COVID-19 sixth leading cause of death in Sonoma County last year, but drug overdoses surged

Coronavirus fatalities, which climbed gradually in 2020, ended the year as the sixth leading cause of death in Sonoma County, at 210 lives lost by the time the calendar turned.

COVID-19 followed cancer, heart disease, Alzheimer’s, stroke and unintentional injury — the top five listed causes of death in the county by total number in 2020, just as in recent years past, according to mortality data released Wednesday by Sonoma County Public Health.

But while not included in the rankings by category, officials reported a tragic spike in drug overdose deaths, which, at 142 reached 78% above the three-year average from 2017-2019.

The information was included in a survey of mortality trends released as part of a public briefing Wednesday in which officials said most of the data still needed to be submitted to an analytical “deep dive” before they could draw any real conclusions.

The county said 135 overdose deaths were unintentional, with nine more being intentional. Officials could not be reached after the briefing to explain the discrepancy in the death totals.

At least 102 deaths involved opiates — 92% of which were linked to fentanyl, an extremely potent synthetic opioid. That’s more than double the year before.

After months of concern among county officials and the public about a potential surge in “diseases of despair” as the pandemic and lockdown lingered — and, with it, economic loss and social isolation — the rise in overdose deaths is striking.

Its impact on Black and Latino communities was particularly pronounced, with overdoses in the Black population at five times the expected rate last year, compared with the three-year average. Overdoses among Latino individuals reached 2.75 times the number expected. Among non-Hispanic white people, the number was 1.58 times what was expected.

“We know that there are a lot of things happening in our current environment that would contribute to that,” said Bill Carter, the county’s behavioral health director. “… For example we know that folks are under stress, and economic stress, isolation, and we know that has an impact on this.

“We know that access to treatment is impaired,” Carter said. “You don’t have access to in-person treatment services in the way you did before COVID hit. This is (also) a law enforcement issue. Fentanyl is a phenomenon in and of itself, and the kind of fentanyl that’s hitting our system is. So all of these things are happening at the same time.”

While deaths by suicide declined overall last year, dropping from a 3-year average of 75 to 64, Carter said he and his staff remain “concerned about what the future holds,” and hope to increase prevention efforts in the coming year.

The data also show that the number of suicides was “significantly greater” last year than expected among Latino residents, when compared with the three-year average.

“We recognize that while the rates are down, the stressors that people are experiencing are the stressors that generally are risk factors for suicide, and we are concerned about what happens as the community opens up and we get back to normal interactions,” Carter said.

The county appears on track for broader economic and social activity in just a matter of weeks, given continued declines in cases and in the percentage of tests that come back positive. People are moving around the region more liberally since the state dropped Sonoma County from the most restrictive purple tier on the state’s reopening map to red earlier this month.

Sonoma County Health Officer Dr. Sundari Mase said Wednesday that the county is close to meeting the threshold for the next level, the orange tier, which requires a county to have a daily case rate below four new COVID-19 cases per 100,000 people.

Right now, Sonoma County has an adjusted case rate of 5.6 per 100,000, which is keeping it in the red. But once the state as a whole has delivered 4 million doses of COVID vaccine to the most disadvantaged communities — hopefully in the next two to three weeks — it will move the bar for getting into the orange tier from 4 new cases per 100,000 people to 6 new cases per 100,000 — which Sonoma County already meets, Mase said.

She urged residents to continue to exercise caution and use protective measures like masks and social distancing to continue to limit transmission of coronavirus as vaccinations continue to ramp up.

Fifth District Supervisor Lynda Hopkins, the board’s chair, announced Wednesday that Sonoma County had “crossed the quarter million mark,” administering at least one vaccine dose to more than 259,000 residents, or more than 51% of people, as of Tuesday.

She said nearly two-thirds of those aged 65 to 69 and 80% of those 70 and older have now received at least one dose.

But local health officials say the county continues to receive about a sixth of the vaccine doses it has the infrastructure to deliver — a problem state Sen. Mike McGuire said is expected to persist for the next three weeks, as arrivals in California remain static at around 1.8 million doses a week.

But the federal government has directed the state to be prepared to received 4 million doses a week by May or June, as availability of the vaccines improves.

“Are things improving? Yes they are. Am I satisfied? Absolutely not,” McGuire said. “We must do better, and I can tell you tonight, we will. Folks have a right to be frustrated. The vaccine rollout has been less than smooth, both on the federal and state fronts, but I can promise you this — and I don’t say this lightly — positive changes are coming.”

You can reach Staff Writer Mary Callahan at 707-521-5249 or mary.callahan@pressdemocrat.com. On Twitter @MaryCallahanB.