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Dying in Orange County: COVID-19, fentanyl struck lethal blows in recent years

It’s as natural to die as to be born, Francis Bacon once said. Philosopher Lucius Annaeus Seneca described death as the wish of some, the relief of many, and the end of all

We turn to philosophical observation to cushion these grim facts: Deaths in Orange County leaped 20% between 2017 (pre-pandemic) and 2021 (the pandemic’s height), according to data from the Orange County Health Care Agency. And the number of young people in their prime who died accidentally — read, from fentanyl poisoning/overdoses — skyrocketed 100% over that same time period.

Overall, heart disease and cancer remained the No. 1 killers — but for O.C. Hispanics, the demographic term used in the data for Latinos, COVID-19 shoved all other causes of death aside to become the No. 1 killer in both 2020 and 2021. No other group was so ravaged.

“That’s a devastating statistic,” said Cassie Rossel of Families Together of Orange County, a community clinic serving primarily Latino clients. “In Orange County, it’s not a matter of lack of access. We — and all the other community health centers — worked so hard to provide education and information about the COVID vaccines in different languages, in different ways, with mobile units out in the community. It just really is something that might be a cultural preconception, a lack of trust in government, in science perhaps.

“If you look at Orange County and the poverty line, the deaths do line up with the communities that are facing poverty. That’s true not just here, but across the entire country.”

A doctor with Families Together was recently extolling the virtues of vaccination to a patient. “I’ve already had COVID, I’m going to be fine,” the patient said.

FILE - In this July 31, 2020, file photo, Romelia Navarro, 64, holds the hand of her dying husband, Antonio, as nurse Michele Younkin injects the patient with a solution in his final moments in a COVID-19 unit at St. Jude Medical Center in Fullerton, Calif. (AP Photo/Jae C. Hong, File)
In this July 31, 2020, file photo, Romelia Navarro, 64, holds the hand of her dying husband, Antonio, as nurse Michele Younkin injects the patient with a solution in his final moments in a COVID-19 unit at St. Jude Medical Center in Fullerton. (AP Photo/Jae C. Hong)

Killer COVID

In 2017, cancer was the top killer of Latinos, claiming 755 lives.

In 2021, COVID-19 took nearly twice as many, claiming 1,423 lives.

Not coincidentally, Latinos also have the lowest COVID vaccination rates of Orange County’s racial and ethnic groups. Countywide, 73.5% of folks completed the initial series of shots, while only 10.7% have gotten the bivalent booster, which targets two strains of omicron. Among Latinos, only half completed the primary series, with only 5.7% getting the latest booster, according to state statistics.

Why? COVID’s toll on the Latino community is a function of employment networks intersecting with living networks, said UC Irvine epidemiologist Andrew Noymer. Think of multi-generational households where kids attend school, parents work front-line jobs and older grandparents stay home. Kids or parents contract the virus and spread it among family members. Kids and parents recover. Grandparents, often, do not.

“Most of those deaths are going to be in older people. The death demographics are overwhelmingly 85-plus,” Noymer said.

In this March 2021 file photo, registered nurse Hannah Fauni loads a syringe with the single-dose Janssen COVID-19 vaccine by Johnson & Johnson as the Riverside County made the new vaccine available to residents at the former Sears inside the Moreno Valley Mall in Moreno Valley. OnTuesday, April 13, the U.S. recommended that states pause giving the J&J vaccine on Tuesday while authorities examine six reports of the unusual clots, including a death, out of more than 6.8 million Americans given the one-dose vaccination so far. (Photo by Watchara Phomicinda, The Press-Enterprise/SCNG)
Registered nurse Hannah Fauni loads a syringe with COVID vaccine in 2021. (Photo by Watchara Phomicinda, The Press-Enterprise/SCNG)

The lack of enthusiasm for more vaccines is regrettable, but understandable, he said. “People are just sick of COVID, they want it to go away, and they act accordingly. This, combined with poor communication on what they are and why they’re needed — frankly, the CDC has managed communication around these boosters with Neolithic incompetence — it’s not surprising that most people haven’t gotten them.”

People also see that, while shots are quite good at preventing severe disease and death, they don’t work very well to prevent infection — and for a lot of people, that’s a deal-breaker. “They say, ‘Why bother?’” Noymer said. “I think most people try to act in their own self-interest, but the case for the vaccines hasn’t been made strongly enough.”

In the big picture, regional politics may also come into play. Dylan Roby, an associate professor of health, society, and behavior at UCI, worked on an observational study comparing COVID-19 mortality data to county voting behavior in the 2020 presidential election. Counties that overwhelmingly supported former President Donald Trump had nearly 73 additional COVID-related deaths per 100,000 people compared to Democratic counties, and COVID-19 vaccine uptake on its own explained about 10%

“We hope two takeaways are clear: One, that we need enhanced, comprehensive public health approaches that provide multi-pronged policy solutions beyond simply focusing on vaccines. … And two, that vulnerable people living in Republican areas, regardless of their politics, are more likely to die from COVID due to the political beliefs, compliance with public health measures, and health behaviors of their neighbors,” he said on UCI’s Academic Minute.

Killer fentanyl

Accidental deaths for Orange County, ages 18-44 (Data source: OCHCA)
Accidental deaths for Orange County, ages 18-44 (Data source: OCHCA)

At the risk of stating the obvious, death is an age-related phenomenon. Once babies make it to their first birthday, they’re quite hardy and remain so well into late adulthood.

So it’s with consternation that experts note the meteoric rise in O.C. folks lost in the prime of their lives — aged 18 to 44 — in what’s officially called “accidents.”

There were 325 accidental deaths in this age group in 2017. There were precisely double that — 650, or a 100% increase — in 2021.

That’s the work of deadly fentanyl, the cheap synthetic opioid that’s 50 to 100 times more powerful than morphine, experts said. It’s pressed into fake pills that are remarkable look-alikes for prescription Adderall, Oxycodone, Percocet, et al, and are widely available online to anyone seeking a high. The doses are wildly inconsistent, and often deadly.

The size of a penny compared to a lethal dose of fentanyl (Photo courtesy of the Orange County Sheriff's Department).
The size of a penny compared to a lethal dose of fentanyl (Photo courtesy of the Orange County Sheriff’s Department).

But youngsters remain woefully uninformed about fentanyl’s dangers. Less than half of young Americans, and slightly more than a third of teens, were aware that fentanyl is being used to create counterfeit pills, according to new research from the nonprofit Song For Charlie, based in Pasadena.

“(T)here is often significantly less knowledge of the dangers associated with pills than with other powerful substances like cocaine and heroin, and thus misusing prescription medications can be more socially acceptable among young people,” the group said in a summary of the research.

Young folks considered cocaine and heroin considerably more dangerous, even though fake prescription pills containing fentanyl were responsible for the overwhelming majority of overdose deaths.

And hauntingly, about 1 in 10 teens said they’ve used prescription medicine off script, and 1 in 5 young adults have as well, the research found. Nearly half of young people knew someone who has used pills this way, aiming to have fun and relieve stress.

“These findings underscore the importance of accelerating our work to educate young Americans about the dangers of fentapills,” said Ed Ternan, president of Song for Charlie, in a prepared statement. “Like far too many families, we suffered an unspeakable loss because our son didn’t know the pill he was buying was fake and could be deadly. Today, more young Americans understand that danger than they did last year – but millions remain at risk because they don’t understand just how grave the consequences can be of taking a pill purchased from an illegitimate source. We’re grateful to our partners that are getting the word out and we all must do more to arm kids with what they need most: truthful, reliable information.”

Screenshot from "Dead on Arrival," a documentary/public safety announceme nt warning of fentanyl's dangers. Clockwise from top: Amy Neville holding a photo of her son Alexander, who died at 14; Steve Filson with daughter Jessica, who died at 29; Jaime Puerta with son Daniel, who died at 16; and Matt Capelouto with daughter Alexandra, who died at 20.
Screenshot from “Dead on Arrival,” a documentary/public safety announcement warning of fentanyl’s dangers. Clockwise from top: Amy Neville holding a photo of her son Alexander, who died at 14; Steve Filson with daughter Jessica, who died at 29; Jaime Puerta with son Daniel, who died at 16; and Matt Capelouto with daughter Alexandra, who died at 20. www.youtube.com/watch?v=iJgPmrLjkuo

Forward

It’s a little early to make definitive statements about 2022 deaths, OCHCA officials said, given the time it takes for the coroner to complete investigations and toxicology reports for overdose cases.

But overdose deaths are expected to continue their rise this year, while COVID-19 deaths will decline.

Orange County Health Care Agency

So far in 2022, the number of deaths per month appears consistent with 2020 and 2021 — with the exception of those COVID-related spikes in December 2020 and January 2021, officials said.

It takes four to six months to complete toxicology, but preliminary drug overdose data from the coroner — which include some non-residents who died in O.C. — suggest that opioid and fentanyl-related overdose deaths, both accidental and suicide, will indeed be higher in 2022.

Education and outreach, activists say, are key to stemming both tides.

Young Americans would be most receptive to learning about fentanyl through social media, Song for Charlie’s research found, and parents who’ve lost children to the scourge will keep pushing to get the message out every way they can.

Orange County Health Care Agency

And on the COVID-19 front, community organizations like Families Together of Orange County, which has put nearly 57,000 shots in arms, will keep stressing the importance of flu and vaccinations with its patients. UCI’s Noymer expects another COVID-19 wave this winter, but also predicts the death toll will be considerably lighter in 2022.

The first year of the pandemic, 2,707 people in Orange County died from COVID, according to state data. Last year, there were 3,338 deaths. So far this year, there have been 1,496 deaths. Heart disease and cancer will continue to top the killer list, and COVID may surrender its third-place spot.

Until all those numbers are crunched, experts urge you to eat well, exercise, and keep current on your vaccinations. “We all die,” author Chuck Palahniuk said. “The goal isn’t to live forever, the goal is to create something that will.”

After all, as Jim Morrison noted, “No one here gets out alive.”


Source: Orange County Register

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