Associated Press

Jerry Ramos spent his final days in a California hospital, hooked to an oxygen machine with blood clots in his lungs from COVID-19, his 3-year-old daughter in his thoughts.

“I have to be here to watch my princess grow up,” the Mexican American restaurant worker wrote on Facebook. “My heart feels broken into pieces.”

Ramos didn’t live to see it. He died Feb. 15 at age 32, becoming not just one of the nearly 600,000 Americans who have now perished in the coronavirus outbreak but another example of the outbreak’s strikingly uneven and ever-shifting toll on the nation’s racial and ethnic groups.

The approaching 600,000 mark, as tracked by Johns Hopkins University, is greater than the population of Baltimore or Milwaukee. It is about equal to the number of Americans who died of cancer in 2019. And as bad as that is, the true toll is believed to be significantly higher.

On the way to the latest round-number milestone, the virus has proved adept at exploiting inequalities in the U.S., according to an Associated Press data analysis.

In the first wave of fatalities, in April 2020, Black people were slammed, dying at rates higher than those of other ethnic or racial groups as the virus rampaged through the urban Northeast and heavily African American cities like Detroit and New Orleans.

Last summer, during a second surge, Hispanics were hit the hardest, suffering an outsize share of deaths, driven by infections in Texas and Florida. By winter, during the third and most lethal stage, the virus had gripped the entire nation, and racial gaps in weekly death rates had narrowed so much that whites were the worst off, followed closely by Hispanics.

Now, even as the outbreak ebbs and more people get vaccinated, a racial gap appears to be emerging again, with Black Americans dying at higher rates than other groups.

Overall, Black and Hispanic Americans have less access to medical care and are in poorer health, with higher rates of conditions such as diabetes and high blood pressure. They are also more likely to have jobs deemed essential, less able to work from home and more likely to live in crowded, multigenerational households, where working family members are apt to expose others to the virus.

Black people account for 15% of all COVID-19 deaths where race is known, while Hispanics represent 19%, whites 61% and Asian Americans 4%. Those figures are close to the groups’ share of the U.S. population — Black people at 12%, Hispanics 18%, whites 60% and Asians 6% — but adjusting for age yields a clearer picture of the unequal burden.

Because Blacks and Hispanics are younger on average than whites, it would stand to reason that they would be less likely to die from a disease that has been brutal to the elderly. But that’s not what is happening.

Instead, the Centers for Disease Control and Prevention, adjusting for population age differences, estimates that Native Americans, Latinos and Blacks are two to three times more likely than white people to die of COVID-19.

Also, the AP analysis found that Latinos are dying at much younger ages than other groups.

Thirty-seven percent of Hispanic deaths were of those under 65, versus 12% for white Americans and 30% for Black people. Hispanic people between 30 and 39 — like Ramos — have died at five times the rate of white people in the same age group.

Public health experts see these disparities as a loud message that the nation needs to address deep-rooted inequities.

“If we want to respect the dear price that 600,000 people have paid, don’t return to normal. Return to something that is better than what was,” said Dr. Clyde Yancy, vice dean for diversity and inclusion at Northwestern University’s medical school in Chicago.

He added: “It will be an epic fail if we simply go back to whatever we call normal.”

Ramos had asthma and diabetes and had quit his job as a chef at Red Lobster before the pandemic because of diabetes-related trouble with his feet.

He died during the devastating winter surge that hit Latinos hard, and the rest of his household of seven in Watsonville, an agricultural city of around 54,000 people about 90 miles south of San Francisco, also got sick.

That included his toddler daughter; the family matriarch, 70-year-old Mercedes Ramos; and his girlfriend, who was the only one in the household working and the first to get infected, bringing home the virus from her job managing a marijuana dispensary, according to family members.

Mother and son were admitted to the same hospital, their rooms nearby. They would video chat or call each other every day.

“He would tell me he loved me very much and that he wanted me to get better and that he was doing fine, but he was telling me that so I wouldn’t worry,” Mercedes Ramos said in Spanish, her voice breaking. She has since returned to her job picking strawberries.