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. 

A woman walks her dog at Lindo Lake on Dec. 10, 2022.
A woman walks her dog at Lindo Lake in Lakeside on Dec. 10, 2022. / Photo by Ariana Drehsler

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. 

A Covid-19 vaccine sign can be seen in front of Leo's Lakeside Pharmacy on Dec. 10, 2022.
A Covid-19 vaccine sign can be seen in front of Leo’s Lakeside Pharmacy on Dec. 10, 2022. / Photo by Ariana Drehsler

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. 

Janet Keating holds a framed photo of her and husband Patrick at her home in Lakeside on Dec. 10, 2022.
Janet Keating holds a framed photo of her and husband Patrick at her home in Lakeside on Dec. 10, 2022. / Photo by Ariana Drehsler

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. 

Janet Keating at her home in Lakeside on Dec. 10, 2022.
Janet Keating at her home in Lakeside on Dec. 10, 2022. / Photo by Ariana Drehsler

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 or

Jesse Marx is a former Voice of San Diego associate editor.

Will Huntsberry is a senior investigative reporter at Voice of San Diego. He can be reached by email or phone at or 619-693-6249.

Join the Conversation


  1. There is an old saying that applies to these people,

    “You can educate ignorance, but there is no cure for stupid.”

    There are however consequences.

  2. Another fat person died of covid. If you are fat and over 75. You should be staying home. I had my life limited to protect the sick and fat people. Start working out. Lose some weight then covid will not attack your weak body.
    Mike Johnson
    South Mission Beach

    1. Such a cruel, selfish and ignorant comment. And not so ironically confirming a point of the article.

  3. I wish articles like this would have a more complete set of statistics. If I have my math correct, with Lakeside having about 21,000, the number of dead in 2021 was around 11 and in 2022 was around 26. That is such a terrible. But saying the totals seems more appropriate to the situation than saying that the death rate increased by 144%. Hard to know what were talking about specifically.

  4. No one is really surprised by this, are they? Lakeside and east county are solid republican and MAGA headquarters in San Diego county. They’re vehemently opposed to mask mandates and vaccinations.

    1. Masks do absolutely nothing to stop spreading of viruses just like in 1918. Masks block oxygen to your lungs and harbor bacteria. Masks make you sick. Stop believing this hate from Democrats and the media.

    2. I live in Lakeside. The local residents are among some of the stupidest, uneducated, willfully and proudly ignorant people I have ever seen.

      The Eastbound Grill, during the period discussed, willfully violated local restaurant guidelines and became a major “server” of Covid in the area. I believe it was cited for several violations, but never had to comply or pay any fines for their repeated violations.

    3. This is a lie. While some are opposed to vaccine mandates, the vast majority of people support vaccination programs. Mask mandates are dangerous which is why they are opposed by some. They provide little if any protection from a respiratory virus and provide only a false sense of protection since many people don’t wear the masks correctly and consistently. Being skeptical of 1 particular vaccine doesn’t make one an anti-vaxxer.

  5. Reviewing the links provided shows many other zip codes had lower vaccination rates and lower death rates so the Lakeside anomaly must have something else that’s creating these results. Homeless population? Trailer parks? Some other socio-economic reason? Keep digging, it’s not so simple as a 55% vaccine rate.

Leave a comment
We expect all commenters to be constructive and civil. We reserve the right to delete comments without explanation. You are welcome to flag comments to us. You are welcome to submit an opinion piece for our editors to review.

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.