California is about to feel Delta’s full force

Experts fear hyperlocal outbreaks in communities with low vaccination rates.

Patient sample for COVID-19 test. (Photo by James Gathany for U.S. Centers for Disease Control and Prevention)

By Mark Kreidler

This story is produced by the award-winning journalism nonprofit Capital & Main and co-published here with permission.

The World Health Organization (WHO) calls the Delta variant of COVID-19 the “fastest and fittest,” a term suggesting that this strain of the virus both spreads more rapidly and picks off vulnerable people more efficiently than do its predecessors. California is about to experience Delta’s full force – and the state’s lagging vaccination efforts in low income neighborhoods will once again put those populations at unequal risk.

Late last month, Delta became the dominant variant in the state, according to the California Department of Public Health. Its growth is accelerating rapidly: In the CDPH’s monthly report, the virus accounted for 35.6 percent of all genetically sequenced cases in the state in June, whereas in May that figure stood at just 5.6 percent.

Health officials are quick to note that while all viruses mutate, not all of the mutations become more transmissible and efficient than previous versions, as Delta has. WHO officials last month said that Delta is becoming the dominant strain worldwide. Yale researcher Dr. Perry Wilson added that the variant “will certainly accelerate the pandemic” because of its rapid rate of spread.

For weeks, California has experienced low numbers of virus-related cases, hospitalizations and deaths. Cases are now on the rise, in part because of the state’s much publicized reopening on June 15. And with Delta making up nearly half of all new cases analyzed in Los Angeles County for the week ending June 19, it’s clear that this strain of the virus may ramp up the numbers very quickly.

All of this brings the state back to the issue of vaccination. All three vaccines being used in the U.S. – Pfizer, Moderna and Johnson & Johnson – provide protection against the Delta variant. Last week, Dr. Rochelle Walensky, director of the Centers for Disease Control and Prevention, said fully vaccinated people are safe from Delta and do not need to wear masks indoors, despite recent recommendations to the contrary by Los Angeles County health officials and the WHO.

But California faces the same problem it faced weeks and even months ago: Its vaccination rates lean strongly in favor of higher income communities and white populations, and the state continues to struggle to increase its rates among communities of color and lower income workers.

Moreover, the CDPH’s own reports indicate a systemic failure by government officials, from Gov. Gavin Newsom on down, to reach those communities and workers effectively – the direct result of Newsom’s decision to bypass local health experts in favor of contracts with longtime corporate political supporters, such as Blue Shield.

“The resounding barrier to vaccination has been confusion as a result of inconsistent, contradictory or insufficient messaging from government and public health officials on how to navigate all aspects of life under COVID,” read the department’s report. “People are hesitant and/or unwilling to get vaccinated for multiple reasons.”

According to the latest data compiled by the Kaiser Family Foundation, Latinos in California account for 63 percent of the state’s COVID cases and 48 percent of deaths. But despite making up 39 percent of the state’s population overall, Latinos have received only 29 percent of the vaccines administered so far.

And the figures look worse when overall living conditions are considered. State health officials divide California’s 1,741 ZIP codes into four quartiles, ranking them from the healthiest community conditions to the least healthy. In the state government’s most recent report, 73 percent of those living in the healthiest quartile were fully vaccinated and 82.5 percnt had received at least one shot. In the least healthy quartile, only 49.5 percent were fully vaccinated – and more than 40 percent had not received a single dose. (Statewide, 59.8 percent are fully vaccinated and 69.3 percent have had at least one shot.)

Early previews of these kinds of numbers sent community activists and local clinicians scrambling months ago, especially when it became apparent that Newsom’s administration was going to cut them out of the process. Leaders of the state’s association of 1,370 community clinics pleaded with Newsom in February to direct a share of available vaccines their way, where workers with boots on the ground could reach vulnerable urban populations, rural residents and farmworkers who otherwise might have little access to the medicine.

In June, Newsom’s revised state budget included no funding for the state’s cash-strapped 61 local public health departments, despite a surplus estimated at $75.7 billion. The County Health Executives Association of California responded on Twitter with disbelief, noting that the budget “fails to recognize that lives were lost during the COVID-19 crisis due to longstanding neglect of our public health workforce and infrastructure.”

The state’s My Turn sign-up system for vaccinations was so problematic that people began ignoring it altogether. And Blue Shield’s standing as the state-contracted administrator of doses – deciding who got what, and where – prompted alarmed officials in several counties to opt out of the program and negotiate shipments of doses directly with the state.

The upshot was that California missed its chance to communicate directly and effectively with people living in communities of color and lower income neighborhoods – and thus muffed an opportunity to limit the COVID damage in those areas. A snapshot from last month in Los Angeles County, with overall vaccination numbers on the rise, helps explain the magnitude of the mistake: Calculated over a two-week period, the county’s coronavirus case rates dropped 45 percent for Asian American residents and 33 percent for whites, but just 22 percent for Latinos and 11 percent for Black residents.

Now comes the Delta variant, faster and stronger than those before, and capable of dangerously quick spread. Yale’s Wilson noted that with some neighborhoods now reaching high levels of overall vaccination and thus inoculated against a rapid spread, the virus may well concentrate in areas where rates are still low. This will lead to what the researcher called hyperlocal outbreaks, allowing the virus “to hop, skip and jump from one poorly vaccinated area to another.”

In California, that means extending the misery in neighborhoods and communities already ravaged by the disease. It falls squarely on Newsom and his administration to reinvigorate efforts to reach these vulnerable residents – and they must begin by using the local clinics and health officials who have been begging the governor to let them help.

Copyright 2021 Capital & Main

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