Covid still kills, but the demographics of its victims are changing

As California settles into the third year of the epidemic, Covid-19 continues to pose a serious threat of death. But the number of people who died – and the demographics of those affected – has shifted significantly since the first two years.

Through a combination of mass vaccination and protection from prior infection given the population’s collective immunity, Californians overall were much less likely to die from Covid in 2022, when the Omicron variant predominated than in the first two years of the pandemic, when other variants were largely in play, amplifying a national trend. by doing

Yet, every week, the virus is killing hundreds of Californians, hitting the unvaccinated the hardest. The virus remained the leading cause of death in the state in July, behind heart disease, cancer, stroke and Alzheimer’s disease, but overtook diabetes, accidental deaths and 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 for that period, behind heart disease and cancer. From December 2020 to February 2021, it briefly surpassed heart disease as the leading cause of death, claiming more than 38,300 California lives in just three months. During its most recent peak in January 2022, Covid claimed around 5,900 lives.

Covid dropped out of the top 10 causes of death briefly in the spring only to re-enter this summer as the omicron variant 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 show.

Clearly the vaccine made a difference. The Covid death rate has fallen in recent months because the Covid shot and earlier infections offered significant protection against serious illness to much of the population, said Dr. Timothy Brewer, professor of medicine and epidemiology at UCLA. Brewer said the Omicron variant, while more transmissible than earlier strains, appears to be a milder version of the virus. Research into that question is ongoing, but preliminary data suggest that Omicron is less likely to cause serious illness and death, according to the Centers for Disease Control and Prevention, which also notes that the severity of symptoms can be influenced by vaccination status, age and Other health conditions.

The decline in deaths among California’s Latino population was particularly noticeable.

In 2020 and 2021, Latino residents accounted for 47% of Covid deaths in California — about 35,400 deaths — even though they make up 40% of the state’s population. By comparison, Latinos accounted for 34% of Covid deaths from January to July 2022, according to state data. This translates to about 4,600 deaths.

Conversely, the proportion of Covid deaths involving white residents increased from 32% in the first two years of the epidemic to 44% in the first seven months of 2022. This equates to 24,400 deaths involving white residents in 2020-21 and nearly 6,000 deaths. First seven months of 2022. About 35% of the state’s population is white.

Researchers have pointed to several reasons for the change. In the first two years of the pandemic, a large number of workers deemed essential, who continued to report in person to job sites, were Latinos, while white residents were more likely to be employed in occupations that allowed them to work from home, the U.S. Census Bureau study found. shows

“They’re more exposed,” said Dr. George Rutherford, professor of epidemiology and biostatistics at the University of California-San Francisco. “They were doing essential work and had to leave home to go to work.”

An imbalance in remote work remains, census data show, but the large majority of both Latino and white workers in California today report to work in person.

Sekiah Aquino, deputy director of the Latino Coalition for a Healthy California, said efforts to ensure that testing, treatment and vaccinations were available to underserved communities of color also had an impact. And Latino communities were hit so hard during the pandemic, he said, that many California Latinos still wear masks. “They’re still making sure they stay home when they’re sick,” he said. “They still adhere to those principles even if the larger narrative has changed.”

Age is also a key factor in changing demographics, Brewer said.

Californians age 75 and older accounted for 53% of all Covid deaths as of July 2022, up from 46% in 2020 and 2021. Only 6% of state residents are 75 and older. And white Californians 75 and older outnumber Latinos by about 3 to 1.

In the initial vaccination rollout, California prioritized seniors, first responders and other essential workers, and for several months in 2021, older residents were much more likely to be vaccinated than younger Californians.

“Now, vaccination rates are much higher for everyone except children under 18,” Brewer said. “You can see that it goes back to what we’ve seen 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 initial Covid shot series. But the protection provided by the vaccines wanes over time, and because many seniors get their shots early, enough time passes between their second shot and the Omicron wave in early 2022 to weaken them. About one-third of Californians 65 and older did not receive a booster by early 2022, when the Omicron wave peaked, and about one-quarter still did not receive a booster.

Geographic shifts in the outbreak of Covid occurred throughout the pandemic: the outbreak hit one region while another was spared, and then another community served as the epicenter months later.

Residents of the San Francisco-Oakland metro area accounted for 7.8% of the state’s deaths in 2022, as of early September, up from 5.4% in 2020-21. This area is home to about 12% of the state’s population. The Sacramento metro area also accounted for a higher share of Covid deaths 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% of all Covid deaths in 2022, down slightly from 43% in 2020-21. This area is home to about 33% of the state’s population. Similar flooding occurred in the nearby Riverside-San Bernardino metro area.

Again, age may be a factor in geographic variation. San Francisco and Sacramento have a higher proportion of residents 75 and older than Los Angeles and Riverside, census data show.

It is not clear if this move will be permanent. As the Los Angeles Times reports, Covid deaths rose at a faster pace in July in L.A. County than in the Bay Area.

Data also show that vaccination remains one of the strongest preventers of 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 gap narrowed because the Omicron variant was more likely than earlier variants to “break out” and infect Californians who received the vaccine. The Omicron variant, although less lethal, also infected many more people than the earlier variant.

This trend may also prove short-lived: The next generation of Covid booster shots is rolling out across the state.

Philip Rees is a data reporting expert and assistant professor of journalism at California State University-Sacramento.

This story was produced by KHN, which publishes California Healthline, the editorially independent service of the California Health Care Foundation.

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