that in the worst way,” Elena Marks, the president and CEO of Episcopal, said in a statement. “Something has to change in Texas.”

It’s those same factors, like poverty and racial health disparities, that help account for the differences in life expectancies across the tri-county. “COVID-19 has highlighted all the things we’ve known all along,” said Brian Sasser, a spokesperson for Episcopal.

Sasser gave the analogy of a checklist. “There’s a whole bunch of boxes to check,” he said, from pre-existing conditions like diabetes to a lack of medical care and places to exercise. “They’re both economic and sociological.” As a community checks more boxes, life expectancy goes down and COVID deaths rates go up. And on average, low-income and non-white people check more boxes.

Low-income people also face unique challenges in the COVID pandemic that wouldn’t necessarily affect their general life expectancy. They’re more likely to have frontline jobs, for example. They’re more likely to live in multigenerational households, where a frontline worker in their 20s has more vectors to pass disease to an elderly relative.

Sasser worries the same disparities will play out in vaccine distribution. “We have to make sure it’s not just first-come, first-serve.” Instead, he said officials should be looking at where they could put vaccine distribution sites to ensure there is equity — for example, by placing them early in neighborhoods with high COVID death rates.

Dr. John Ray, a doctor at Preventative Care Health Services, works throughout the tri-county, including in Presidio. When asked about the disparities in death rates across the tri-county, he said his work was focused on individual patients — not on big-picture trends.

Even still, Dr. Ray said he had noticed a relative scarcity of medical resources in Presidio. “There’s no pharmacy. There’s no physical therapy.”

The response to the pandemic has also varied greatly amongst communities in the tri-county. Places like Presidio, with its high death rates, have taken the pandemic seriously, even launching a protest movement last year when Presidio public schools planned to require in-person schooling. In places like Jeff Davis County — where 97% of residents are white, where the median household income is more than $50,000, and where there’s just been one COVID death — some residents have refused to wear masks or even acknowledge that there is an ongoing pandemic.

Sasser, the Episcopal spokesperson, wasn’t surprised to hear that. The more the pandemic affected a community, he said, the more seriously they would likely take it.

“You talk to people in communities of color, and they just seem to know somebody who’s been affected,” he said, giving the example of a woman who lost her job, her brother and a cousin to COVID. He compared the example of an executive at a meat plant to a worker at that same plant. “Everything about that person’s situation regarding COVID is different.”

COVID has highlighted long-standing injustices, Sasser said. “I think it may be one of the silver linings of COVID,” he said, “that we start to be more aware of health equity issues.” Those disparities aren’t just about access to health care but about making sure low-income and non-white families have access to healthy food, safe places to exercise and strong support networks. Going forward, he hopes the pandemic will provide an impetus for Americans to finally start righting these wrongs.