Undocumented And Uninsured: NC Family’s Battle With COVID-19 And The Health Care System
Sitting at home and from her cellphone screen on July 24, Ana Chagoyán, a Mexican mother who lives near Charlotte, said her last goodbye to her brother Juan. He was just 40 years old.
It was a virtual funeral, and Ana was with her mother, her other brother, her husband, three of her children, her son-in-law and her grandson. They all live under the same roof in the Cabarrus County town of Midland.
Eight of the 10 people living in the household have shown symptoms of or tested positive for the coronavirus.
Juan Chagoyán came to the country illegally from León, Guanajuato, Mexico, 20 years ago. Ana followed two years later in 2002. Many Latino families, particularly immigrants, have living situations similar to Ana's family, said Viviana Martinez-Bianchi, a community health expert at Duke Health.
And Martinez-Bianchi said such crowded living arrangements make it easy for the coronavirus to spread through families.
“Many of the most beautiful things about the Latino community -- like supporting each other, living together with the rest of the family -- in the middle of a pandemic, where distance is necessary, ends up being something that plays against us,” she said.
In the Chagoyán household, Ana’s brother Juan was the first to show symptoms early in July. Because of their immigration status, the family wasn’t eligible for federal help. So he continued to work as a stonemason, Ana said, because the family depended on him. They believe that’s how the virus spread through the home: Ana’s daughter, grandson and mother would eventually all test positive for the coronavirus.
Ana's mother, Sofía Suárez, showed severe symptoms a few days after Juan got sick.
"The ambulance came for her and took her to the hospital with a high fever,” Ana said. “They said, 'Your mom has a lot of COVID symptoms.'”
They were told she tested positive for the coronavirus. Despite her poor health and against the will of the family, Suárez, 57, was discharged from Novant Health Presbyterian Medical Center in Charlotte that same night. They think their lack of medical insurance played a role in releasing her.
Ana was the next to show symptoms, along with her 21-month-old grandson. Meanwhile, Suárez got worse and had to go back to the hospital.
"We had to get my mother to the hospital because my mother was dying here at home,” Ana said. “She needed oxygen. She couldn’t breathe.”
By then, Cabarrus County's health department had ordered the family to isolate for three-and-a-half weeks.
“They said we had to get tested and (that) if we left the house we’d be arrested,” Ana said.
Early the next day, Ana's husband and 21-year-old daughter joined Juan to get tested at a Novant urgent care clinic in Indian Trail, a Union County suburb of Charlotte.
When they got back home, Ana's daughter yelled for her. Juan had collapsed.
"My brother was convulsing badly,” she said. “He wouldn’t stop vomiting and squirming."
She called 911. Paramedics told them they suspected Juan was having a stroke or a heart attack. He was immediately taken to the Atrium Health Cabarrus emergency department in Concord.
The family says doctors confirmed Juan had a stroke and found blood clots in his brain. Records show that because of his family members' confirmed COVID-19 status, he was presumed positive. He was rushed to the ICU at Carolinas Medical Center in Charlotte the next morning.
Ana’s daughter, who assumes many of the family responsibilities because she speaks English, authorized an emergency surgery that doctors told them could save Juan's life. Juan’s medical records show it was never performed because, after several CT scans, doctors decided he didn’t need it. The medical records also show that the stroke disabled 85% of Juan’s functions. Family members had no idea until their attorney received his medical records.
Health Care And Language Barriers
Juan was in the hospital for five days. The family wasn’t allowed to visit him because of COVID-19 restrictions.
Family members understood that, but were hoping to talk to and see him. If it couldn’t be in person, how about a video call? It never happened. At first, according to hospital records, family members were told Juan wouldn’t be able to take a call because of his condition. The family says they were later given permission to call but were told a tablet for ICU patients didn’t work.
"The entire time they kept telling us that my brother was fine, that he didn't need the surgery and they had done CT scans," Ana said.
Atrium did not comment because the family has hired an attorney, but there are instances of medical records documenting his medical condition as much worse that what they believed was the case.
For example, on July 19, Ana says they were told Juan was stable and taken off oxygen, which his medical records confirm.
But the family interpreted that as meaning he was recovering. Medical records say he was encephalopathic — that means with damaged brain function.
Ana’s daughter called the next day to get an update on her uncle.
“My daughter screamed and screamed,” Ana said. “My youngest told me: 'Mom, my uncle is dead.' And I said, 'What do you mean he’s dead?'"
According to their attorney, Melissa Hordichuk, Juan's cause of death is listed as cardiac arrest and COVID-19 pneumonia. But the only mention of pneumonia in Juan’s medical records was in his discharge notes, signed by a doctor on July 22, two days after his death. In fact, throughout his progress notes, his lungs are described as “clear” and “normal.”
The daughter says the coronavirus test Juan took before going to the hospital came back negative.
The Ugly Truth
Data from the state Department of Health and Human Services show Latinos make up 37% of North Carolina’s COVID-19 cases in which ethnicity is known. In Cabarrus County, Latinos make up 38% of coronavirus cases as of Sept. 1.
At the end of August, the number of adults in intensive care for COVID-19 in the Metrolina region, which includes most hospitals in the Charlotte area, was 59. The health department does not provide specific data for ethnicity or race hospitalized.
Four of the 10 people living in the Chagoyán household tested positive. Four others showed mild symptoms.
Ana Chagoyán’s family continues to be on the lookout for COVID-19 symptoms. They say Juan's death leaves them with more questions than answers in the midst of a pandemic that is disproportionately affecting people like them.
"Please take care of your family," Ana said. “If you know you have the disease, do not go out so that there are no more deaths. Wear your mask, your essentials, your gloves and your sanitizer. Try to go out as little as possible. Take care of yourself as much as you can because it hurts. It deeply hurts to lose a loved one and not be able to be with him and say goodbye."
This article is the first in a two-part series that explores how the Latino, Spanish-speaking and undocumented communities have been affected by the coronavirus pandemic in North Carolina through the story of the Chagoyán family in Midland. Read Part 2 here.
A Spanish version of this story is available on La Noticia.
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