As California settles into the third year of the pandemic, Covid-19 poses a serious threat of death. But the number of people who died – and the demographics of their victims – has changed significantly since the first two years.
Given the herd immunity people have acquired through a combination of mass vaccinations and protections built up from prior infections, Californians overall were much less likely to die from Covid in 2022, when the Omicron strain dominates. was, during the first two years of the pandemic, when other variants were mostly in play, fueling a national trend.
Yet, each week, the virus is killing hundreds of Californians, hitting the hardest among the unvaccinated. The virus was one of the state’s leading causes of death in July, behind heart disease, cancer, stroke and Alzheimer’s disease but outpacing diabetes, accidental death, and many other debilitating diseases. In the first seven months of the year, about 13,500 Californians died of Covid, according to preliminary death certificate data from the state Department of Public Health. By comparison, the virus killed about 31,400 people in 2020 and about 44,000 in 2021.
From April 2020 to December 2021, Covid killed an average of 3,600 people a month, making it the third leading cause of death in the state overall for the period behind heart disease and cancer. From December 2020 to February 2021, it briefly surpassed heart disease as the leading cause of death, killing more than 38,300 Californians in just three months. During its most recent peak, in January 2022, Covid claimed around 5,900 lives.
Covid briefly dropped out of the top 10 causes of death in the spring only to re-enter this summer as Omicron variants continued to mutate. In July, even with more than 70% of Californians fully vaccinated, Covid was the fifth leading cause of death, claiming more than 1,000 lives, state data showed.
Clearly the vaccine has made a difference. Dr. Timothy Brewer, a professor of medicine and epidemiology at UCLA, said that the death rate from Covid has decreased in recent months because the Covid shots and earlier infections provided much of the population with significant protection against severe disease. The omicron variant, while more transmissible than the earlier strain, appears to be a milder version of the virus, Brewer said. Research on that question is ongoing, but preliminary data suggest that Omicron may reduce the chance of serious illness and death, according to the Centers for Disease Control and Prevention, which also notes that the severity of symptoms May be affected by vaccination status, age, and Other health conditions.
The drop in mortality among California’s Latino population was particularly striking.
In 2020 and 2021, Latinos accounted for 47 percent of California’s Covid deaths — about 35,400 deaths — even though they make up 40 percent of the state’s population. By comparison, Latinos accounted for 34 percent of all Covid-related deaths from January to July 2022, according to state data. It causes about 4,600 deaths.
In contrast, the proportion of Covid deaths among whites increased from 32% in the first two years of the pandemic to 44% in the first seven months of 2022. This equates to 24,400 white resident deaths in 2020-21 and nearly 6,000 deaths in 2020. First seven months of 2022. White people make up about 35% of the state’s population.
Researchers point to several factors in the shift. During the first two years of the pandemic, the majority of workers deemed essential, who continued to report in person to job sites, were Latino, while white residents were more likely to be employed in occupations that They were allowed to work from home, US Census Bureau surveys show.
“They’re just more exposed,” said Dr. George Rutherford, a professor of epidemiology and biostatistics at the University of California-San Francisco. “They are doing essential work and had to leave home and go to work.”
Census data shows that the imbalance in remote work remains, but large majorities of Latino and white workers in California today report working in-person.
Efforts to ensure that testing, treatment, and vaccinations are available to communities of color have also had an impact, said Sequia Aquino, deputy director of the Latino Coalition for a Healthier California. And because Latino communities were hit hard during the pandemic, he said, many Latinos in California are still wearing masks. “They’re still making sure they’re staying home if they’re sick,” he said. “They are still adhering to these policies even if the larger narrative is changing.”
Age is also an important factor in demographic changes, Brewer said.
Californians age 75 and older accounted for 53% of all Covid-related deaths in 2022 through July, up from 46% in 2020 and 2021. Only 6% of the state’s residents are 75 and older. And white Californians 75 and older outnumber Latinos in that age group by about 3 to 1.
In the initial vaccination rollout, California prioritized seniors, first responders, and other essential workers, and by several months in 2021 older residents were significantly more likely to be vaccinated than younger Californians.
“Now, vaccination rates have increased substantially with everyone except children under 18,” Brewer said. “You see this is what we saw before, which is that age is the most important risk factor for death.”
More than 86% of Californians age 65 and older have completed their primary immunization series. But the protection provided by vaccines wears off over time, and because many seniors get their shots early, there would be a long time between their second shot and the Omicron wave of early 2022. So that they become weak. About a third of Californians 65 and older had not received a booster by early 2022, when the Omicron wave peaked, and about a quarter had not yet received a booster.
Geographic shifts in the spread of Covid have occurred throughout the pandemic: the outbreak infects one area while another is spared, and then a few months later another community serves as the epicenter.
Residents of the San Francisco-Oakland metro area accounted for 7.8 percent of the state’s deaths in 2022, as of early September, up from 5.4 percent in 2020-21. This area is home to about 12 percent of the state’s population. The Sacramento metro area also had a higher share of deaths from Covid this year: 6% in 2022 vs. 4.5% in 2020-21.
At the same time, residents of the Los Angeles-Long Beach-Anaheim metro accounted for 42 percent of all Covid-related deaths in 2022, down slightly from 43 percent in 2020-21. This area is home to about 33 percent of the state’s population. The nearby Riverside-San Bernardino metro area saw similar declines.
Again, age may be a factor in geographic changes. Census data shows that San Francisco and Sacramento have a larger proportion of residents 75 and older than Los Angeles and Riverside.
It is unclear whether this change will continue. As the Los Angeles Times reported, L.A. County saw a faster increase in Covid deaths than the Bay Area in July.
The data also show that vaccination is one of the strongest barriers to death from Covid. From January to July, unvaccinated Californians died at nearly five times the rate of vaccinated Californians. But the gap has narrowed. From April to December 2021, unvaccinated Californians died, on average, at nearly 10 times the rate of vaccinated Californians.
Brewer said the difference narrowed because the Omicron variant was more likely than earlier variants to cause “breakdowns” and infections in vaccinated Californians. The Omicron variant, while less lethal, also affected far more people than earlier variants.
This trend may also prove short-lived: The next generation of covid-booster shots is rolling out across the state.
Philip Reese is a data reporting expert and assistant professor of journalism at California State University-Sacramento.
This story was prepared by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
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