The Bay Area was a collaborative model during the early years of the COVID pandemic, where residents were protected on-site, queuing for vaccines and wearing masks in public. While sanitary measures were politicized in other parts of the country, many locals stared in amazement.
However, vigilance did not continue even in this conscientious area. As another winter COVID surge swept the region, large numbers of people are forgetting masks and skipping the latest booster, a vital tool in preventing serious illness due to reduced immunity from previous vaccines or infection.
Since the advent of vaccines and better COVID treatments and the removal of strict government measures such as mask requirement, the public’s approach to the coronavirus has become more laissez-faire. Some call this approach the “fix it yourself” period of the pandemic. But individual choices still take a heavy toll on vulnerable populations such as the elderly and immunocompromised, and some of them are again withdrawing from the square.
Growing widespread disinterest in the latest volatility is significant confusion about how to act at this stage of the crisis. In particular, the launch of the new bivalent vaccine booster, which is the first vaccine to target both the original coronavirus and the omicron variant family, is lukewarm, experts say. Without a strong marketing push and government resources deployed, many Americans are unaware of the benefits, or even existence, of the booster.
“The thing is, people are left to decide individually,” said Denise Herd, UC Berkeley professor of behavioral sciences in the 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 to do now.”
To date, only 20.5% of eligible Californians have received the bivalent vaccine, leaving the majority more vulnerable to serious illness. California’s intake is above the national average of 14.6%, but still only a fraction of 72.5% of people who receive their first two-dose series of vaccines. The bivalent vaccine is approved for Californians older than 6 months, based on when the person completed their first two-dose series and the last time they received the old “monovalent” booster vaccine.
Bay Area counties lead the California average in supplement intake, but the rate is still relatively low, ranging from 23% to 38% of the eligible population. This may be contributing to the sharp increase in local COVID cases last month and increased hospitalizations that further strain a medical system already strained by flu and respiratory syncytial virus or RSV outbreaks.
“Pandemic fatigue malaise” and confusion
Marin County public health officer Matt Willis said some fatigue due to the pandemic was “natural, expected and real”. Willis noted that the term has been used since 2020. Maybe now, “we’re getting epidemic fatigue fatigue,” Willis said.
After all, the ability to self-regulate is “like a tired muscle,” said Benjamin Rosenberg, a psychology professor at the Dominican University of California. “It’s exhausting to do this risk calculation every time you go out,” he said.
A recent Chronicle study found that despite the current COVID resurgence, fewer Bay Area residents are wearing masks to go to the supermarket. While not a scientific study, the comments made available to reporters—unmasked people said they “give up” and want to “get on with life”—underlined how difficult it is for public health to promote voluntary compliance.
Kevin Schulman, Professor of Stanford medicine, who is researching marketing campaigns for the first vaccines in 2021, said it is relatively easy for people to make sound decisions and make decisions when they have clear, reliable and accessible information. The epidemic landscape, Schulman said, said these features are hard to find.
“This is no longer a scientific initiative that we all follow every week,” Schulman said.
Indeed, Rosenberg added “other important items that replace COVID at the top of the list of things people want to read”, such as inflation, layoffs, Ukraine, abortion rights, Warriors, or the weather. And there’s a lot of bad news that’s healthy to digest: psychologists have actually measured an increase in news-related stress, according to the American Psychological Association.
“Some people literally turn their backs on information about COVID. It’s almost like a ‘ignorance is bliss’ instinct,” Rosenberg said.
Declining attention is reducing collaboration with public health efforts. For example, a September survey found that half of the American public “heard little or nothing” about the bivalent vaccine.
But Schulman said moderate messaging and the lack of a mass marketing campaign share the blame. “We don’t put as much effort into it as we do in getting people to vote for someone,” he said, referring to political advertisements during the midterm elections.
Debbie Toth, CEO of the Pleasant Hill-based nonprofit Election Aging, added that the information isn’t reaching the people who need it most. Older people get their information mostly from radio and television news and sometimes from local newspapers. “I can tell you that older adults don’t go to public health websites to look for things,” she said.
Lack of federal funds, mobilization
The White House acknowledged some degree of confusion. But he also accused Congress of failing to authorize additional funding to support the coronavirus response.
Meanwhile, Stanford medical professor Seema Yasmin, a science communications specialist, said the Centers for Disease Control has delegated most of the pandemic response to state and local public health departments, who are also looking to the CDC for guidance.
“In the midst of this, ‘Who is responsible for what happened and what should I do?'” Yasmin said. There are hundreds of millions of Americans who say so.” said.
San Francisco Health Officer Susan Philip said resources are “really limited” as there is no additional federal funding for mass vaccination sites or other major campaigns.
Programs such as those that send teams to nursing homes to vaccinate the elderly in 2021 have been restricted or removed.
“The ones who can still really choose whether or not to get vaccinated are people with health insurance, computers, and transportation options,” said Herd of UC Berkeley.
Some related elderly and disabled people
The urge to return to “normal” life may be stronger among younger people, but they are also at lower risk. According to the latest data from the state COVID-19 dashboard, more than half of confirmed COVID cases in California are between the ages of 18 and 49. Still, Californians older than 65, who make up one-sixth of the population, account for about three-quarters of confirmed deaths in the state.
Another group at high risk of serious illness and hospitalization are people with compromised immune systems. As masks fall and precautions melt away, disabled writer, speaker and model Charis Hill, a patient with ankylosing spondylitis (inflammatory disease), went into isolation to protect herself.
“The fatigue of so many people without a disability is that they want to travel again,” Hill said. “My fatigue, I just want autonomy over my own life and activities of daily living.”
Hill said the return to normal ignores that “normal is never good for people with disabilities.”
Some jurisdictions are now taking action to reinstate limited regulations. Last week, the Oakland City Council reinstated the requirement to wear masks in public buildings after lobbying by groups such as the Senior and Disabled Movement.
Senior & Disability Action director Jessica Lehman has given up on the mentality that COVID isn’t serious if mostly elderly and disabled people go to the hospital and die. She reinforces the idea that “the elderly and disabled are less important and valued less in society.”
But most public health officials remain reluctant to enact mask instructions. “We will not enforce the behavior unless there is a major change in the virus, a more virulent and highly contagious strain,” Willis said.
Possible solutions
With a lack of overarching mandates or expensive marketing and promotion campaigns, healthcare professionals are seeing ways to re-engage the general public in helping to slow the virus and protect themselves.
Santa Clara County public health officer Dr. “You’re changing the environment to make the healthy choice the easy choice,” said Sara Cody.
Simple measures can go a long way: offering free masks at the entrance of buildings or advising patients to get the bivalent vaccine when they visit their doctor or go to the pharmacy for a prescription. Rosenberg, of Dominican, said the key is to get their attention “at a momentary moment” when they are motivated.
It may also involve rebranding the vaccine: If some of the pandemic fatigue is due to a sense of uncertainty, then Marin County’s Willis said, “actually, the vaccine itself is the cure because it makes you safer in every way.”
San Francisco’s Philip added that “we need to reinforce the message that it is very effective in keeping people out of the hospital.”
Claire Hao is a San Francisco Chronicle author. Email: [email protected] Twitter: @clairehao_
