And they're still trying to figure out where the monster goes and what it does when it gets there.
Peggy Rampersad believed everyone should have a signature style, and hers included red lipstick and circular black-rimmed eyeglasses.
A retired sociologist and academic, she loved art, opera, dancing and music. When she lost her hair from chemotherapy after one of her three bouts with cancer, she grew a faux-hawk and tipped it blonde. When she lost her eyesight from macular degeneration, she started going to her local gym and attending fitness classes for seniors three times a week.
“Every decade she reinvented herself,” said Gita Rampersad, Peggy’s daughter. “I really admired that.”
Gita moved to Fredericksburg, Virginia, at the start of the pandemic in early 2020 to be with her 87-year-old mother. Although Peggy had been in and out of hospitals for other health issues, it wasn’t until she tested positive for Covid-19 in early 2022 that things took a turn for the worse. Peggy and her daughter were both vaccinated and boosted, and practiced social distancing.
Fewer than 40 percent of people are vaccinated against Covid in Fredericksburg, CDC data shows, and as the omicron variant swept through the city, Gita said the hospital her mother was in was packed with Covid patients.
“The waiting room was full. There were no rooms in the E.R.,” she said. “People were waiting up to 36 hours in the E.R. to get a bed. Covid was on every floor.”
Gita hoped her mother would get better, that this trip to the hospital would be like the others. But Peggy developed a rash on her leg, and it turned into sepsis, a common complication of severe Covid. Her vital signs continued declining, and she died on Jan. 20, a week after her 89th birthday.
“Nobody’s safe,” Gita said. “You can do everything that you think is right and still get it.”
Peggy Rampersad was one of the more than 125,000 people who died of Covid-19 as the omicron variant drove up case numbers in January and February, according to NBC News’ tally. Health officials determined that the omicron Covid variant caused less serious illness than previous variants, but what the virus lacked in severity it made up for in sheer contagiousness.
Deaths spiked during January, and 10 days after Peggy’s death came the deadliest week of the omicron wave.
Deadly toll in the South
No week of the omicron wave saw more deaths than the week of Jan. 30 to Feb. 5. More than 18,400 deaths were recorded, according to NBC News’ tally, more deaths in a single week than in all of June and July 2021 combined. The death toll — which occurred two weeks after cases peaked across the United States — made the week the deadliest thus far of 2022 and one of the deadliest weeks of the pandemic.
An NBC News analysis of Covid data for the week found:
Older adults were the majority of Covid fatalities among all Americans.
Middle-aged adults were the majority of Black Covid deaths.
Covid deaths occurred across the country, but deaths rates in the South and Southeastern U.S. outpaced other parts of the country.
Older people and unvaccinated people made up the vast majority of fatalities during the week. Data from the Department of Health and Human Services shows that almost 80 percent of deaths during the week of Jan. 30 were adults aged 65 and older, and HHS data for the first four weeks of January also showed that each week unvaccinated people died at a rate 8 to 10 times higher than that of vaccinated people when adjusted for age and population.
But HHS data also shows a racial disparity between Black Covid victims and the general population, with middle-aged people making the highest share of Black victims.
U.S. counties saw an average of four Covid deaths out of every 100,000 people during that week. But an NBC News analysis of data from the Johns Hopkins Coronavirus Research Center found several counties in the South and Southeast where the death rate was significantly higher, including several counties in northern Mississippi and western Virginia.
Pittsylvania County, Virginia, 300 miles southwest of Fredericksburg, was one such place where Covid deaths surged.
Krysta Luzynski, a district epidemiologist at the Virginia Department of Health, told NBC News in an email that the department had expected an increase in cases following the holiday season. Officials hoped the severity of the surge would be blunted by rising vaccinations, but the cutback in indoor capacity restrictions and other mitigation measures made predictions difficult.
“Unfortunately, the Pittsylvania-Danville Health District did see a large surge, particularly as Omicron swept through rural Southern Virginia,” Luzynski wrote. “As with all of the other surges we have experienced, our staff worked long hours, evenings and weekends to meet the needs of the community.”
Covid surged through the county, sending the death rate to 26 per 100,000 people during the week of Jan. 30, more than six times the country’s average.
Dr. Robert Wachter, the chair of the Department of Medicine at the University of California, San Francisco’s School of Medicine, said that the omicron wave was complex. It wasn’t drastically less severe than previous variants, but it was far more contagious. It hit almost a year into the vaccination effort, when more than 80 percent of adults had received at least one vaccine dose. But it arrived early in the booster dose effort, when immunity began to wane in those who received the earliest doses.
And while large portions of the country weren’t vaccinated, Wachter said those that recovered from infection during the summer’s delta wave probably had some natural immunity against serious illness.
But at the same time, a public tired from almost two years of masking and social distancing had begun to relax on those important measures, Wachter said.
“More people were burned out,” Wachter said. “More politicians were exhausted. If omicron hit a year earlier, it would have been taken as a more serious threat and would have been grounds for putting up our guard.”
“People latched on to the word milder. Even if it’s a little bit milder, you still end up at a pretty bad place.”
The omicron wave, like each previous wave, was so deadly to older adults because they mount a less effective immune response, said Dr. Justin Feldman, research associate at the Harvard T.H. Chan School of Public Health’s FXB Center. Older adults also tend to already have serious health conditions, like diabetes, high blood pressure or histories of cancer, leaving them more vulnerable to serious illness.
But Feldman noted that data from the Centers for Disease Control and Prevention on excessive mortality from Covid showed death rates have skyrocketed during the pandemic.
“We’re at way higher levels of mortality than we would expect,” Feldman said.
Omicron hits the vaccinated
From the time Covid vaccines became available to all adults in April 2021, there has been a strong relationship between vaccination rates and Covid surges, with bigger case surges in areas with lower vaccination rates. But omicron was different, experts said, with Covid cases rising even in highly vaccinated regions.
Though significantly less common, omicron still killed vaccinated people. Peter Colbert, 61, was vaccinated and boosted when he fell ill with Covid in late January, his sister, Jeanine Boucher-Colbert, said.
Colbert had a “bartender personality,” his sister said, and would find a way to connect with people.
“He was always the one that would seek out people [at parties] that didn’t know anyone,” Jeanine said. “The elder sitting by themselves, our garbage guy that we really like. The kids in the corner at an all-adult party. He’d go up and start a conversation with them.”
Colbert, a former Hollywood production assistant, worked as a grocery store clerk in Yamhill County, Oregon, where 63 percent of the population is vaccinated. His job didn’t allow time off for precautions, Jeanine said, only allowing workers with symptoms to take sick time.
The siblings spoke for the last time on the afternoon of Jan. 29, when Colbert told his sister he wasn’t feeling well. He went to bed in the evening, saying goodnight to Jeanine’s older sister, whom he lived with. He died sometime overnight, she said.
“He had a couple of chronic conditions, but he had been doing really well,” Jeanine said. “His numbers were really good.”
“He was doing fine. He had a full-time job. And then he got Covid. Then he died.”
High vaccination rates may have helped prevent deaths from surging in highly vaccinated areas, but Wachter said that low vaccination rates weren’t necessarily a signal of increased deaths during the omicron wave. That’s because many people in lower-vaccinated areas had some level of immunity from serious illness during previous waves.
When a population gained its immunity — whether through vaccination or prior infection — was a strong indicator of outcomes.
“Everyone’s immunity tomorrow is less than it was today,” Wachter said, explaining that people who received their last vaccine dose or recovered from Covid six months before the omicron wave had less protection than those who were vaccinated, boosted or recovered more recently.
The true picture of omicron’s toll is somewhat skewed by its increased transmissibility, Wachter said: Because all hospital patients are tested for Covid when they are admitted, it’s hard to know how many patients tested positive but died from other causes and how many specifically died from Covid.
Black boosters lag
Black Americans bore a disproportionate brunt of the omicron wave. NBC News’ analysis found that the counties with the highest death rates during the week of Jan. 30 had a higher percentage of Black residents than an average county. A March 18 report from the CDC found that Black adults were hospitalized at four times the rate of white adults.
Black omicron deaths also skewed younger than whites. An NBC News analysis of HHS Covid data found that across four age groups — 30-39 years, 40-49 years, 50-64 years, and 65-74 years, Black fatalities outpaced the general population in each age group.
Feldman, from the Harvard T.H. Chan School of Public Health, attributed the differences in racial Covid death rates to pervasive structural and economic differences.
“Black people tend to have poorer health in the first place than white people, but they also have less access to health care,” Feldman said. “That means getting treated later, or being less likely to get the help earlier, when it could help most.”
Blacks and whites have similar vaccination rates, but data from the Kaiser Foundation shows that booster rates among Blacks lag that of whites by as much as 20 percentage points in some states. Black people are also more likely to work in higher-risk service jobs; Bureau of Labor Statistics data shows that Blacks make up 12 percent of the working population but 40 percent of postal service clerks, 35 percent of bus drivers and 33 percent of security guards.
“Those are places where people have less ability to protect themselves,” Feldman said.
Covid cases are again starting to rise in parts of the country, with case counts in Arizona, Florida, Georgia and New York increasing more than 50 percent in the past two weeks. Experts worry that pandemic-weary leaders are sending the wrong message to the public in getting rid of mask and vaccine mandates, and encouraging a return to pre-pandemic routines.
“We don’t have to accept permanently higher levels of death,” Feldman said. “But the way to reject it is to take a more collective response, to demand better policy. When there are waves coming, we shouldn’t try to prevent just the hospital from overflowing.”
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