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California COVID deaths top 100,000. Here’s how it got there

It took three years and an unending amount of heartache and turmoil for the Golden State to cross a grim milestone this month: More than 100,000 Californians have died from COVID-19.

Consider whether the combined populations of Los Gatos, Menlo Park, and Pleasant Hill disappeared in the space of three years.

While it’s unclear when and where the virus claimed its 100,000th victim in California in recent weeks, the number was officially announced on Thursday with the latest release of data with which we have become intimate since the beginning of the pandemic:

Total number of COVID cases: 11,105,535.

Total dead: 100,187.

The somber reminder of the deadly impact of the virus comes as California prepares to close the book on the pandemic emergency, even as COVID is still responsible for the deaths of about 150 Californians each week. But three years into the pandemic, strong therapies, our immunity to previous infections and the power of vaccines that blunt serious illness have reduced the death toll from its peak of about 600 a day in January 2021.

The country’s most populous state is the first to cross the 100,000 COVID death mark, but it is far from suffering the blemish of the United States’ highest death rate. Thirty-nine states had higher rates than the Golden State, which benefited from this aggressive public health mandates and high vaccination rates.

If the US had California’s death rate, about 282,000 fewer people would have died.

But even here those deaths, and the resulting grief, are concentrated in some provinces and regions, while others have been nearly spared.

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California’s smallest county, Alpine, with a population of just over 1,000, has yet to record any official COVID deaths — but that doesn’t tell the whole story. Nestled in the Sierra Nevada mountains just south of Lake Tahoe, Alpine has no health care. So at least two Alpine residents who died of COVID were recorded as Nevada deaths because they died in a hospital on the other side of the state line, county public health officer Richard Johnson said.

Other rural counties were beaten by COVID deaths. On the southern edge of the state in Imperial County, on the border with Mexico, the death rate from the virus is more than double the statewide rate, and four times higher than that of the Bay Area.

“That’s been the theme of the pandemic,” said Dr. John Swartzberg, clinical professor emeritus of infectious diseases and vaccinology at UC Berkeley’s School of Public Health. “The Bay Area has done better than California. California has done better than the United States.”

With some of the state’s most far-reaching mandates and a public that has largely followed suit, each of the Bay Area counties has outperformed the state as a whole, which has seen about 250 COVID deaths per 100,000 residents over the past three years. San Mateo County has the lowest death rate in the region, with only 96 deaths per 100,000. The highest is in Santa Clara County at 137, still well below the state average.

The country’s death rate is around 350, according to data from the Centers for Disease Control and Prevention.

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In all, the six-county Bay Area’s total death rate is 128, just over a third of the rate in Los Angeles, the state’s most populous county, which has recorded 35,000 COVID deaths. Los Angeles County has the fourth highest COVID death rate of any county in California at this time of the pandemic.

As California moves forward, it’s often difficult to put into perspective the devastation COVID has wrought in three years. For example, cancer is responsible for the deaths of about 50,000 Californians each year. Alzheimer’s disease kills about 16,000.

“The national flu death rate is about 10 deaths per (100,000 population) per year, and a severe flu season is about 15,” Dr. Erica Pan, the California State Epidemiologist and director of the California Department of Public Health’s Center of Infectious Disease, said in a public forum earlier this month. “You can see how dramatically higher COVID-19 is.”

Swartzberg recalls the start of the pandemic when estimates of COVID lethality varied wildly.

“People wondered if the death rate was 3 percent,” he said of estimates at the start of the pandemic, when scenes of refrigerated trucks outside New York City hospitals became common. The death rate is now just under 1 percent.

But health inequalities — obesity, diabetes, chronic lung disease, access to health care, among others — are a major factor in why some regions of the state, such as Imperial County, have been hit harder than regions like the Bay Area, Swartzberg said.

As the state softens its pandemic focus, some experts believe this trend will continue.

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