COVID-19 can hit any child in Delaware. But it's worst among Latino children
The mother knew something was wrong. She just knew it.
Her 4-year-old son, who loves solving puzzles and gobbling down Mexican lamb, was not eating or drinking. He did not have any energy to play. A brown, reddish rash covered his body.
Doctors told her at first that she shouldn’t worry. Maybe it was just chicken pox? But his fever persisted for days, reaching 104 degrees at one point.
It was early June, and she, like everyone else, had read about
the coronavirus. But at first, she thought this was just another bug because no one she knew had tested positive for the coronavirus.
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But she still had this nagging feeling that something was wrong. She and her husband took their only child to the emergency department, where moments later her son was rushed away to the intensive care unit.
Tests confirmed what she feared. COVID-19 had invaded her son’s body.
The boy is among the Latino children in the state who have been infected with the COVID-19 virus at a vastly disproportionate rate, a Delaware Online/The News Journal analysis of state data has found.
Between April and June, about 47% to 60% of children diagnosed with COVID-19 were Latino, according to state data. Latinos make up about 16% of the child population in Delaware.
The boy's immune system was attacking his organs. Doctors discovered he had contracted a rare condition associated with COVID-19, in which the brain, heart or lungs can become inflamed.
It can be deadly.
“I never thought that it was going to happen to us,” the mother said in Spanish through a hospital translator. Delaware Online/The News Journal is not identifying anyone in the family because the mother said there is a stigma in her community associated with the coronavirus.
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Latinos of all ages, particularly those living in Sussex County, have the highest rate of infection among any racial group in the state — five times as high as the rate among white residents.
That led to state health officials significantly increasing testing in these sometimes hard-to-reach communities. To do this, the state relied on nonprofits that already had their trust.
Doctors began knocking on doors, urging people to get tested. Community advocates helped find alternate housing for those who needed to quarantine and organized groceries for those who couldn't leave their homes.
Doctors, advocates and politicians in Delaware’s Latino community all agree that testing capability and educational resources have improved from the early weeks of the pandemic.
In the past month, the state has seen a significant drop in the number of new positive cases among Latino children — though the rate is still disproportionate.
The virus has not gone away, and neither have the problems that exacerbated it.
“We thought it would never happen to us,” the New Castle mother said. “But a lot of people didn’t believe this was going to happen.
“But now we understand that this is real.”
‘He was very close to dying’
The mother was scared. This was worse than she could have imagined.
In the ICU room, the boy was hooked up to an intravenous tube supplying medicine and fluids. A machine was helping him breathe, and he was barely awake. In his four short years, he had never been this sick before.
She was allowed to be in the ICU room with him, but she was required to wear personal
protective equipment. Her husband could not be, due to Nemours/A.I. duPont Hospital for Children’s COVID-19 visitation policies.
“He was very close to dying,” the mother said, her voice breaking.
Nationally, Latino and Black children are more likely to require hospitalization for COVID-19, according to a report by the Centers for Disease Control and Prevention.
The 4-year-old boy was diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C), a mysterious secondary immune response to COVID-19. Since the pandemic began, he is one of 16 patients Nemours has treated with this condition.
Most of these children had a mild case of the coronavirus, said Dr. Deepika Thacker, a pediatric cardiologist. Weeks later, their bodies mount an immune response to their organs, resulting in a high fever, a rash and vomiting.
Of these 16 cases, seven have been in Black and Latino children, Thacker said.
State health officials say a majority of the COVID-19 cases in Latino children happened when Delaware saw its explosion of cases in Sussex County in late April and May.
Gov. John Carney declared Sussex County to be a COVID-19 hot spot in May. Small towns, including Seaford and Georgetown, saw some of the highest numbers of cases, particularly in Latino and Haitian communities.
In March, no cases were confirmed in Latino children, health officials said. Then, from April to June, up to 60% of children diagnosed with COVID-19 were Latino.
Dr. Marisel Santiago, a pediatrician at La Red Health Center in Georgetown, said she has seen at least a dozen COVID-19 cases in Latino children. In most, their condition was mild — often resembling a cold, she said.
Many of the children infected were likely exposed to family members who had COVID-19, health officials said. For many of Santiago’s patients, the child’s father is an essential worker, while the mother earns money through babysitting other children.
In Sussex County, many Latinos work in the chicken plants, where to complete their jobs, workers must stand close together.
And after a long day of this grueling, physical work, many of these essential employees come home to apartments or houses where living quarters are close — sometimes with multiple families together under one roof. Social distancing can be impossible.
A total of 1,032 Delaware poultry workers have been infected with the virus and seven have died, according to data released by the state Aug. 25.
For almost six months, the state had not released any data about the toll the virus has had on poultry workers.
During the early weeks of the pandemic, some Sussex County residents didn't get tested because they could not afford to lose a paycheck. If they had tested positive, they would have had to stay home for 14 days.
Others were concerned seeking treatment could put them in jeopardy because of their immigration status. Language barriers also made it difficult to get information about care.
The New Castle County mother told The News Journal she felt there was a stigma about coronavirus in her community. She feared some people were not educated about COVID-19, and as a result, her family would be treated differently.
Dr. Fabricio Alarcon, La Red’s chief medical officer, estimated he saw 10 COVID-19 adult patients a day at the height of the outbreak in Sussex.
“In the beginning, people didn’t pay much attention,” Alarcon said. “Now, they have seen more cases and the consequences of family members getting sick and acquaintances dying.”
Now, he finds his phone is not ringing as much.
The flood-the-zone approach
When Delaware saw the outbreak in Sussex County, the state discovered how dramatically Latino children were being affected, said Molly Magarik, the state’s new health secretary.
Nationally, Latinos of all ages are bearing more of the brunt of the coronavirus. According to the CDC, Latinos have been four times as likely as whites to be hospitalized.
Experts and advocates blame it partially on inadequate testing.
In order to provide care to the Delaware children, a “full family approach” was needed, Magarik said. This resulted in a “flood-the-zone” strategy, in which the state increased testing in areas throughout the county, in addition to performing universal testing at the chicken processing plants.
But to do that, Magarik said, the state needed to have the trust of residents, which meant relying on organizations already embedded in the community, such as La Red and La Esperanza Community Center.
The state and these organizations began handing out care kits, which included hand sanitizer, bandannas, thermometers and educational materials.
Health care providers began knocking on doors, while doctors like Santiago made pleas for people to get tested on Spanish-speaking radio stations. No-cost temporary housing is available for those who have tested positive and are unable to properly quarantine because they live in a crowded home.
For caregivers who tested positive and were unable to quarantine, community organizations helped coordinate getting groceries, Magarik said.
In July and August, infection rates showed a decline. From 24% to 30% of the new cases in children were among Latino children — a large drop from previous months, according to state data.
The rate of testing among Latinos also exceeds all other racial groups in Delaware, state data shows.
“If the state had to do that on our own,” Magarik said of outreach efforts, “I don’t think we would have been as successful.”
While Erika Gutierrez, a community advocate, has seen testing and educational resources increase, it doesn’t change the fact that many Delaware Latinos are essential workers — some of whom can’t afford to quarantine and lose a paycheck.
“The risk is higher,” she said. “And this reflects back on the kids.”
‘We live this reality’
The mother watched her son battle this invisible monster for four days in Nemours’ ICU unit.
The boy was lucky. He responded quickly to treatment. Other children have been hospitalized for up to two weeks, sometimes being dependent on a ventilator.
No Delaware children have died from COVID-19, according to state data.
When the family returned to their New Castle County home in mid-June, the boy was still weak. At first, he didn’t want his mother to touch him. In the weeks since, his mother has watched most of his 4-year-old's energy return.
He is skinnier and still seems weak at times, she said. He will continue to go to Nemours for checkups.
The mother has temporarily stopped working, and her husband had to take time off to quarantine. She wants to care for her son until he has fully recovered.
The boy no longer goes to day care.
As schools prepare to open under a hybrid model, there are still many unknowns about how COVID-19 affects children. While it has been discovered to be milder in children, some have been hospitalized.
A study by South Korean researchers found that those between the ages of 10 and 19 can spread COVID-19 as easily as adults. In the study, children younger than 10 transmitted the virus much less than adults.
As Delaware schools reopen under hybrid models, many Latinos are among the families who fear their children could be at risk for becoming infected with in-person instruction.
Rony Baltazar-Lopez, a member of Milford School District, said a vast majority of Latino families in his town have safety concerns about sending their children back to school — especially because many are essential workers.
“The reality is that our Hispanic families are still having to work in these conditions,” he said. “It creates such a bad mixture for our students.”
Dr. Marisel Santiago, the La Red pediatrician, was a member of the state’s schools
reopening working group. Each of the reopening scenarios present challenges to some
Latino families, she said.
In the Georgetown area, where the health center is based, many of the schools struggled with overcrowding before the pandemic, she said. Santiago believes some schools will have a hard time applying safety protocols.
But virtual learning also isn't easy.
The Milford School District announced its schools will be remote this fall. More than a third of its students are low-income, many of those Latinos, Baltazar-Lopez said.
Many parents struggle to help their children with schoolwork because English is not their first language.
In her New Castle County neighborhood, the mother has pleaded with friends and
neighbors to wear masks and to not go outside unless they need to.
Describing the details of her son’s hospitalization helps. Neighbors are now avoiding crowds, she said.
“We live this reality,” the mother said.
Contact Meredith Newman at (302) 324-2386 or at firstname.lastname@example.org. Follow her on Twitter at @merenewman.