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.

Nikita Rahman, Reza Chowdhury’s daughter:

My therapist says grief is the final act of love. Every time I miss him, I think about how that is my love for him, showing up again. I like that framing of it. I think I only recently realized just how much I loved him.

He was so beloved by the community for just being a general practitioner who did his job really well and cared and was honest. He was so present and could find life and enjoyment in the little things, like taking a walk. He loved his breakfast, even if it was the same breakfast every day.

In March, I flew home from California to be with my family. I was reading about covid cases spiking in Italy and was freaking out. My mom and I tried to convince my dad, who was immunocompromised, to stay home from work. He said: “No, it’s not a big deal.”

Then in mid- to late March he started to feel sick. At that time, everyone was so worried about hospitals being over capacity that the [guidance] was not to come in unless you’re insanely sick. We eventually took him to the hospital. He was there for about 10 days and then he had a heart attack.

I’ll sometimes visit my dad’s grave by myself and bring tea, because my dad always drank tea, and read letters my friends have written over the past year. He was into growing nice grass, so whenever [my mother, brother and I] go, we bring nice grass to make sure his plot is nicely manicured. He told really good stories. I would do anything for audio recordings of him telling stories. Now I’ve started recording conversations with family members.

When someone dies, the world carries on. You’ll take a walk and you’re so upset, but people around you may be laughing or carrying on with their lives. You want the world to reflect how you feel inside. You want it to rain. Because of the pandemic, everyone’s kind of miserable. Everyone’s at home, having to process a lot. It has been nice, in a way, to be forced to sit down and process it. There’s no running away from confronting your feelings.

Nueva Parazo was a and one of scores of health care workers from the Philippines who have died of covid-19. Her father, Chito Parazo, described her as a skilled and compassionate nurse and doting daughter. She died on Sept. 5, 2020.

Chito Parazo, Nueva Parazo Singian’s father:

It’s true, life has to go on, but it will never be the same. I’m 70 years old. I have maybe 10, 15 years left. Maybe less. Of course, I’m happy I’m still alive, but for me, we’re just going through the motions of living. We lost our 9-year-old son, Xerxes, years ago in an accident and I still cannot accept the fact that he died. My children were the priceless jewels in my life, and I lost both of them.

During the early days of the pandemic, I asked [Nueva] to file a leave of absence. She said, “I cannot just turn my back on these helpless people. This is the job that I chose.”

Her youngest son brought her to the hospital on Aug. 3 because she was complaining about difficulty breathing. She probably suspected that she had contracted the virus. When my wife was admitted to the same hospital in December with covid, the staff remembered Nueva. They said: “We tried to save her, Mr. Parazo, but we couldn’t. Her lungs were so badly damaged.”

I’m so proud of her. She did her best to save people despite all the dangers she faced.

I shaved my head after Nueva died and made a vow to let it grow after the first anniversary of her death. I’ve been taking medication to combat my depression. Despite the fact that I have psoriatic arthritis in both of my knees, a bone spur in my left foot and spinal stenosis, I still go bowling to forget what happened. It’s hard, but I have to be strong for the sake of my three grandkids and my wife.

Jessica Cavazos was a , and the family member everyone turned to for sage advice and a dose of optimism. Cavazos had not seen her son, Jayden Arrington, since 2013. After she died on July 12, 2020, Arrington, 19, reunited with her family.

Jayden Arrington, Jessica Cavazos’ son:

I called her Mamo. There were some family issues that kept me from having more time with her, and that is hard for me to live with. I hadn’t seen her since I was 10. When I was 17, I called her and we spoke for two or three hours, and I assumed after I turned 18 I’d start seeing her again. She passed without having her own son with her.

Some days I can’t function or accept that some people’s expiration dates are not what you want them to be.

I’ve learned that God’s not going to give it to you how you want it. He’s going to give it to you in a way to see how you’re going to bounce back. I’ve grown over the last several months. I’ve learned how to control my feelings, and be more open to what’s given to me in life. And also be more thankful for what I have.

I see things a little differently since [my mom died]. I try to find ways where every day is a good day, where I don’t regret anything or have a negative effect on anyone. I try to keep people around me who I know can help me get through my days.

Sometime this month, I’m hoping to receive an acceptance letter [to a nursing program]. I want to become a registered nurse, just like Mamo.

These conversations have been condensed and edited.

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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 .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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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Dr. Reza Chowdhury didn’t charge copays when his patients were low on cash. He gave them his home phone number and answered their medical questions at all hours. Once, when Chowdhury’s daughter, Nikita Rahman, struck up a conversation with a New York taxi driver, it turned out that he was from Bangladesh and knew her dad: “Dr. Reza? He’s my doctor — he’s the best doctor!” she recalled.

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 .

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

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.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

It is the most comprehensive accounting of U.S. health care workers’ deaths in the country.

As coronavirus cases surge — and dire shortages of lifesaving protective gear like N95 masks, gowns and gloves persist — the nation’s health care workers are again facing life-threatening conditions in Southern and Western states.

Through crowdsourcing and reports from colleagues, social media, online obituaries, workers unions and local media, Lost on the Frontline reporters have identified 922 health care workers who reportedly died of COVID-19 and its complications.

A team of more than 50 journalists from the Guardian, KHN and journalism schools have spent months investigating individual deaths to make certain that they died of COVID-19, and that they were indeed working on the front lines in contact with COVID patients or working in places where they were being treated. The reporters have also been investigating the circumstances of their deaths, including their access to personal protective equipment (PPE), and tracking down family members, co-workers, union representatives and employers to comment about their deaths.

Thus far, we have independently confirmed 167 deaths and published their names, data and stories about their lives and how they will be remembered. We are continuing to confirm additional victims and are publishing new names weekly.

The tally includes doctors, nurses and paramedics, as well as crucial support staff such as hospital custodians, administrators and nursing home workers, who put their own lives at risk during the pandemic to care for others.

The early data indicates that dozens have died who were unable to access adequate PPE and at least 35 succumbed after federal work-safety officials received safety complaints about their workplaces. Early tallies also suggest that the majority of the deaths were among people of color, and many were immigrants. But because this database is a work in progress — with new confirmed cases added weekly — the early findings represent a fraction of total reports and are not representative of all health care worker deaths.

Of the 167 workers added to the Lost on the Frontline database so far:

• A majority — 103 (62%) — were identified as people of color.
• At least 52 (31%) were reported to have had inadequate PPE.
• The median age was 57 and ages ranged from 20 to 80, with 21 people (13%) under 40.
• About one-third — at least 53 — were born outside the United States, and 25 were from the Philippines.
• The majority of the deaths, 103, were in April, after the initial surge on the East Coast.
• Roughly 38% — 64 — were nurses, but the total also included physicians, pharmacists, first responders and hospital technicians, among others.
• At least 68 lived in New York and New Jersey, two states hit hard at the outset of the pandemic, with Illinois and California next.

Some of these deaths were preventable. Poor preparation, government missteps and an overburdened health care system increased that risk. Inadequate access to testing, a nationwide shortage of protective gear and resistance to social distancing and mask-wearing have forced more patients into overburdened hospitals and driven up the death toll.

Gaps in government data have increased the need for independent tracking. The federal government has failed to accurately count health care worker fatalities. As of Sunday, the Centers for Disease Control and Prevention reported 587 deaths among health workers — but the agency does not list specific names and has conceded this is an undercount.

Recent moves by the White House underscore the need for public data and accountability. In July, the Trump administration ordered health facilities to send data on hospitalizations and deaths from COVID-19 directly to the Department of Health and Human Services, bypassing the CDC. In the succeeding days, vital information on the pandemic disappeared from the public eye. (The data was later restored following a public outcry, but the agency indicated it may no longer update the figures because of a change in federal reporting requirements.)

Lost on the Frontline reporters have compiled hundreds of potential cases through crowdsourcing and reports from colleagues, social media, online obituaries, workers unions and local media. They are independently confirming each death before publishing names, data and obituaries.

Exclusive stories by the reporters have revealed that many health care workers are using surgical masks that are far less effective than N95 masks and have put them in jeopardy. Emails obtained via a public records request showed that federal and state officials were aware in late February of dire shortages of PPE.

Further investigations found that health workers who contracted the coronavirus and their families now struggle to access death and other benefits in the workers’ compensation system. Our reporting has also examined the deaths of 19 health care workers under age 30 who died from COVID-19.

We are continuing to gather the names of health care workers who’ve died and dig into why so many are falling ill. We welcome tips and feedback at frontline@theguardian.com and covidtips@kff.org.

KHN senior correspondent Christina Jewett and Melissa Bailey contributed to this report.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .

The tally includes doctors, nurses and paramedics, as well as crucial health care support staff such as hospital janitors, administrators and nursing home workers, who have put their own lives at risk during the pandemic to help care for others. Lost on the Frontline has now published the names and obituaries for more than 100 workers.

A majority of those documented were identified as people of color, mostly African American and Asian/Pacific Islander. Profiles of more victims, and an updated count, will be added to our news sites twice weekly going forward.

There is no other comprehensive accounting of U.S. health care workers’ deaths. The Centers for Disease Control and Prevention 368 COVID deaths among health care workers, but acknowledges its tally is an undercount. The CDC does not identify individuals.

The Guardian and KHN are building an interactive, public-facing database that will also track factors such as race and ethnicity, age, profession, location and whether the workers had adequate access to protective gear. The database — to be released this summer — will offer insight into the workings and failings of the U.S. health care system during the pandemic.

In addition to tracking deaths, Lost on the Frontline reports on the challenges health care workers are facing during the pandemic. Many were forced to reuse masks countless times amid widespread equipment shortages. Others had only trash bags for protection. Some deaths have been met with employers’ silence or denials that they were infected at work.

The number released today reflects the 586 names currently in the Lost on the Frontline internal database, which have been collected from family members, friends and colleagues of the deceased, health workers unions, media reports, unions, among other sources. Reporters at KHN and The Guardian are independently confirming each death by contacting family members, employers, medical examiners and others before publishing names and obituaries on our sites. More than a dozen journalists across two newsrooms — as well as student journalists ― are involved in the project.

Many of the health care workers included here studied physiology and anatomy for years. They steeled themselves against the long hours they’d endure. Emergency medical technicians raced by ambulance to help. Others did the cleanup, maintenance, security or transportation jobs needed to keep operations running smoothly.

They undertook their work with passion and dedication. They were also beloved spouses, parents, friends, military veterans and community activists.

None started 2020 knowing that simply showing up to work would expose them to a virus that would kill them.

This project aims to capture the human stories, compassion and heroism behind the statistics. Among those lost were Dr. , a nephrologist, who continued to review her patients’ charts until she was put on a ventilator. Her father, a retired surgeon, succumbed to the disease just days after his daughter.

Susana Pabatao, one of thousands of Philippine health providers in the United States, became a nurse in her late 40s. Susana died just days after her husband, Alfredo, who was also infected with COVID-19.

Dr. James Goodrich, , acclaimed for separating conjoined twins, was also remembered as a renaissance man who collected antique medical books, loved fine wines and played the didgeridoo.

Some of the first to die faced troubling conditions at work. Rose Harrison, 60, a registered nurse, wore no mask while taking care of a COVID-19 patient at an Alabama nursing home, according to her daughter. She felt pressured to work until the day she was hospitalized. The nursing home did not respond to requests for comment.

Thomas Soto, 59, a Brooklyn radiology clerk faced delays in accessing protective gear, including a mask, even as the hospital where he worked was overwhelmed with COVID-19 patients, his son said. The hospital did not respond to requests for comment.

The Lost on the Frontline team is documenting other worrying trends. Health care workers across the U.S. said failures in communication left them unaware they were working alongside people infected with the virus. And occupational safety experts raised alarms about CDC guidance permitting workers treating COVID patients to wear surgical masks ― which are far less protective than N95 masks.

The Occupational Safety and Health Administration, the federal agency responsible for protecting workers, has launched dozens of fatality investigations into health workers’ deaths. But recent agency memos raise doubts that many employers will be held responsible for negligence.

As public health guidelines have largely prevented traditional gatherings of mourners, survivors have found new ways to honor the dead: In Manhattan, a medical resident played a tribute for a fallen co-worker; a nurses union placed 88 pairs of outside the White House commemorating those who had died among their ranks; fire departments have trucks for funeral processions and held for EMTs.

The Lost on the Frontline death toll includes only health care workers who were potentially exposed while caring for or supporting COVID-19 patients. It does not, for example, include retired doctors who died from the virus but were not working during the pandemic.

The number of reported deaths is expected to grow. But as reporters work to confirm each case, individual deaths may not meet our criteria for inclusion — and, therefore, may be removed from our count.

You can read our first 100 profiles here. And if you know of a health care worker who died of COVID-19, please with us.

This article first appeared on ºÚÁϳԹÏÍø News and is republished here under a .