Disasters' Great Divide: How COVID divided Sonoma County's health
Editor’s note: Chase Hunter’s reporting on environmental health inequity was funded for the Index-Tribune by a USC Annenberg Center for Health Journalism 2023 California Health Equity Impact Fund Grant. This is the third in a three-part series.
Going back to normal after the pandemic was never an option, especially for the families who still feel its effects.
As the tide of the virus and COVID regulations has faded over the past year, residents have been left to grapple with its enduring trials -- some more than others.
“It was clear that there were vulnerable populations that are a reflection of structural racism, structural inequities that had been there for probably a couple of centuries,” Tim Gieseke said, a former medical director of the Santa Rosa senior living facility Springs Lake Village, who came out of retirement to research COVID-19. “Those on the bottom end, who are working multiple jobs, were the ones that were most affected by COVID.”
While many have adapted to the changes wrought by the pandemic — normalized nasal plunging for COVID tests and work from home — many of its longterm harms remain, magnifying the inequities that plague Sonoma County.
In housing, overcrowded homes struggled to quarantine family members and recorded higher infection rates. In education, low-income children fell further behind than their peers. Meanwhile, the mental health care system has been taxed by burnout and turnover just as the needs of the community began to skyrocket.
“There's always been natural disasters. But the pandemic added on to that,” Karin Sellite said, a Sonoma County client care manager who coordinates mental health resources and provides behavioral health services. “That's a unique experience that we haven't really had to deal with, and I think that has very disproportionately impacted kids... Over time, we may see that natural disasters are creating some specific mental health reactions that we hadn't anticipated, in addition to PTSD and trauma and grief.”
When Sonoma County entered the COVID-19 state of emergency in March 2020, it was the fourth time the county called for a federal state of emergency since 2017 in a region known for wildfires, flooding and public safety power shut-offs. The direct impacts, such as hospitalizations, and the indirect effects, like school lockdowns, have receded but continue to cast a long, cold shadow.
“It exposed that for years public health was almost nonexistent,” Gieseke said. “Now, the resources are going away, maybe too quickly in some sense of the word, but that's how life moves. We are a crisis-oriented culture.”
While infection from the coronavirus was unprejudiced, the opportunity for infection was not, Gieseke said. This made the pandemic comparable to a “natural experiment” by public health researchers, demonstrating how a virus moves across the spectrum of income and race.
“Unfortunately, you can say it's a great experiment, but you can also say it's like setting up a nuclear bomb because it's so complicated,” Gieseke said.
Virus spreads through cramped housing
As Sonoma County health officers advocated for protections like masking and social distancing in the spring of 2020, packed low-income households in places like Boyes Hot Springs, where multiple people can share a bedroom, questioned what to do.
“They wanted to protect other (household) members, especially if there were grandparents in the house. They were really concerned about spreading the virus,” Providence Memorial Mobile Health Clinic nurse practitioner Jennifer Eid Ammons said.
But residents faced a Catch-22, she said: “Do you isolate the grandparents, or do you isolate the person with COVID?”
A national look at COVID shows a pandemic of the poor. In April 2022, The Poor People’s Campaign, an advocacy group against income inequality, released a study analyzing the influence of wealth on COVID-19 deaths, separated by county.
“While vaccines will prevent the worst impacts of COVID-19, they will not inoculate against poverty,” the report concluded.
“In early summer, Latinos accounted for as much as 77% of all COVID-19 cases, though they only comprise about a quarter of the county’s population,” The Press Democrat reported in October 2020. The article followed a state mandate to reduce the impact on minorities and disadvantaged communities — Sonoma was one of four Bay Area counties called out for its inequitable handling of COVID.