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As California settles into a third year of the pandemic, COVID-19 continues to pose a serious death threat. But the number of people dying, and the demographics of the victims, has changed markedly since the first two years.
Given the herd immunity that people have gained through a combination of mass vaccination and protections created from previous infections, Californians overall were much less likely to die from covid in 2022, when the omicron variant dominated, than during the first two years of the pandemic, when other variants were largely in play, amplifying a national trend.
Still, each week, the virus is killing hundreds of Californians, hitting the unvaccinated hardest. The virus remained among the state’s leading causes of death in July, behind heart disease, cancer, stroke and Alzheimer’s disease, but surpassed diabetes, accidental death and a host of other debilitating illnesses. In the first seven months of the year, some 13,500 California residents 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 almost 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 cumulatively during that period, behind heart disease and cancer. From December 2020 to February 2021, it briefly overtook heart disease as the leading cause of death, claiming the lives of more than 38,300 Californians in just three months. During its most recent peak, in January 2022, covid claimed some 5,900 lives.
Covid dropped out of the top 10 causes of death for a brief period 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, taking more than 1,000 lives, state data shows.
Clearly, the vaccines made a difference. Covid death rates have fallen in recent months as Covid vaccines and previous infections gave much of the population significant protection against serious illness, said Dr. Timothy Brewer, a professor of medicine and epidemiology at the UCLA. Brewer said the omicron variant, while more transmissible than previous strains, appears to be a milder version of the virus. Research on that question is ongoing, but preliminary data suggests that omicron is less likely to cause severe illness and death, according to the Centers for Disease Control and Prevention, which also notes that the severity of symptoms can be seen affected by vaccination status, age, and other health conditions.
The decline in deaths was particularly striking among California’s Latino population.
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 through July 2022, according to state data. That translates to about 4,600 deaths.
By contrast, the proportion of Covid deaths involving white residents increased from 32% in the first two years of the pandemic to 44% in the first seven months of 2022. That equates to 24,400 deaths involving white residents in 2020-21 and about 6,000 deaths in the first seven months of 2022. Whites make up about 35% of the state’s population.
The researchers point to several factors in the change. During the first two years of the pandemic, a large number of workers deemed essential, who continued to show up at workplaces in person, were Latino, while white residents were more likely to be employed in occupations that allowed them to work from home. home, US Census Bureau surveys show.
“They just got more exposed,” said Dr. George Rutherford, a professor of epidemiology and biostatistics at the University of California-San Francisco. “They are doing essential jobs and they had to leave home and go to work.”
An imbalance in remote work remains, census data shows, but today the vast majority of Latino and white workers in California report to work in person.
Seciah Aquino, deputy director of the Latino Coalition for a Healthy California, said efforts to ensure underserved communities of color had access to testing, treatment and vaccinations also had an impact. And because Latino communities have been hit so hard during the pandemic, she said, many California Latinos still wear masks. “They’re still making sure to stay home if they’re sick,” she said. “They still comply with those policies even if the overall narrative is changing.”
Age is also a key factor in demographic changes, Brewer said.
Californians age 75 and older accounted for 53% of COVID deaths through July 2022, up from 46% in 2020 and 2021. Only about 6% of state residents are age 75 or older. And white Californians age 75 and older outnumber Latinos in that age group by a ratio of 3 to 1.
In the initial vaccination rollout, California prioritized seniors, first responders, and other essential workers, and for several months into 2021, older residents were much more likely to be vaccinated than younger Californians.
“Now, vaccination rates have reached pretty much everyone except children, people under the age of 18,” Brewer said. “You’re seeing that it goes back to what we saw earlier, which is that age is still the biggest risk factor for death.”
More than 86% of Californians age 65 and older have completed their primary series of COVID-19 vaccines. But the protection that vaccines provide wanes over time, and since many older people got their shots early, enough time passed between their second shot and the wave of omicrons in early 2022 to leave them vulnerable. About a third of Californians age 65 and older had not received a booster in early 2022, when the wave of omicrons peaked, and about a quarter have yet to receive a booster.
Geographic shifts in Covid prevalence have occurred throughout the pandemic: Outbreaks hit one area while another is spared, and then another community serves as the epicenter a few months later.
Residents of the San Francisco-Oakland metro area accounted for 7.8% of the state’s deaths in 2022, through early September, up from 5.4% in 2020-21. The area is home to approximately 12% of the state’s residents. The Sacramento metro area also accounted for a higher proportion of Covid deaths this year: 6% in 2022 versus 4.5% in 2020-21.
At the same time, residents of the Los Angeles-Long Beach-Anaheim metro area accounted for 42% of Covid deaths in 2022, down slightly from 43% in 2020-21. The area is home to about 33% of the state’s residents. A similar drop occurred in the nearby Riverside-San Bernardino metropolitan area.
Again, age could be a factor in geographic changes. A higher proportion of residents in San Francisco and Sacramento are age 75 and older than in Los Angeles and Riverside, census data show.
It is not clear if this change will last. As the Los Angeles Times reported, Covid deaths grew at a faster rate in July in Los Angeles County than in the Bay Area.
The data also shows that vaccination remains one of the strongest deterrents to dying from covid. From January through July, unvaccinated Californians died at about five times the rate of vaccinated Californians. But the gap has narrowed. From April through December 2021, unvaccinated California residents died, on average, at a rate about 10 times that of vaccinated Californians.
Brewer said the gap narrowed because the omicron variant was more likely than previous variants to “break through” and cause infection in vaccinated Californians. The omicron variant, although less deadly, also infected many more people than previous variants.
This trend may also prove short-lived: the next generation of covid booster shots are being rolled out statewide.
Phillip Reese is a data reporting specialist and assistant professor of journalism at California State University-Sacramento.
This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.