Income a big factor in COVID fatalities

Remember being thrust into that Salvador Dali painting? Aisle after aisle of empty store shelves melting into bleak oblivion … finger paintings cracking in abandoned classrooms … blue industrial gloves in the supermarket …

We knew squat about the new virus sweeping the planet three years ago. Our hopes for normalcy — nay, for survival! — hung on the development of new vaccines to keep the beast at bay. In a stunning triumph, science delivered. But millions, to this day, refuse the needle — a refusal that researchers say has resulted in hundreds of thousands of unnecessary deaths.

Data from the U.S. Census Bureau and the California Department of Public Health reveal a disturbing, if predictable, pattern: Vaccination status goes hand in hand with education and income, in near lockstep.

More modest Southern California is vastly less-vaccinated than wealthier Northern California, with perhaps a slight underperformance by Santa Clara County.

This would all be a numbers game except for one thing: Unvaccinated people are about three times more likely to die from COVID-19 than are vaccinated people.

As we toss our masks — even in health care settings — and reclaim pre-pandemic normalcy, we should understand that it comes at a price: the lives of our parents and grandparents.

The overwhelming majority of COVID-19 deaths in the Golden State — 72% — are among those 65 and older.

“We're saying, `This pandemic is over; older adults, tough luck,'” said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley. “Older adults have to take responsibility for themselves because they can't count on society to protect them. That is a sad thing.”

More than 1.1 million Americans have died of COVID-19 — some 267,000 last year — and we're on track for another 100,000 or so to die this year as the unavoidable price of returning to normal. That toll far exceeds even the worst flu season, and suggests a flip view of seniors as expendable.

“There is absolutely ageism at work here,” said Andrew Noymer, an epidemiologist and demographer at UC Irvine. “The mortality we're seeing in the older age group is being downplayed in the public consciousness, and by statisticians who should know better.”

Health, wealth

We know that being affluent, educated and vaccinated can keep you alive. Here's the evidence:

• In Marin County, 90.4% of folks had the primary round of shots, and 41.6% had the latest booster against omicron. (There, 60.1% have at least a bachelor's degree and median household income is $131,008.) There has been one COVID-19 death for every 821 residents.

• In San Francisco, 85% of folks had the primary,

and 41.4% had the booster. (There, 59.5% have at least a bachelor's, and median income is $126,187.) There has been one COVID-19 death for every 691 residents.

• In Santa Clara

County, 85.5% had the primary and 32.9% had the booster. (There, 54.4% have at least a bachelor's, and median income is $140,258.) There has been one COVID-19 death for every 720 residents.

• In Alameda County, 84.1% had the primary and 35.6% had the booster. (There, 49.6% have at least a bachelor's, and median income is $112,017.) There has been one COVID-19 death for every 783 residents.

• In Orange County, 73.8% had the primary and 23.6% had the booster. (There, 42.1% have at least a bachelor's, and median income is $100,485.) There has been one COVID-19 death for every 396 residents.

• In Los Angeles County, 74% had the primary and 23.7% had the booster. (There, 34% have at least a bachelor's, and median income is $76,367.) There has been one COVID-19 death for every 283 residents.

• In Riverside County, 60.2% had the primary and 18.3% had the booster. (There, 23.4% have at least a bachelor's, and median

income is $76,066.) There has been one COVID-19 death for every 359 residents.

• In San Bernardino County, 57.9% had the primary, and 17.2% had the booster. (There, 21.9% have at least a bachelor's, and median income is $70,287.) There has been one COVID-19 death for every 271 residents.

These numbers didn't surprise Swartzberg at all.

“They're consistent with all the literature,” he said. “Being fully vaccinated markedly decreases the risk of hospitalization and death. Most people, informed with this data, would make the rational decision to avoid hospitalization and death and get vaccinated.”

But not everyone is informed with the data — or trusts it, based on variables like education, historical mistreatment in the health care system, and the “bizarre politicization” of vaccines, he said.

“History isn't going to treat kindly the people who've politicized vaccination,” he said. “They've caused an awful lot of people to lose their lives. It's tragic.”

Life expectancy fell almost a full two years in California in 2020, and data suggest another halfyear drop in 2021, the first appreciable downturns since World War II, according

to the Public Policy Institute of California.

Outlook

The good news, experts said, is that we're at very low levels of significant disease compared with just about any other time since the pandemic began.

Why? Most everyone has been infected or vaccinated — or both — by now, in excess of 90% of the population. That has built an “immunity wall” that didn't exist three years ago, Swartzberg said.

We're also dealing with a virus that is much more transmissible — and much less virulent — than any variant that preceded it. But what's next?

“It's really hard to say,” said Noymer. “The crystal ball is getting hazy. It's clear that COVID is just not as bad as it once was. We can argue about why, but the fact is, it's just not as bad. I think COVID will keep receding in people's consciousness.”

But will COVID-19 remain an afterthought? No one dares venture a guess. The virus has proven again and again that it can turn on a dime.

“Right now, the psychology of the country is that we're going to be living with COVID at a low level, and I will live my life the way I want to live,” Swartzberg said. “That's the advice you're getting

through public health. Nobody knows what spring, summer, next fall are going to be — but I'm in the camp of the optimistic.”

Swartzberg is aghast that masks are no longer required in health care settings — where older, frailer, sick people turn for help — and said the Food and Drug Administration and the Centers for Disease Control and Prevention should do what Canada and the United Kingdom do: push spring boosters for older people at risk of bad outcomes.

The FDA is weighing whether to do just that. A decision is reportedly forthcoming.

The uptake of the most recent booster has been abysmal, Noymer said, so it's clear why the U.S. has embraced an annual COVID-19 vaccine schedule.

“I think they've just decided it's going to be like the flu shot, and anything more often than that isn't sustainable,” he said. “There's not a lot of transparency around these decisions, but it's not an unreasonable one, given the low numbers. Doing a full-court press for a 10% uptake is not going to be a winning strategy here.”

Time may tell which approach is best — or it might not. Meantime, it's every man for himself. If you want or need extra protection, it's on you.