This story is part of our reporting series, “Covid Year Two: After the Vaccine.” See the full series here.
Michael Arthur Jackson and his aunt Teri were living in a mobile home park that overlooks Lakeside when the highly contagious Omicron variant of Covid-19 hit San Diego County in late 2021.
Both Michael and Teri came down with the virus and required hospitalization. Teri walked free a few days later. Michael spent the remaining two months of his life in isolation, hooked up to a ventilator as his respiratory system began to fail.
Because of his underlying health conditions — he suffered from asthma and diabetes — Michael was especially vulnerable to the virus. But he declined to take the vaccine. Teri chose to go ahead with it.
Michael, who designed and sold his own clothing, had a number of allergies. He concluded that he’d already built up an immunity to Covid and that the vaccine posed the real danger to his body.
“He believed all that talk on the radio and all this ‘don’t do it blah, blah, blah, you don’t need it, it’s probably got something bad in it,’ and he actually fell for that,” said Jo Alix, his mother. “I tried to convince him [to get the shot] and it just didn’t work.”
Michael was 47 when he died in January.
In the pandemic’s second year, even as vaccines became widely available, a confusing pattern emerged in Lakeside. The Covid-related death rate more than doubled there, even though it dropped in almost every other ZIP code in San Diego County. The rate of Covid-related death rose from 55 per 100,000 residents in the first year of the pandemic, when there was no vaccine available to blunt the virus’s toll, to 134 per 100,000 residents in the pandemic’s second year, a new analysis by Voice of San Diego finds.
Lakeside, a small town in the shadow of Cuyamaca Mountains, went from having the 62nd highest death rate in year one to having the highest death rate of any ZIP code in the county in the pandemic’s second year.
Death rates increased in six other ZIP codes, but nowhere was the increase as acute as Lakeside. Several nearby areas — Ramona, Santee and a ZIP code south of Mission Trails — experienced the next highest increases, creating a cluster in eastern San Diego County in which the virus actually became more deadly while death rates were plummeting everywhere else.
One conspicuous detail sticks out among these four ZIP codes: They have some of the lowest Covid vaccination rates in the county, according to state health data. The areas, demographically, also have higher concentrations of White people than the rest of the region.
Just 55 percent of people in Lakeside have received two Covid vaccination shots. The median for all ZIP codes across San Diego County is 73 percent.
Troy Foley is a property manager at a Lakeside apartment complex where three people died during the second year of the pandemic. He began locking the screen door to the leasing office — keeping residents on the other side — to protect himself and staff during surges, he said. Still, he was surprised to learn about the rise in Covid-related deaths. He attributed it to changing behaviors over the pandemic, as the sense of urgency faded.
“I think people got their guard down,” he said.
Ryn Corbeil, a retired software engineer and part-time librarian who volunteers with a social justice group, wasn’t so shocked.
He stressed that there are plenty of people in Lakeside who took the pandemic seriously, but conceded that his own progressive views are in the minority. He recalled an incident outside a shopping center where someone yelled at him from across the parking lot to take his mask off.
To a person like that, Corbeil said, wearing a mask in public “was sending the wrong message. It was showing fear.”
Other locals reacted to Voice’s analysis with shrugs and skepticism, expressing a disbelief that the numbers could even be correct because they don’t know anyone personally who died. Some argued that the medical establishment must be exaggerating the seriousness of Covid for financial gain by citing the virus when someone died of another ailment.
But the one question no one really answered: Why did Covid deaths go up in Lakeside while going down virtually everywhere else?
“I’m an anti-vaxxer myself,” said one woman, as she got out of her car to begin a walk around Lindo Lake downtown. She recently tested positive for Covid, she said, and was wearing the mask for the sake of her friend, who she was about to meet.
“Maybe the vaccine helped some people, older people,” she said. “But I see younger people dying now and I think it’s the vaccine that’s killing them.”
Younger people are, in fact, dying in larger portions as the pandemic progresses, but public health professionals have said vaccines are not the problem — quite the opposite. Instead, they point to lower vaccination rates among the non-elderly, the reopening of society, and disruptions in the healthcare industry that forced some to avoid or delay care.
Officials for the San Diego County public health department made well-publicized efforts to boost vaccine uptake in areas where Covid death rates had been highest during the first year of the pandemic, most notably in South Bay. Epidemiologists said those efforts likely played a role in Covid death rates narrowing between racial groups during the second year, as Voice previously reported.
Officials also created several programs that targeted more rural areas out east, said spokesman Michael Workman. Firefighters ran pop-up vaccine sites in some rural areas and county health officials ran a “long-term vaccination site” at Lindo Lake itself, he said.
Greg Winter is a doctor who signed dozens of Covid-related death certificates, including seven in Lakeside. Winter conceded, when presented with some of the claims of anti-vaxxers, that determining Covid’s role in a person’s death required some subjectivity. He tended to cite the virus as not an immediate cause of death, but a significant contributing condition — essentially the thing that weakened a body’s defenses and set the stage for its demise.
Even that was too much for some. Winter recalled families who got upset at him for putting Covid-19 anywhere on the paperwork.
“Just because it’s on the death certificate doesn’t mean people are going to acknowledge it,” he said.
Janet Keating is among them.
Both she and her husband Patrick drove trucks for a living, hauling hazardous waste locally. She described him as funny and opinionated, a news hound who in his spare time liked to gamble at Sycuan Casino.
Though Janet was admittedly freaked out when Covid-19 hit the United States, her opinion began to change in the face of conflicting information from government officials about face coverings. She came to believe that the virus was being blown out of proportion to undermine the re-election of President Donald Trump.
Her and Patrick’s decision not to get vaccinated — even though he was obese and on blood pressure medication and therefore vulnerable — put them at odds with other family members.
He went to bed one night in their Lakeside apartment complaining of a cold. She, too, had had a sore throat the day before. Patrick made a snorting noise around 6 a.m. and didn’t exhale, Janet said. She thought he was only snoring. She pushed him and found no resistance.
He never woke up.
Looking back almost a year later, Janet is unfazed by their refusal to get vaccinated — even as she continues to mourn his passing. Instead, she’s troubled by something else. Patrick was diagnosed with sleep apnea and relied on a CPAP. The machine pumps pressurized air into the lungs through a mask, but he didn’t wear it that night.
“If he had used it,” she said, choking back tears, “would he still be around?”
Janet also recalled that medical professionals had warned Patrick about something concerning they’d seen on his chest x-ray during a recent exam required for his truck driver certification. He’d scheduled an appointment to have it checked out but died at age 49 before he could see a doctor.
Bolstered by the fact that no autopsy was performed, Janet is convinced, despite what the death certificate says, that Patrick’s heavy smoking caused his heart to simply shut down. She would be open to Covid as a cause of death, she said, if it all hadn’t been so sudden.
As the body was being examined, another thought went through her mind.
“If Pat is listed as a Covid statistic, he’s gonna be pissed,” she remembered. “And sure enough, he was.”
This series is supported by the Data-Driven Reporting Project. To request access to our data for research or reporting purposes email firstname.lastname@example.org or email@example.com.