Table 2. Themes, Subthemes, and Illustrative Quotes From Adult Latinx Survivors Hospitalized for COVID-19.
| Theme: COVID-19 was a distant and secondary threat | |
| Invincibility | “I would hear COVID-19 information and think I’d never get it. It isn’t until you get COVID-19 that you realize the truth. I was very sick and now I’m too scared to leave my house.” (Participant 26) |
| “Unfortunately, we Latinos think that illnesses come and go, and that they will not affect us, and if we are affected, that we don’t need to give them attention. That’s the problem, we don’t take it seriously.” (Participant 41) | |
| Misinformation and disbelief | “The men go to the streets and work then they go to the grocery store and their kids run around. I think they don’t protect themselves because they don’t know. There is no information.” (Participant 3) |
| “I obtained most of my information from Facebook … I didn’t understand how to protect myself at first.” (Participant 17) | |
| “I kept hearing we needed to hold our breath and so that is what I did … and then I got sick.” (Participant 54) | |
| Ingrained social norms | “We became sick at the same time because we were all together. My sister-in-law was pregnant and had COVID-19. We all got together, and she was with us. She didn’t know that she had COVID-19 because she didn’t have symptoms.” (Participant 12) |
| “I was careful for weeks and then I had a gathering at my house and I invited a lot of people and that is how I think I got sick.” (Participant 47) | |
| Theme: COVID-19 was a compounder of disadvantage | |
| Fear of unemployment and eviction | “I feared not fully recovering … I wasn’t sure if my boss would let me keep my job … I knew that I was dispensable and they could fill my position … I’d understand if they fired me for being unable to work because of COVID-19.” (Participant 10) |
| “If we get evicted because we can’t pay rent, that’s when we all help each other, and then that’s when families come together and live together. You live with friends or families, but then that’s how we also all expose each other.” (Participant 46) | |
| “My fear is that they close all the restaurants and then there is no work, and no way to pay the rent or bills. This worries me because we live day to day.” (Participant 47) | |
| Lack of safeguards for undocumented immigrants | “I was worried because my husband could be unemployed and then how would we pay our bills? Being an immigrant, we are at a disadvantage. We know that we won’t have the same support.” (Participant 5) |
| “I am scared of not having a job because being undocumented and sick, there isn’t help. One has to work. This is the main worry that we all have.” (Participant 13) | |
| Inability to protect self from COVID-19 | “I had to leave the house daily to work … they gave us gloves but no mask … I worked cleaning apartments and well, they only gave us gloves.” (Participant 13) |
| “I think I got COVID-19 because I was using public transportation to get to work … when I would get on the bus, there were lots of people without face masks or gloves and it didn’t look like they had their own hand sanitizer either.” (Participant 46) | |
| High-density housing | “We Mexicans may have 2 or 3 families in the same home, with kids in the same house, and well … that is very dangerous because the infection is very contagious.” (Participant 3) |
| “We have no space. If one room in the house gets sick, it goes to the next room … that is what most worried me. Even if we followed the rules, we can’t distance in the home. It’s complicated when you can’t move in your home.” (Participant 59) | |
| Theme: reluctance to seek medical care | |
| Worry about health care costs | “I was worried about getting sick and needing to go the hospital, because then there are bills, and it is not easy to pay those bills. It becomes very difficult for someone who isn’t from this country. Every day while I was in the hospital, I thought about the bill. Believe me, this was so distressing, knowing that each extra day would cost more.” (Participant 18) |
| “I kept telling myself, to force myself to stay home, to bare the breathlessness, but once I couldn’t breathe anymore, there was no other option.” (Participant 19) | |
| “I did not have health insurance. I was scared of the bill, but I had to go because I couldn’t handle the fever.” (Participant 55) | |
| Concerned about ability to access care if uninsured or undocumented | “As an undocumented Latino, the truth is that one wonders, when one gets this illness and is unemployed and without money, how will one pay for this? And if we can’t pay, can we receive care?” (Participant 18) |
| “When one is hospitalized, all one can think about is the bills and well, one does not have support because of immigration status—because not all of us have documents.” (Participant 18) | |
| Undocumented immigrants fear deportation | “People go very scared, and I understand because I was in the same situation, not knowing if you’ll receive care, not knowing the steps, not knowing if your information will be shared.” (Participant 3) |
| “We fear going to the doctor, hospital, or clinic. We are fearful because we think that they will share our information and immigration officials will take you, incarcerate you, and deport you.” (Participant 10) | |
| “I am undocumented and in this country without papers. I have been here for 28 years and so you know, one worries that the hospital will call ICE, and that they will come and take us. I don’t leave my house and worry so much.” (Participant 44) | |
| Theme: health care system interactions | |
| Social isolation and change in hospital procedures | “I was scared of going to the hospital because once you’re there, you can’t have any visitors, you are alone and if something happens to you, your family can’t come visit you. I was very scared that I would die there.” (Participant 42) |
| “Family cannot come in and see you, not even if you’re in your last days, and so that it was caused me the most distress … to not see my children again.” (Participant 54) | |
| Appreciation for clinicians and language access | “I was very scared and lonely but I called my family using facetime and the nurses were wonderful. They came to the room and I know they couldn’t stay long because everyone is scared of getting this, but they did a great job taking care of me.” (Participant 2) |
| “My appreciation for the care is infinite. Infinite because everyone was always attentive, and my wife and I are so grateful … the doctors, the nurses, the housekeepers, these are divine, extraordinary people.” (Participant 3) | |
| “The clinicians were so kind, they gave me motivation and when you are sick, you need motivation, because sometimes when you are sick you have to depend on others and well, the clinicians lifted your spirits by giving you their hand.” (Participant 18) | |
| Discharge with insufficient resources or clinical information | “I don’t have health insurance and so I had to pay for the oxygen when I was discharged. I used my credit card. I had to pay before I left the hospital … all I wanted was to leave and even though it meant I would have to work more to pay for the oxygen, well I just wanted to leave.” (Participant 13) |
| “They didn’t inform me well about the treatment, about what the medication would do. I didn’t understand the side effects to make a decision about taking or not taking the medication and being in the study. They didn’t tell me what would happen if the study medication didn’t work and I ended up back in the hospital.” (Participant 23) | |
| Theme: faith and community resiliency | |
| Spirituality | “I put myself in God’s hand and I said, ‘Dear God, I know that you have my family in your hands,’ … we must all have faith in God that this is all going to pass and that someday, everything will be normal again.” (Participant 8) |
| “I just felt like God is in control. When one is a believer, one believes that everything is in God’s hands. If I came back to my family or I died, it would be God’s will.” (Participant 17) | |
| “I had a lot of faith in God, faith that the illness would leave me and that I would be survive this. It’s not good to think about bad or sad things … but if one has faith in God, then one can survive this.” (Participant 45) | |
| Latinx COVID-19 as advocates | “Our community believes COVID-19 won’t affect us … I now urge people to listen … I say, ‘Take care of yourselves, use the face mask, maintain distance, wash all the things that you buy like fruit, and don’t have gatherings.’” (Participant 41) |
| “The Latino community needs to know that we are the ones getting sick and dying … that it’s not a joke … that we need to protect our families, use a mask, and wash our hands.” (Participant 36) | |
| “The truth is that I didn’t take this seriously. Even though I was hearing about it on the news … people need to learn to maintain their 6 feet distance, use the face masks, wash their hands, use hand sanitizer, all of these measures are necessary. Sometimes, people don’t understand until someone ends up sick and in bed.” (Participant 60) | |
Abbreviation: COVID-19, coronavirus disease 2019.