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Santos Aparicio Rivas of East Boston was one of those people who never went to the doctor. The last time he saw a physician was seven years ago. His family was constantly nagging him about it. When his youngest son turned 26 in early March, he asked his dad: All I want for my birthday is for you to go to the doctor and get an annual check-up.

But Rivas would always say, “Si yo estoy bien, I don’t need to go,” said his daughter, Vanessa, in an interview. Even when he became sick with a fever the first week of April, he kept saying, “It’s just the flu, I’ll be OK.”

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But he wasn’t. A few days letter he ended up at Massachusetts General Hospital. On the third day, he was put on a ventilator. Rivas, a 58-year-old small-business owner in East Boston who had moved from El Salvador in 1989, died two weeks later.

The family soon faced another big hurdle: how to pay for the funeral and burial expenses. Vanessa said she had to borrow nearly $18,000, since they had no savings and were not receiving income from Rivas’s business, a moving company that was not deemed essential and had shut down. “And that was choosing the cheapest coffin that there was,” said Vanessa.

Mourners break down during a wake at Ruggiero Family Memorial Home in East Boston for Santos Aparicio Rivas, who died of COVID-19.
Mourners break down during a wake at Ruggiero Family Memorial Home in East Boston for Santos Aparicio Rivas, who died of COVID-19.Jessica Rinaldi/Globe Staff

For Latinos, the coronavirus has been a story of compounding crises — layer upon layer of challenges. Not only are Latinos being diagnosed with COVID-19 at a higher rate, but they also had the highest unemployment rate in April among all racial and ethnic groups, at 18.9 percent. For a community that’s so economically marginalized, it shouldn’t be so shocking that Latino families like the Rivases would be ill-prepared to afford death.

That’s why city leaders in Chelsea — a city with the highest rate of COVID-19 infection statewide and a population that is 66 percent Hispanic — decided to establish a funeral fund for its residents. As of Monday, there have been 132 deaths in Chelsea, a per capita rate that’s more than four times that of the state as a whole. “We have been hearing from residents, ‘This was so unexpected, everything happened all at once,’ meaning the job losses and a sudden inability to pay for food,” said Chelsea City Council vice president Judith Garcia. “We wanted to be proactive with this and ensure that our residents have a little bit of help to give a decent burial to their loved ones.”

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The Rev. Edgar Gutierrez-Duarte, of St. Luke’s-San Lucas Episcopal Church, is managing the Chelsea funeral fund, currently at $750 (Oxfam is planning to contribute $5,000 next week.) The goal is to raise $20,000 and grant aid of up to $1,700 per family to cover cremation costs, which are typically less expensive than burials. “We are anticipating a need here,” he said. “But we haven’t had any requests for help yet. It could be that people in Chelsea still don’t know about this fund."

Family members embrace as other mourners look on from their cars during the funeral service for Santos Aparicio Rivas at Woodlawn Cemetery in Everett.
Family members embrace as other mourners look on from their cars during the funeral service for Santos Aparicio Rivas at Woodlawn Cemetery in Everett. Jessica Rinaldi/Globe Staff

State authorities and other municipalities should follow Chelsea’s example in foreseeing the disproportionate impact of COVID-19 deaths in communities of color precisely because it might be underreported or hidden. Consider the confounding mortality data that may very well be muddling the public health response to the crisis among Latinos and other minorities. Hispanics are overrepresented among COVID-19 infections in Massachusetts but have a lower mortality rate. It’s as if — wait for it — equity gaps magically dissolve with death.

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Well, we know that’s not true. First, statewide numbers are infamously incomplete: Race and ethnicity are missing for roughly half of COVID-19 deaths. “We have to be cautious. It’s like when Hurricane Maria hit Puerto Rico,” said Dr. Joseph Betancourt, vice president and chief equity and inclusion officer at Mass. General. “Deaths there went from a couple hundred to thousands very quickly.” The same is likely to be true with the coronavirus — it’s like a photo that hasn’t been fully developed yet.

Second, age is a huge factor that should be accounted for when assessing the correct mortality rate of COVID-19 among populations of color. “Latinos, compared to the general population, are a younger community,” said Marty Martinez, Boston’s chief of Health and Human Services. ”They’re getting infected younger, and we know the virus is fatal to an older population.” (This pattern holds when looking at national data: A recent analysis by Latino Decisions, a national research firm, shows why we shouldn’t necessarily hold as good news a “lower-than-expected” death rate for Latinos because we’re generally younger. When adjusted for age, according to an analysis in three geographic areas, the COVID-19 death rate for whites is much lower than that of Latinos and Blacks.)

The virus has been as least one step ahead of the health response, especially in Chelsea and places like it with underlying risk factors such as crowded housing conditions or a reluctance to seek health care. Unfortunate families like the Rivases (who eventually raised nearly $17,000 with a Go Fund Me campaign) and countless others can only catch up to the virus when they look to bury their dead. To help them financially is another important act of humanity for Boston and other cities to consider.

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Marcela García is a Globe editorial writer. She can be reached at marcela.garcia@globe.com. Follow her on Twitter @marcela_elisa.


Marcela García can be reached at marcela.garcia@globe.com. Follow her on Twitter @marcela_elisa.