As COVID ushers in another return of winter, many Californians don’t seem to care
Thank you for reading this post, don't forget to subscribe!The Bay Area was a model of cooperation in the early years of the COVID pandemic, as residents sheltered in place, lined up for vaccines and wore masks in public. Many locals watched in horror as health precautions became politicized in other parts of the country.
Yet, even in this conscientious region, vigilance has not lasted. Like
new winter COVID spike
covers the region, a large number of people are
refusal of masks
and
skipping the latest booster
— a vital tool for preventing serious illness as immunity from previous vaccines or infection wanes.
Since the advent of vaccines and better treatments for COVID—and the rollback of draconian government measures like mask mandates—the public’s approach to
coronavirus
has become
more laissez-faire.
Some call this approach
“figure it out for yourself”
the pandemic era. But individual choices still take a toll on vulnerable populations, such as the elderly and immunocompromised, some of whom are once again withdrawing from the public square.
Widespread apathy toward the latest spike is compounded by considerable confusion about how to behave at this stage of the crisis. In particular, experts say the introduction of the new bivalent vaccine booster – the first to target both the original coronavirus and the omicron family of variants – has been lukewarm. Without a strong marketing push and government resources released for distribution, many Americans are unaware of the booster’s benefits or even that it exists.
“The situation is that people are left to decide as individuals,” said Dennis Hurd, a professor of behavioral science at the University of California, Berkeley’s School of Public Health. “Without a lot of information, without a lot of support for some of these public health measures, we’ll see what we do now.”
To date, only 20.5% of eligible Californians have received the bivalent vaccine, leaving the majority more vulnerable to severe disease. California’s absorption is higher than
average for the country 14.6%,
but still only a fraction of the 72.5% of people who received the initial two-dose vaccine series. The bivalent vaccine is authorized for Californians
older than 6 months,
depending on
when someone finished their initial two-dose series and when they last received the older ‘monovalent’ booster.
Bay Area counties lead the California average in booster uptake, but the ratio is still relatively low, ranging from 23 percent to 38 percent of the eligible population. This may contribute to
sharp increase in local cases of COVID
in the last month and
increasing hospitalizations
which further tax a medical system already burdened by outbreaks of influenza and respiratory syncytial virus, or RSV.
“Pandemic fatigue” and confusion
Some pandemic fatigue is “natural, expected and real,” said Marin County Public Health Officer Matt Willis. He noted that the deadline
used since 2020
Perhaps now “we’re getting pandemic fatigue,” Willis said.
After all, the ability to self-regulate “is like a muscle that gets tired,” said Benjamin Rosenberg, a psychology professor at Dominican University in California. “Doing that risk calculation every time you go out is exhausting,” he said.
A
a recent Chronicle survey
found that fewer Bay Area residents are wearing masks to go to the supermarket, despite the ongoing resurgence of COVID. While not a scientific study, the comments offered to reporters — people without masks said they had “surrendered” and wanted to “get on with life” — highlighted the public health challenge of encouraging voluntary compliance.
It’s easier to make healthy decisions when people have clear, reliable and accessible information, and when the decision itself is relatively easy to make, said Stanford professor of medicine Kevin Shulman, who researched marketing campaigns for the initial vaccines in 2021. But in the current pandemic landscape, Shulman said, those attributes are hard to find.
“It’s no longer a scientific endeavor that we all follow every week,” Shulman said.
Indeed, Rosenberg added, other “precious items have replaced COVID at the top of the list of things people want to read about,” whether inflation, layoffs, Ukraine, abortion rights, the Warriors or the weather. And there’s so much bad news that’s healthy to take in: psychologists have actually measured
increase in stress related to news,
according to the American Psychological Association.
“Some people are literally avoiding information about COVID. It’s almost like an “ignorance is bliss” instinct, Rosenberg said.
Diminishing attention reduces cooperation with public health efforts. A study in September found that, for example
half of the American public
has heard “little or nothing” about the bivalent vaccine.
But tepid messaging and the lack of a mass marketing campaign share the blame, Shulman said. “We don’t put nearly as much effort into that as we do into getting people to vote for somebody,” he said, referring to political ads during the midterm elections.
Information is not reaching the people who need it most, added Debbie Toth, CEO of the Pleasant Hill-based nonprofit Choice in Aging. Older people get information mostly from radio and television news, and sometimes from the local newspaper. “I can tell you that older people don’t go to public health websites to look things up,” she said.
Lack of federal funding, mobilization
The White House
has acknowledged the confusion
to somewhere. But it also blamed Congress for not authorizing additional funding to support the coronavirus response.
Meanwhile, the Centers for Disease Control has delegated much of the response to the pandemic to state and local public health departments, which in turn say they are looking to the CDC for guidance, said Stanford Medicine Professor Seema Yasmin, a science communication expert.
“In the middle of this, you have hundreds of millions of Americans saying to themselves, ‘Who’s in charge of what’s going on and what am I supposed to do?'” Yasmin said.
Resources are “really tight” without additional federal funding to set up mass vaccination sites or other major campaigns, said San Francisco Health Officer Susan Phillip.
Programs like the one that sent teams of people into nursing homes to vaccinate the elderly in 2021 have been curtailed or eliminated.
“People with health insurance, with computers, with transportation options can still really choose to get vaccinated or not,” the UC Berkeley herd said.
Some older people and people with disabilities are concerned
The desire to return to “normal” life
may be stronger
among younger people, but they are also at lower risk. More than half of confirmed COVID cases in California are among people ages 18 to 49, according to the latest data from
state COVID-19 dashboard.
Yet Californians over the age of 65 — who make up one-sixth of the population — account for nearly three-quarters of the state’s confirmed deaths.
Another group at increased risk of severe illness and hospitalization are people whose immune systems are compromised. As the masks came off and the safeguards melted away, disabled writer, speaker and model Charisse Hill, who has the inflammatory disease ankylosing spondylitis, went into self-defense isolation.
“The fatigue of a lot of non-disabled people is that they want to travel again,” Hill said. “My fatigue is that I just want autonomy over my own life and daily activities.”
The return to normal ignores that “normal has never been good for people with disabilities,” Hill said.
Some jurisdictions are now moving to restore limited provisions. Last week, the Oakland City Council
reimposed a mask mandate
in community-run buildings after lobbying by groups such as Senior & Disability Action.
Director of Senior & Disability Action Jessica Lehmann despaired of the attitude that COVID is not serious if mostly elderly and disabled people go to hospital and die. It reinforces the idea that “elderly people and people with disabilities are less important, less valued in society,” she said.
But most public health officials remain reluctant to introduce mask mandates. “We’re not going to impose behavior unless there’s a big change in the virus,” such as a more virulent strain that’s highly infectious, Willis said.
Possible solutions
Barring blanket mandates or expensive marketing and incentive campaigns, health experts see ways the general public can be re-engaged to help slow the virus and protect themselves.
“You’re changing the environment to make the healthy choice the easy choice,” said Dr. Sara Cody, Santa Clara County Public Health Officer.
Simple measures can go a long way: offering free masks at the entrance of buildings or offering patients the bivalent vaccine when they visit their doctor or go to the pharmacy to pick up a prescription. The key is to grab their attention “in that fleeting moment” when they’re motivated, said the Dominican Republic’s Rosenberg.
It could also involve rebranding the vaccine: If part of the pandemic fatigue stems from a sense of uncertainty, then “the vaccine itself is actually the medicine because it makes you safer in every way,” said Marin County’s Willis.
Philip, of San Francisco, added, “we need to reinforce the message that … it’s very effective at keeping people out of the hospital.”
Claire Hao is a staff writer for the San Francisco Chronicle. Email: [email protected] Twitter: @clairehao_
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