These health care workers were profiled in KHN and The Guardian’s yearlong “” project.

Dr. Reza Chowdhury was a with a private practice in the Bronx and a trusted voice in New York’s Bengali community. His daughter, Nikita Rahman, said that despite underlying health issues putting him at higher risk of developing covid complications, he saw patients through mid-March last year, when he developed symptoms. He died on April 9, 2020.

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Pronto, fueron sus colegas del Hospital Universitario de Newark, enfermeras, técnicos y médicos con los que había estado trabajando codo con codo, quienes se presentaban en la emergencia luchando por respirar. “Muchos de nuestros propios compañeros de trabajo se enfermaron, especialmente al principio; literalmente diezmó a nuestro personal”, contó.

A fines de junio, 11 de los colegas de Beniquez habían muerto. Como los pacientes que habían estado tratando, la mayoría eran de raza negra y latinos (que pueden ser de cualquier raza).

“Nos vimos afectados de manera desproporcionada por la forma en que nuestras comunidades se han visto afectadas de manera desproporcionada en cada [parte de] nuestras vidas, desde las escuelas hasta los trabajos y los hogares”, dijo.

El 14 de diciembre, Beniquez se convirtió en la primera persona en Nueva Jersey en recibir la vacuna contra el coronavirus, y fue una de los muchos trabajadores médicos de color .

Fue una ocasión alegre, que reavivó la posibilidad de volver a ver a sus padres y a su abuela de 96 años, quienes viven en Puerto Rico. Pero esas imágenes transmitidas a nivel nacional también fueron un recordatorio de aquéllos para quienes la vacuna llegó demasiado tarde.

Covid-19 se ha cobrado entre los afroamericanos y los hispanounidenses. Y esas disparidades se extienden a los trabajadores médicos que los intubaron, limpiaron sus sábanas y tomaron sus manos en sus últimos días, halló una investigación de KHN/The Guardian.

Las personas de color representan aproximadamente el en los casos en los que hay datos de raza y etnia.

Un encontró que los trabajadores de salud de color tienen más del doble de probabilidades que sus contrapartes caucásicas de dar positivo para el virus. Son más propensos a tratar a pacientes diagnosticados con covid, y a trabajar en hogares de adultos mayores, los principales focos de coronavirus; y también a reportar un suministro inadecuado de equipo de protección personal, según el informe.

En una muestra nacional de 100 casos recopilados por KHN/The Guardian en los que un trabajador de salud expresó su preocupación por la insuficiencia de EPP antes de morir por covid, tres cuartas partes de las víctimas fueron identificadas como negras, hispanas, nativas americanas o asiáticas.

“Es más probable que los trabajadores de salud de raza negra quieran ir a atenderse al sector público donde saben que tratarán de manera desproporcionada a las comunidades de color”, dijo Adia Wingfield, socióloga de la Universidad de Washington en St. Louis, quien ha estudiado la desigualdad racial en el industria del cuidado de salud. “Pero también es más probable que estén en sintonía con las necesidades y desafíos particulares que puedan tener las comunidades de color”, dijo.

Wingfield agregó que muchos miembros del personal de atención médica afroamericanos no solo trabajan en centros de salud de bajos recursos, sino que también son más propensos a sufrir muchas de las mismas comorbilidades que se encuentran en la población negra en general, un legado de décadas de inequidades sistémicas.

Y pueden ser víctimas de estándares de atención más bajos, agregó la , pediatra de raza negra de 52 años de Indiana, quien fue hospitalizada con covid en noviembre y, según un , tuvo que pedir repetidamente pruebas, remdesivir y analgésicos. Dijo que su médico (caucásico) desestimó sus quejas de dolor y fue dada de alta, solo para ser internada en otro hospital 12 horas después.

Numerosos estudios han encontrado que los afroamericanos a menudo reciben peor atención médica que sus contrapartes blancas: en marzo, una empresa de biotecnología de Boston publicó un análisis que mostraba que era menos probable que los médicos remitieran a para pruebas de coronavirus que a los blancos sintomáticos.

Los médicos también son menos propensos a a pacientes negros.

“Si fuera blanca, no tendría que pasar por eso”, dijo Moore en el video publicado desde su cama de hospital. “Así es como matan a los negros, cuando los envías a casa, y no saben cómo luchar por sí mismos”. Moore por complicaciones de covid, dijo su hijo Henry Muhammad a los medios de comunicación.

Junto con las personas de color, los trabajadores de salud inmigrantes han sufrido pérdidas desproporcionadas a causa de covid-19. Más de un tercio de los trabajadores de salud que mueren por covid en el país nacieron en el extranjero, desde Filipinas y Haití, hasta Nigeria y México, según un análisis de KHN/The Guardian de casos registrados. Representan el 20% del total de trabajadores de salud de los Estados Unidos.

El doctor Ramon Tallaj, médico y presidente de Somos, una red sin fines de lucro de proveedores de atención médica en Nueva York, dijo que los médicos y enfermeras inmigrantes a menudo ven a pacientes de sus propias comunidades, y muchas comunidades inmigrantes de clase trabajadora han sido devastadas por covid.

“Nuestra comunidad son trabajadores esenciales. Tuvieron que ir a trabajar al comienzo de la pandemia, y cuando se enfermaban, iban a ver al médico de la comunidad”, dijo. Doce médicos y enfermeras de la red Somos han muerto por covid, dijo.

El doctor Eriberto Lozada era médico de familia de 83 años en Long Island, Nueva York. Todavía estaba viendo pacientes fuera de su consulta cuando los casos comenzaron a aumentar la primavera pasada. Originario de Filipinas, un país con un historial de envío de a los Estados Unidos, estaba orgulloso de ser médico y “de haber sido un inmigrante próspero”, dijo su hijo James Lozada.

Los miembros de la familia de Lozada lo recuerdan como estricto y de voluntad fuerte; lo llamaban cariñosamente “el rey”. Inculcó a sus hijos la importancia de una buena educación. Murió en abril.

Dos de sus cuatro hijos, John y James Lozada, son médicos. Ambos fueron vacunados el mes pasado. Considerando todo lo que habían pasado, dijo John, fue una ocasión “agridulce”. Pero pensó que era importante por otra razón: ser un ejemplo para sus pacientes.

Las desigualdades en las infecciones, y las muertes, por covid podrían alimentar la desconfianza en la vacuna. En un estudio reciente del , alrededor del 42% de los encuestados de raza negra dijeron que “definitivamente o probablemente” recibirían la vacuna en comparación con el 60% de la población general.

Esto tiene sentido para Patricia Gardner, enfermera nacida en Jamaica y gerenta en el Centro Médico de la Universidad de Hackensack, en Nueva Jersey, quien contrajo el coronavirus junto con familiares y colegas. “Mucho de lo que escucho es, ‘¿Cómo es que no fuimos los primeros en recibir atención, pero ahora somos los primeros en vacunarnos?’”, dijo.

Al igual que Beniquez, se vacunó el 14 de diciembre. “Para mí, dar un paso al frente y decir: ‘Quiero estar en el primer grupo’, espero que eso envíe un mensaje”, dijo.

Beniquez dijo que sintió el peso de esa responsabilidad cuando se inscribió para ser la primera persona en su estado en recibir la vacuna. Muchos de sus pacientes han expresado escepticismo, impulsado, opinó, por un sistema de salud que les ha fallado durante años.

“Recordamos los juicios de Tuskegee. Recordamos las ‘apendicectomías’ ”: informes de mujeres que fueron en un centro de detención del Servicio de Inmigración y Control de Aduanas de Georgia. “Estas son cosas que le han sucedido a esta comunidad, a las comunidades negras y latinas durante el último siglo. Como trabajadora de salud, tengo que reconocer que sus temores son legítimos y explicarles ‘Esto no es lo mismo’”, dijo.

Beniquez dijo que su alegría y alivio por recibir la vacuna se ven atenuados por la realidad del aumento de casos en la sala de emergencias. La adrenalina que ella y sus colegas sintieron la primavera pasada se ha ido, reemplazada por la fatiga y la cautela de los meses venideros.

Su hospital colocó 11 árboles en el vestíbulo, uno por cada empleado que murió de covid; han sido adornados con recuerdos y obsequios de sus colegas.

Hay uno para Kim King-Smith, de 53 años, el amable técnico de EKG, que visitaba a amigos de amigos, o a familiares cada vez que terminaba en el hospital.

Uno para Danilo Bolima, 54, el enfermero de Filipinas que se convirtió en profesor y era el jefe de servicios de atención al paciente.

Otro para Obinna Chibueze Eke, de 42 años, asistente de enfermería nigeriano, que pidió a sus amigos y familiares que oraran cuando estuvo hospitalizado con covid.

“Cada día, recordamos a nuestros colegas y amigos caídos como los héroes que nos ayudaron a seguir adelante durante esta pandemia y más allá”, dijo el doctor Shereef Elnahal presidente y director ejecutivo del hospital, en un comunicado. “Nunca olvidaremos sus contribuciones y su pasión colectiva por esta comunidad y por los demás”.

Justo afuera del edificio, está el árbol número 12. “Será para otro u otra que perdamos en esta batalla”, dijo Beniquez.

Esta historia es parte de “Lost on the Frontline”, un proyecto en curso de The Guardian y Kaiser Health News que tiene como objetivo documentar las vidas de los trabajadores de  salud de los Estados Unidos que mueren a causa de COVID-19, e investigar por qué tantos son víctimas de la enfermedad. Si tienes un colega o un ser querido que deberíamos incluir, por favor comparte su historia.

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Soon, it was her colleagues at Newark’s University Hospital — the nurses, techs and doctors with whom she had been working side by side — who turned up in the ER, themselves struggling to breathe. “So many of our own co-workers got sick, especially toward the beginning; it literally decimated our staff,” she said.

By the end of June, 11 of Beniquez’s colleagues were dead. Like the patients they had been treating, most were Black and Latino.

“We were disproportionately affected because of the way that Blacks and Latinos in this country have been disproportionately affected across every [part of] our lives — from schools to jobs to homes,” she said.

Now Beniquez feels like a vanguard of another kind. On Dec. 14, she became the first person in New Jersey to receive the coronavirus vaccine — and was one of many medical workers of color next to headlines heralding the vaccine’s arrival at U.S. hospitals.

It was a joyous occasion, one that kindled the possibility of again seeing her parents and her 96-year-old grandmother, who live in Puerto Rico. But those nationally broadcast images were also a reminder of those for whom the vaccine came too late.

Covid-19 has taken an on Black and Hispanic Americans. And those disparities extend to the medical workers who have intubated them, cleaned their bedsheets and held their hands in their final days, a KHN/Guardian investigation has found. People of color account in cases in which there is race and ethnicity data.

found health care workers of color were more than twice as likely as their white counterparts to test positive for the virus. They were more likely to treat patients diagnosed with covid, more likely to work in nursing homes — major coronavirus hotbeds — and more likely to cite an inadequate supply of personal protective equipment, according to the report.

In a national sample of 100 cases gathered by KHN/The Guardian in which a health care worker expressed concerns over insufficient PPE before they died of covid, three-quarters of the victims were identified as Black, Hispanic, Native American or Asian.

“Black health care workers are more likely to want to go into public-sector care where they know that they will disproportionately treat communities of color,” said Adia Wingfield, a sociologist at Washington University in St. Louis who has studied racial inequality in the health care industry. “But they also are more likely to be attuned to the particular needs and challenges that communities of color may have,” she said.

Not only do many Black health care staffers work in lower-resourced health centers, she said, they are also more likely to suffer from many of the same co-morbidities found in the general Black population, a legacy of systemic inequities.

And they may fall victim to lower standards of care. , a 52-year-old Black pediatrician in Indiana, was hospitalized with covid in November and, according to a posted to her Facebook account, had to ask repeatedly for tests, remdesivir and pain medication. She said her white doctor dismissed her complaints of pain and she was discharged, only to be admitted to another hospital 12 hours later.

Numerous studies have found Black Americans often receive worse medical care than their white counterparts: In March, a Boston biotech firm published an analysis showing physicians were to refer symptomatic Black patients for coronavirus tests than symptomatic whites. Doctors are also less likely to to Black patients.

“If I was white, I wouldn’t have to go through that,” Moore said in the video posted from her hospital bed. “This is how Black people get killed, when you send them home, and they don’t know how to fight for themselves.” She of covid complications, her son Henry Muhammad told news outlets.

Along with people of color, immigrant health workers have suffered disproportionate losses to covid-19. More than one-third of health care workers to die of covid in the U.S. were born abroad, from the Philippines to Haiti, Nigeria and Mexico, according to a KHN/Guardian analysis of cases for which there is data. They account for 20% of health care workers in the U.S. overall.

Dr. Ramon Tallaj, a physician and chairman of Somos, a nonprofit network of health care providers in New York, said immigrant doctors and nurses often see patients from their own communities — and many working-class, immigrant communities have been devastated by covid.

“Our community is essential workers. They had to go to work at the beginning of the pandemic, and when they got sick, they would come and see the doctor in the community,” he said. Twelve doctors and nurses in the Somos network have died of covid, he said.

Dr. Eriberto Lozada was an 83-year-old family physician in Long Island, New York. He was still seeing patients out of his practice when cases began to climb last spring. Originally from the Philippines, a country with a of sending skilled medical workers to the United States, he was proud to be a doctor and “proud to have been an immigrant who made good,” his son James Lozada said.

Lozada’s family members remember him as strict and strong-willed — they affectionately called him “the king.” He instilled in his children the importance of a good education. He died in April.

Two of his four sons, John and James Lozada, are doctors. Both were vaccinated last month. Considering all they had been through, John said, it was a “bittersweet” occasion. But he thought it was important for another reason — to set an example for his patients.

The inequities in covid infections and deaths risk fueling distrust in the vaccine. In a recent , around 42% of Black respondents said they would “definitely or probably” get the vaccine compared with 60% of the general population.

This makes sense to Patricia Gardner, a Black, Jamaican-born nursing manager at Hackensack University Medical Center in New Jersey who has been infected with the coronavirus along with family members and colleagues. “A lot of what I hear is, ‘How is it that we weren’t the first to get the care, but now we’re the first to get vaccinated?’” she said.

Like Beniquez, the nurse in Newark, she was vaccinated on Dec. 14. “For me to step up to say, ‘I want to be in the first group’ — I’m hoping that sends a message,” she said.

Beniquez said she felt the weight of that responsibility when she signed on to be the first person in her state to receive the vaccine. Many of her patients have expressed skepticism over the vaccine, fueled, she said, by a health system that has failed them for years.

“We remember the Tuskegee trials. We remember the ‘appendectomies’” — reports that women were in a U.S. Immigration and Customs Enforcement detention center in Georgia. “These are things that have happened to this community to the Black and Latino communities over the last century. As a health care worker, I have to recognize that their fears are legitimate and explain ‘This is not that,’” she said.

Beniquez said her joy and relief over receiving the vaccine are tempered by the reality of rising cases in the ER. The adrenaline she and her colleagues felt last spring is gone, replaced by fatigue and wariness of the months ahead.

Her hospital placed 11 trees in the lobby, one for each employee who has died of covid; they have been adorned with remembrances and gifts from their colleagues.

There is one for Kim King-Smith, 53, the friendly EKG technician, who visited friends of friends or family whenever they ended up in the hospital.

One for Danilo Bolima, 54, the nurse from the Philippines who became a professor and was the head of patient care services.

One for Obinna Chibueze Eke, 42, the Nigerian nursing assistant, who asked friends and family to pray for him when he was hospitalized with covid.

“Each day, we remember our fallen colleagues and friends as the heroes who helped keep us going throughout this pandemic and beyond,” hospital president and CEO Dr. Shereef Elnahal said in a statement. “We can never forget their contributions and their collective passion for this community, and each other.”

Just outside the building, stands a 12th tree. “It’s going to be for whoever else we lose in this battle,” Beniquez said.

This story is part of “,” an ongoing project from  and Kaiser Health News that aims to document the lives of health care workers in the U.S. who die from COVID-19, and to investigate why so many are victims of the disease. If you have a colleague or loved one we should include, please .

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But despite the trauma and exhaustion of the past eight months, she was shocked when North Dakota Gov. Doug Burgum that health care workers who test positive for the coronavirus but do not display symptoms could still report to work. The order, in line with for mitigating staff shortages, would allow asymptomatic health workers who test positive to work only in COVID units, and treat patients who already have the virus.

But many feel the idea endangers the workers and their colleagues. It comes as faces one of the worst outbreaks of COVID-19 and grapples with health care staff shortages.

“We’re worried about somebody dying, frankly, because we couldn’t get to them in time,” said McKamey, an emergency room registered nurse in Bismarck.

According to data from the COVID Tracking Project, North Dakotans tested positive for COVID-19 last week alone. About 1 in 12 North Dakota residents have with the virus; nearly 1 in 1,000 have died. In early November, the North Dakota Department of Health that there were only 12 open ICU beds in the state.

McKamey said Burgum’s order goes against everything she’s been taught as a nurse.

“If hospital administrators start forcing COVID-positive staff to go to work, it’s going to be very scary. We’re trained to do no harm, and asking COVID-positive, asymptomatic nurses to return to work is putting patients at risk. It’s putting fellow staff members at risk.”

Nine months into the pandemic, it’s clear health care workers already face increased risks. , a joint effort by The Guardian and KHN, is investigating the deaths of 1,375 health care workers who appear to have died of COVID-19 since the start of the pandemic. Nearly a third of those health care workers were nurses.

McKamey described long shifts in an emergency room that has begun taking on patients overnight because other wards of the hospital did not have the capacity to admit them. Nurses pick up extra shifts to cover for colleagues who have gotten sick and take on multiple critical patients at once.

It is a scene playing out in hospitals across the country, as the coronavirus spreads unabated. As of Monday, more than 11 million people in the United States with the virus, with health officials reporting 180,000 new infections in a single day. And the country is bracing for another milestone: It will soon surpass a quarter-million deaths from COVID-19.

Health care workers are overwhelmed and exhausted. According to a recent survey from the National Nurses United, more than 70% of hospital nurses said they were afraid of contracting COVID-19 and 80% feared they might infect a family member. More than half said they struggled to sleep and 62 reported feeling stressed and anxious. Nearly 80% said they were forced to reuse single-use PPE, like N95 respirators.

Inaction at the state and federal levels have left many health care workers feeling abandoned. When Gov. Burgum issued the order that infected but asymptomatic nurses could report to work in COVID units, North Dakota had not implemented any kind of statewide mask mandate, despite expert guidance that such a measure could significantly reduce transmission of the virus.

Tessa Johnson is a registered nurse at a Bismarck nursing home and president of the North Dakota Nurses Association, which issued a statement last week denouncing Burgum’s order that infected nurses continue to work.

She said the state could have done much more to ensure patients don’t become infected in the first place. “We’ve asked and asked and asked for a mask mandate, and that hasn’t happened,” she said Thursday.

On Friday night, Burgum did an about-face and issued a mask mandate, ordering individuals to cover their faces when inside businesses, indoor public settings and outdoor public settings where physical distancing may be impossible.

“Our doctors and nurses heroically working on the front lines need our help, and they need it now,” he said in a .

Still, Johnson said there’s a disconnect between what health care workers are experiencing inside North Dakota’s health facilities, and how the general population perceives the virus. And that even before Burgum’s comments, some of her colleagues felt they had to choose between taking all precautions and limited time off. “One of my closest friends, also a health care worker, said to me the other day, ‘There’s no way I will ever get tested unless I’m very sick, because I don’t want to use my paid leave.’”

McKamey, the ER nurse, said she hasn’t had time to process the stress of the past several months. She’s focused on staying healthy, gearing up for what she anticipates will be a difficult winter and keeping her patients alive. “We are willing to break our backs and work as hard as we physically can,” McKamey said. “But then to ask us to come in as a potential infectious source is just stunning.”

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Now, seven months later, Kapsner, who lives across the border in , is weary and exhausted from the steady stream of patients arriving with a virus that is spreading across this part of the Midwest. Hospital beds and personal protective equipment are in short supply, and his colleagues are getting sick. “Even if we put up all the field tents in the world, we don’t have the staff for this,” he said.

Kapsner believes political disfunction at the state level and a “disastrous” federal response are responsible for Wisconsin’s spike in cases. It’s part of the reason he’s running for office.

Kapsner is one of at least four health care workers running for Democratic seats in the Wisconsin state assembly, and one of many in his field, speaking out against President Donald Trump and the GOP’s response to COVID-19.

Wisconsin is in the throes of one of the country’s worst COVID outbreaks. On Oct. 27, the state more than 5,000 new cases and a test positivity rate of over 27%. Nearly 2,000 people have died, and only the Dakotas are currently reporting more cases per capita.

Despite this, Trump has been holding large rallies across the state where crowds gather by the thousands, often without masks. Another Trump rally was planned for Monday evening in Kenosha, the site of unrest last summer after Jacob Blake was shot in the back by police. Wisconsin is a crucial swing state in Tuesday’s election; Trump carried the state by just 27,000 votes in 2016 and is currently .

Last month, a group of 20 doctors sent an open letter to Trump asking him to stop holding rallies in the state. Thursday, the night before Trump was scheduled to appear in Green Bay, hospitals released a joint statement urging locals to avoid large crowds. Earlier in October, the Trump campaign scuttled plans for a rally in La Crosse, in western Wisconsin, after the city’s mayor asked him not to come amid a spike in cases there.

Dr. Kristin Lyerly, an OB-GYN in Appleton, in eastern Wisconsin, said she struggles to find the right words to describe her anger over the rallies, which to subsequent coronavirus outbreaks. On Oct. 24, at a rally in Waukesha, about 100 miles south of Appleton, Trump falsely accused health care workers of inflating the number of COVID cases for financial gain.

“His lies are killing my neighbors,” she said.

Lyerly, who is also running for state assembly, said she spends her days trying to reassure terrified pregnant patients, while fearing she might contract the virus herself. She and her colleagues are overwhelmed. She keeps her PPE in her car to ensure she never goes without it. “We’ve completely forgotten about the human impact on our health care workers. Our health care workers are exhausted, they’re burned out and they feel entirely disrespected,” she said.

Lyerly said she decided to run for office in April, after the Republican-controlled assembly refused to postpone a statewide election in which the Democratic presidential primary and a key state Supreme Court seat were on the ballot. The state GOP also stymied efforts to make it easier for Wisconsinites to vote by mail.

“As a physician, I think many of us were shocked that our legislature would put us in danger, and make us decide between our vote and our health,” she said. She’s running in a district that typically leans conservative but said her campaign’s latest polls put her within the margin of error of her opponent, an incumbent.

Dr. Robert Freedland, an ophthalmologist in southwestern Wisconsin and state lead for the Committee to Protect Medicare, signed the letter asking Trump to stop holding rallies in Wisconsin. He wanted to go on the record as having spoken out in the name of public health.

Freedland, who is 65 and has Type 2 diabetes, said he fears for his health when he goes to work.

Dr. Jeff Kushner, a cardiologist who also signed the letter, said he hasn’t been able to work since March because of the pandemic. Kushner, 65, has non-Hodgkins lymphoma and is on immunosuppressants. “If I got COVID, I wouldn’t survive,” he said.

Though he follows politics closely, Kushner said that he’s not “politically involved” and that he tends to keep his politics to himself and a close inner circle. But he said he doesn’t consider signing the letter to Trump a political act. “It’s a statement of what I believe about our society’s health and not a political statement,” he said. “It wasn’t an anti-Trump letter. We were just saying, ‘Please don’t have these superspreader events in our state.’”

Kapsner, the emergency room doctor, said he still speaks with patients and voters who doubt the severity of COVID-19. “My job isn’t to shame them,” he said. “There are many people out here who have had the good fortune of not being personally affected by COVID. Their friends or families haven’t had it yet. I fear their luck is going to run out.”

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An internal medicine physician with a practice in the Bronx, Chowdhury had studied medicine in his native Bangladesh before immigrating to the United States 30 years ago. He left his family back home while he settled in, and worked as a tutor, a waiter and a security guard as he trained to practice in the U.S.

When COVID-19 came to New York, Rahman pleaded with her father, who had had a kidney transplant and was therefore immunocompromised, to stay home. But he kept working until mid-March, when he developed symptoms. He died on April 9.

The U.S. relies on immigrant labor — from doctors to nurses to health aides — to keep its health system afloat. And now immigrant health workers are dying at high rates during the pandemic. Lost on the Frontline, a joint project by KHN and The Guardian, has found that nearly one-third of health care workers who were confirmed to have died of COVID-19 were born outside the U.S. However, immigrants account for just of the U.S. population and of its health care force.

Chowdhury, 58, belonged to a nonprofit network of health care providers in New York called SOMOS that has been devastated during the pandemic. Founded with the aim of providing “culturally competent care” to low-income New Yorkers, most of its 2,500 physicians and nurses are immigrants, like their patients. They come from Bangladesh, the Dominican Republic and Egypt, among other places. In the early months of the pandemic, SOMOS reported that 12 of its physicians and nurse practitioners had died of COVID-19.

“Our patients are the ones who wash dishes, prepare food, ride buses, drive taxis,” said Dr. Ramon Tallaj, SOMOS’ chairman and co-founder. “And we’re risking our lives for our patients.” Chowdhury practiced in a working-class section of the Bronx, a borough hit hard by the coronavirus.

Most of SOMOS’ practitioners are primary care providers — family doctors, pediatricians, nurse practitioners. “We’re neighborhood doctors,” Tallaj said. “We work with poor people in poor neighborhoods, and we speak the same languages as our patients — none of our doctors are on Park Avenue.”

He said that at the outset of the pandemic public attention and funding went to hospitals and emergency care, while he and his colleagues pooled resources to buy personal protective gear and set up neighborhood testing sites.

It turns out that this early exposure to patients, before they were sick enough to visit the ER,  might have made these workers more vulnerable: A recent found that primary care providers “may have been more likely to see patients with early-stage, mild or asymptomatic — but still contagious — SARS-CoV-2 infection, while having little to no personal protective equipment.”

Family physician Dr. Ydelfonso Decoo, 70, was the quintessential neighborhood doctor. From his practice in New York City’s Washington Heights, he saw generations of patients walk through his doors. Patients and their families — many immigrants from the Dominican Republic, like him — stopped to say hello when they saw him in the street.

“He loved his community and he always took time to listen to them,” said Dorka Cáceres, his assistant of 20 years. Decoo saw patients through late March, when he developed symptoms.

Dr. Ashraf Metwally was a Brooklyn family physician originally from Egypt. Dahlia Ibrahim, a family friend, described him as a “staple” in the local Arab community. A cancer survivor who helped out in emergency rooms early in the pandemic, Metwally “helped people. That’s just who he was,” Ibrahim .

“These providers were like firefighters,” said Liz Webb, SOMOS’ vice president for human resources. “They were going into their communities, communicating in their languages, and making sure [people] didn’t worry about their immigration status” when seeking out testing, she said.

To cope with the loss of their colleagues and uncertainty about the future, SOMOS doctors have organized a nightly prayer group on Zoom that draws dozens of participants. And they’ve begun to lend their services to new COVID hot spots: This summer, they sent health workers to Georgia and Florida to volunteer in clinics and hospitals.

Chowdhury’s family has spent the past few months learning what he meant to his patients. They were overwhelmed by the outpouring of grief and support from people around the world who had sought his care or advice at one point or another. When they held an online memorial, they struggled to find a platform that could accommodate everyone who wanted to pay their respects, Chowdhury’s daughter said.

“Zoom maxes you out at, like, 200 users, so we used another [service] that allowed 500, and even then we were at capacity,” she said.

This story is part of “Lost on the Frontline,” an ongoing project from  and Kaiser Health News that aims to document the lives of health care workers in the U.S. who die from COVID-19, and to investigate why so many are victims of the disease. If you have a colleague or loved one we should include, please .

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Se trata del recuento más completo de las muertes de trabajadores de la salud del país.

KHN y The Guardian están rastreando a los trabajadores de la salud que murieron por COVID-19 y escribiendo sobre sus vidas y lo que vivieron en sus últimos días.

El virus ha cobrado un precio desproporcionado en las comunidades de color y entre los inmigrantes, y los trabajadores de salud no se han librado de esa tendencia.

Los reporteros de Guardian y KHN han publicado perfiles de 177 de las 1.080 víctimas que hemos identificado en base a obituarios, informes de noticias, publicaciones en redes sociales y otras fuentes.

De esos 177, el 62,1% se identificó como de raza negra, latino, asiático/de las islas del Pacífico o nativo americano, y el 30,5% nació fuera de los Estados Unidos. Ambas cifras respaldan los hallazgos de que las personas de color y los inmigrantes (independientemente de la raza) están muriendo a tasas más altas que sus contrapartes, blancos no hispanos y nacidos en los Estados Unidos.

Estas cifras coinciden con otras investigaciones. Según un estudio de la Escuela de Medicina de Harvard publicado en en julio, los trabajadores de salud de color tenían más probabilidades de atender a pacientes con COVID-19 presunto o confirmado y casi el doble de probabilidades que sus homólogos blancos no hispanos de dar positivo para el coronavirus. .

El sistema de salud de los Estados Unidos también depende en gran medida de trabajadores de salud inmigrantes, que representan casi 1 de cada 5 trabajadores de salud. Estos profesionales inmigrantes tienden a trabajar en las comunidades más vulnerables: encontró que las áreas de alta pobreza tienden a tener más médicos capacitados en el extranjero que las regiones más ricas.

Entre las víctimas estaban Corrina y Cheryl Thinn, hermanas que trabajaban en una clínica en la Nación Navajo en el norte de Arizona. Compartían una oficina, vivían en la misma casa, criaban juntas a sus hijos y murieron con pocas semanas de diferencia.

El doctor James “Charlie” Mahoney, neumólogo de Brooklyn, fue uno de los pocos en su Universidad en la década de 1970. Fue recordado como una “leyenda” en su hospital.

El doctor Reza Chowdhury, internista en el Bronx, era una figura querida en la comunidad de Bangladesh de la ciudad. No cobraba copagos cuando sus pacientes tenían poco efectivo y les daba el número de teléfono de su casa para que pudieran llamarlo si tenían preguntas.

Y Milagros Abellera, recordada por sus colegas como una “mama gallina”, fue una de las decenas de enfermeras de Filipinas que sucumbieron al virus en los Estados Unidos.

Además de las disparidades basadas en la raza y el origen, nuestros investigadores encontraron que de los 177 trabajadores sobre los que se realize un perfil hasta ahora para la base de datos de Lost on the Frontline:

• Se informó que al menos 57 (32%) tenían equipo de protección personal (EPP) inadecuado.
• La media de edad era de 57 años y oscilaba entre los 20 y los 80 años, con 21 personas (12%) menores de 40 años.
• Aproximadamente el 38% -68- eran enfermeras, pero el total también incluye médicos, farmacéuticos, socorristas y técnicos hospitalarios, entre otros.

Puedes leer sus historias y otras de profesionales de salud . Y si sabes de un trabajador de salud que haya muerto por COVID, por favor con nosotros.

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The virus has taken a disproportionate toll on communities of color and immigrants — and health workers haven’t been spared.

Guardian and KHN reporters have published profiles of 177 of the 1,079 victims we have identified based on obituaries, news reports, social media posts and other sources. Of those 177, 62.1% were identified as Black, Latino, Asian/Pacific Islander or Native American, and 30.5% were born outside the United States. Both figures support findings that people of color and immigrants (regardless of race) are dying at higher rates than their white and U.S.-born counterparts.

These figures track with other research. According to a Harvard Medical School study in The Lancet Public Health last month, health care workers of color were more likely to care for patients with suspected or confirmed COVID-19 and nearly twice as likely as their white counterparts to test positive for the coronavirus.

The U.S. health system also relies heavily on immigrant health workers, who account for almost 1 in 5 health workers. Immigrant health workers tend to work in the most vulnerable communities: A 2018 found that high-poverty areas tend to have more foreign-trained doctors than do wealthier regions, for example.

Among those lost were Corrina and Cheryl Thinn, sisters who worked in a clinic in the Navajo Nation in northern Arizona. They shared an office, lived in the same home, helped raise each other’s children and died just weeks apart.

Dr. James “Charlie” Mahoney, a Brooklyn pulmonologist, was one of only a handful of at his medical school in the 1970s. He was remembered as a “legend” at his hospital.

Dr. Reza Chowdhury, an internist in the Bronx, was a beloved figure in the city’s Bangladeshi community. He didn’t charge copays when his patients were low on cash and gave out his home phone number so they could call with medical questions.

And Milagros Abellera, remembered by colleagues as a “mother hen,” was one of the dozens of nurses from the Philippines who succumbed to the virus in the United States.

In addition to disparities based on race and origin, our researchers found that of the 177 workers profiled so far from the Lost on the Frontline database:

• At least 57 (32%) were reported to have had inadequate personal protective equipment (PPE).
• The median age was 57 and ages ranged from 20 to 80, with 21 people (12%) under 40.
• Roughly 38% — 68 — were nurses, but the total also includes physicians, pharmacists, first responders and hospital technicians, among others

You can read their stories and those of other healthcare workers . And if you know of a health care worker who died of COVID-19, please with us.

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The Guardian sat in on a conversation with two emergency room physicians — one in and the other in Houston — about what happened when COVID-19 arrived at their hospitals.

Dr. Cedric Dark, Houston: When did you start worrying about how COVID-19 would impact New York?

Dr. Tsion Firew, New York: Back in February, I traveled to Sweden and Ethiopia for work. There was some sort of screening for COVID-19 in both places. On Feb. 22, I came to New York City, and nothing — no screening. At that point, I thought, “I don’t think this country’s going to handle this well.”

Dark: On Feb. 26, at a department meeting, one of my colleagues put coronavirus on the agenda. I thought to myself, “Why do we even need to bother with this here in Houston? This is in China; maybe it’s in Europe?”

Firew: On March 1, we had our first case in New York City, which was at my hospital. Fast-forward 15 days and I get a call saying, “Hey, you were exposed to COVID-positive patients.” I was told to stay home.

Dark: My anxiety grew as I saw what was happening in Italy, a country I’ve visited several times. I remember seeing images of people dying in their homes and mass graves. I started to wonder, “Is this what we’ll see over here? Are my colleagues going to be dying? Is this something that’s going to get me or my wife, who’s also an ER doctor? Are we going to bring it home to our son?”

In March, we repurposed our urgent care pod, which has eight beds, into our coronavirus unit. And for a while, that was enough.

Firew: In late March, health workers without symptoms were told to come back to work. It felt like a tsunami hit. I’ve practiced in very low-resource settings and even in a war zone, and I couldn’t believe what I was witnessing in New York.

The emergency department was silent — there were no visitors, and patients were very sick. Many were on ventilators or getting oxygen. The usual human interactions were gone. Everybody was wearing a mask and gowns and there were so many people who came to help from different places that you didn’t know who was who. I spent a lot more time on the phone talking to family members about end-of-life care decisions, conversations you’d normally have face-to-face.

In New York, the severity of the crisis really depended on what hospital you were at. Columbia has two hospitals — one at 168th and one at 224th — and the difference was night and day. The one on 224th is smaller and just across the bridge from the Bronx, which was hit hard by the virus.

There, people were dying in ambulances while waiting for care. The emergency department was overwhelmed with patients who needed oxygen. Its hallways were crowded with patients on portable oxygen tanks. We ran out of monitors and oxygen for the portable tanks. Staff members succumbed to COVID-19, exacerbating shortages of nurses and doctors.

My friends who work in Lower Manhattan couldn’t believe some of the things we saw.

Dark: I went to medical school at NYU and have a lot of friends in New York I was checking in with at the time. I thought that in Houston, a city that’s almost as big, we had the conditions for a similar crisis: It’s a large city with an international airport, it attracts a lot of business travelers, and thousands of people come here each March for the rodeo.

In late March, a guy about my age came into the hospital. It was the first day we got coronavirus tests. A few days later, a nurse texted me that the patient had tested positive. He hadn’t traveled anywhere — it was proof to me that we had community transmission in Houston before any officials admitted it.

You became infected, right?

Firew: In early April, I became sick, along with my husband. I never imagined that in 2020 I would be writing out a living will detailing my life insurance policy to my family. Walking from my bed to the kitchen would make my heart race; I often wondered: Is this when I drop dead like my patient the other day?

A few days before I got sick, the president had said that anybody who wanted a test could get one. But then I was on the phone with my workplace and with the department of health begging for a test.

It was also around that time that a brown-skinned physician who was about my age died from COVID-19. So I knew being in my mid-30s wouldn’t protect me. I was even more worried when my husband became ill because, as a Black man, his chances of dying from this disease were much higher than mine. We both recovered, but I still have some fatigue and shortness of breath.

When did cases pick up in Houston?

Dark: We saw a gradual increase in cases throughout April, but it stayed relatively calm because the city was shut down. The hospital was kind of a ghost town because no one was having elective procedures. Things were quiet until reopened in May.

I remember when I lost my first COVID patient. He started to crash right in front of me. We started CPR and I ran the algorithms through my mind trying to think how we could bring him back, but kept ending up at the same conclusion: This is COVID and there’s nothing I can do.

It’s like serving on the front lines of a war. We initially struggled to find our own personal protective equipment while the hospitals worked to secure the supply chain. Although that situation has stabilized, a lot of patients who come in for non-COVID reasons wind up testing positive. COVID is everywhere.

Our patient population is heavily Latino and Black and, for a time, our hospital had some of the highest numbers of COVID cases among the nearly two dozen hospitals in the Texas Medical Center network. It’s revealed the fault lines of a preexisting issue in terms of inequities in health care.

As area hospitals fill up, they reallocate additional floors to COVID patients. Who knows, if we don’t get this under control, maybe one day the whole hospital will be COVID.

Firew: Now I’m just chronically angry. The negligence came from the top all the way down. Our leaders do not lead with evidence — we knew what was going to happen when states reopened so quickly.

Dark: Yeah, this was completely avoidable, had the governor [Texas Gov. Greg Abbott] decided not to open up the economy too fast.

How are things in New York now?

Firew: There have been several days where I’ve seen zero COVID cases. If I do see a case, it’s usually someone who has traveled from abroad or other states.

People are coming in for non-COVID reasons. Recently, a woman in her early 40s came in with a massive lesion on her breast. She’d started experiencing some pain three months ago, during the peak of the pandemic, and was too frightened to come to the hospital. To make matters worse, she didn’t have insurance and couldn’t afford the telehealth that many had access to.

By the time she made it to our hospital, the mass had metastasized to her spine and lungs. Even with aggressive treatment, she likely only has a few months to live. This is one of the many cases we’re seeing now that we are back to “normal” — complications of chronic illnesses and delayed diagnoses of cancer. The burden of the pandemic layered with a broken health care system.

Dr. Tsion Firew is an assistant professor of emergency medicine at Columbia University and special adviser to the minister of health of Ethiopia.

Dr. Cedric Dark is an assistant professor of emergency medicine at Baylor College of Medicine and a board member for Doctors for America.

This conversation was condensed and edited by Danielle Renwick.

Ñî¹óåú´«Ã½Ò•îl Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about .

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Lost on the Frontline es una asociación entre las dos redacciones que tiene como objetivo contar, verificar y honrar a cada trabajador de salud de los Estados Unidos que ha muerto durante la pandemia.

Es el recuento más completo de las muertes de trabajadores de salud del país.

A medida que aumentan los casos de coronavirus, y persiste la grave escasez de equipos de protección que salvan vidas, como máscaras N95, delantales y guantes, los trabajadores de salud del país se enfrentan de nuevo a condiciones potencialmente mortales, en especial en los estados del sur y el oeste.

A través de análisis y comparación de registros y fuentes, informes de colegas, redes sociales, obituarios en línea, sindicatos de trabajadores y medios locales, los reporteros de Lost on the Frontline han identificado a 922 trabajadores de salud que murieron por COVID-19 y sus complicaciones.

Un equipo de más de 50 periodistas de The Guardian, KHN y de escuelas de periodismo han pasado meses investigando muertes individuales para comprobar que fueran a causa de COVID-19 y de que los fallecidos efectivamente estuvieran trabajando en la primera línea de batalla, en contacto directo con pacientes con COVID o trabajando en lugares donde reciben tratamiento.

Los reporteros también han estado investigando las circunstancias de sus muertes, incluido su acceso a equipo de protección personal (EPP), y han estado contactando a familiares, compañeros de trabajo, representantes sindicales y empleadores para que comentaran sobre estas muertes.

Hasta el momento, se han publicado167 con nombres, datos, e historias de vida con colegas o seres queridos opinando y recordando sus vidas. Cada semana se publican los nombres de nuevas víctimas. Y Cada muerte se confirma de manera individual antes de publicarla.

El recuento incluye médicos, enfermeras y paramédicos, así como personal de apoyo crucial, como conserjes de hospitales, administradores y trabajadores de hogares de adultos mayores, que arriesgaron sus propias vidas durante la pandemia para cuidar a otros.

Los primeros datos indican que han muerto decenas de personas que no pudieron acceder a equipo de protección personal adecuado y al menos 35 sucumbieron después que funcionarios federales de seguridad laboral recibieran quejas sobre la seguridad en sus lugares de trabajo.

Los primeros recuentos también sugieren que la mayoría de las muertes se produjeron entre personas de color, muchas de ellas inmigrantes. Pero debido a que esta base de datos es un trabajo en curso, con nuevos casos confirmados y sumados semanalmente, los primeros hallazgos representan una fracción del total de informes y no son representativos de todas las muertes de trabajadores de salud.

De los 167 trabajadores agregados a la base de datos de Lost on the Frontline hasta ahora:

• La mayoría, 103 (62%), fueron identificadas como personas de color.
• Se informó que al menos 52 (31%) tenían un equipo de protección inadecuado.
• La edad promedio fue de 57 años, y oscilaba entre los 20 y los 80 años, con 21 personas (13%) menores de 40.
• Aproximadamente un tercio, al menos 53, nacieron fuera de los Estados Unidos y 25 eran de Filipinas.
• La mayoría de las muertes, 103, ocurrieron en abril, después del aumento inicial de casos en la costa este.
• Aproximadamente el 38% (64) fueron enfermeras, pero el total también incluía médicos, farmacéuticos, socorristas y técnicos hospitalarios, entre otros.
• Al menos 68 vivían en Nueva York y Nueva Jersey, dos estados muy afectados al comienzo de la pandemia, seguidos por Illinois y California.

Algunas de estas muertes se pudieron prevenir. La mala preparación, los errores del gobierno y un sistema de salud sobrecargado aumentaron ese riesgo. El acceso inadecuado a las pruebas, la escasez de equipos de protección en todo el país y la resistencia al distanciamiento social y al uso de máscaras han obligado a más internaciones en hospitales ya sobrecargados, y han elevado el número de muertos.

Los vacíos en los datos gubernamentales han aumentado la necesidad de un seguimiento independiente. El gobierno federal no ha registrado con precisión las muertes de trabajadores de salud. Hasta el domingo 9 de agosto, los Centros para el Control y Prevención de Enfermedades (CDC) informaron 587 muertes entre este grupo, pero la agencia no enumera nombres específicos y ha admitido que se trata de un recuento insuficiente.

Las medidas recientes de la Casa Blanca subrayan la necesidad de datos públicos y responsabilidad. En julio, la administración Trump ordenó a los centros de salud que enviaran datos sobre hospitalizaciones y muertes por COVID-19 directamente al Departamento de Salud y Servicios Humanos, sin pasar por los CDC.

En los días siguientes, la información vital sobre la pandemia desapareció del ojo público. (Los datos se restauraron más tarde después de una protesta pública, pero la agencia indicó que es posible que ya no actualice las cifras debido a un cambio en los requisitos de informes federales).

Historias exclusivas de los reporteros de Lost on the Frontline han revelado que muchos trabajadores de salud están usando máscaras quirúrgicas que son mucho menos efectivas que las máscaras N95, lo que los expone a mayor peligro. Los correos electrónicos obtenidos a través de una solicitud de registros públicos mostraron que los funcionarios federales y estatales estaban al tanto a fines de febrero de la grave escasez de equipos de protección.

Investigaciones posteriores encontraron que los trabajadores de salud que contrajeron el coronavirus y sus familias ahora luchan por acceder a las pensiones y otros beneficios del sistema de compensación para trabajadores. El informe también ha examinado las muertes de 19 trabajadores de salud menores de 30 años que murieron por COVID-19.

Seguimos recopilando los nombres de los trabajadores de salud que han fallecido y analizando por qué tantos se han enfermado. Agradecemos sugerencias y comentarios en frontline@theguardian.com y covidtips@kff.org.

La corresponsal senior de KHN Christina Jewett y Melissa Bailey colaboraron con este informe.

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