As COVID makes another winter comeback, many Californians don’t seem to care

Since the advent of vaccines and better treatments for COVID-19 — and the lifting of draconian government measures such as mask mandates — public access
coronavirus
has become
more laissez-faire.
Some call this approach
“figure it out for yourself”
pandemic era. But individual choices still take a heavy toll on vulnerable populations, such as the elderly and immunocompromised, some of whom are retreating from the public eye again.

Widespread apathy toward the latest surge is exacerbated by considerable confusion about how to handle this phase 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 put into distribution, many Americans are unaware of the benefits of the enhancer, or even of its existence.

“The situation is that people are left to make decisions as individuals,” said Denise Herd, a professor of behavioral sciences at UC 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 serious illness. Application in California is greater than
national average 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 approved for California residents
older than 6 months,

depending on
when someone completed the initial two-dose series and when they last received the older “monovalent” booster.

Bay Area counties lead the California average in vaccination uptake, but the share is still relatively low, ranging from 23% to 38% of the eligible population. It can contribute
sudden increase in local cases of COVID
in the past month and
increasing number of hospitalizations
which further burden a medical system already burdened by outbreaks of influenza and respiratory syncytial virus, or RSV.

‘Pandemic fatigue fatigue’ and confusion

Some pandemic fatigue is “natural, expected and real,” said Marin County Public Health Officer Matt Willis. He noted that the appointment
used since 2020.
Maybe 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. “It’s exhausting doing that risk calculation every time you go out,” he said.

AND
recent research by the Chronicle
found that fewer Bay Bay residents are wearing masks to go to the supermarket, despite the current resurgence of COVID. While not a scientific study, the comments offered to reporters — people without masks said they had “given up” and wanted to “get on with life” — highlighted the public health challenge of encouraging voluntary adherence.

It’s easier to make healthy decisions when people have clear, credible and accessible information, and the decision itself is relatively easy to make, said Stanford medicine professor Kevin Schulman, who researched marketing campaigns for the initial vaccines in 2021. But in the current pandemic landscape, he said is Schulman, those attributes are hard to find.

“This is no longer a scientific endeavor that we all follow every week,” Schulman said.

Indeed, Rosenberg added, other “very worthwhile items have replaced COVID at the top of the list of things people want to read about,” whether it’s inflation, layoffs, Ukraine, abortion rights, the Warriors or the weather. And there’s only so much bad news it’s healthy to absorb: Psychologists have actually measured it
an increase in news-related stress,
according to the American Psychological Association.

“Some people literally turn away from information about COVID. It’s almost like an ‘ignorance is bliss’ instinct,” Rosenberg said.

Declining attention reduces cooperation with public health efforts. The September survey showed, for example, that
half of the American public
heard “little or nothing” about the bivalent vaccine.

But tepid messaging and the lack of a massive marketing campaign share the blame, Schulman said. “We don’t put nearly as much effort into this 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, executive director of the Pleasant Hill-based nonprofit Choice in Aging. Older people get their information mainly from radio and television news, and sometimes from local newspapers. “I can tell you that older adults are not going to public health websites to look things up,” she said.

Lack of federal funds, mobilization

White House
admitted the confusion
to some extent. But she also blamed Congress for not approving additional funding to support the coronavirus response.

Meanwhile, the Centers for Disease Control has delegated much of the pandemic response 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 midst of that, you have hundreds of millions of Americans thinking, ‘Who is in charge of what’s going on and what am I supposed to do?'” Yasmin said.

Resources are “really limited,” with no additional federal funding to organize mass vaccination sites or other large-scale campaigns, San Francisco Health Officer Susan Philip said.

Programs like those that sent teams of people into nursing homes to vaccinate the elderly in 2021 have been limited or eliminated.

“People with health insurance, with computers, with transportation options can still really decide whether or not to get vaccinated,” UC Berkeley’s Herd said.

Some elderly people and people with disabilities worried

The need to return to “normal” life
can 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
the state’s COVID-19 dashboard.
Yet Californians over age 65 — who make up one-sixth of the population — account for nearly three-quarters of the state’s confirmed deaths.

Another group with an increased risk of serious illness and hospitalization are people whose immune system is compromised. As the masks come off and precautions melt away, disabled writer, speaker and model Charis Hill, who has the inflammatory disease ankylosing spondylitis, has gone into self-isolation for self-protection.

“The fatigue of many 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 life activities.”

The return to normal ignores that “normal has never been good for people with disabilities,” Hill said.

Some jurisdictions are now moving to reinstate limited regulations. Last week, the Oakland City Council
reimposed the mask mandate
inside public buildings after lobbying by groups such as Senior & Disability Action.

Director of Senior & Disability Action Jessica Lehman despairs at the mindset that COVID is not serious if mostly elderly and disabled people go to the hospital and die. This reinforces the idea that “older people and people with disabilities are less important, less valued in society,” she said.

But most public health officials remain hesitant to impose mask-wearing mandates. “We’re not going to mandate behaviors unless there’s a major change in the virus,” such as a more virulent strain that’s highly contagious, Willis said.

Possible solutions

Without sweeping mandates or expensive marketing and incentive campaigns, health experts are seeing ways the public can re-engage in slowing the virus and protecting 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 to buildings or suggesting patients get the bivalent vaccine when they visit a doctor or go to a pharmacy to pick up a prescription. The key is to get their attention “in the fleeting moment” when they become motivated, Dominican Rosenberg said.

It may also involve rebranding a vaccine: If part of pandemic fatigue stems from a sense of uncertainty, then “the vaccine itself is actually medicine because it makes you safer in every way,” said Marin County’s Willis.

Added Philip, of San Francisco, “we need to reinforce the message that … it’s very effective at keeping people out of the hospital.”

Claire Hao is an editor at the San Francisco Chronicle. Email: [email protected] Twitter: @clairehao_