In the counties in California where most people voted for Trump and where they still believe COVID wasn't a big enough deal to shut down businesses, the Delta surge rages on — and it's a starkly different picture in these counties in terms of deaths and hospitalizations.

Much like red states across the country that have suffered far worse pandemic outcomes due to misinformation and the politicization of the pandemic by Republican governors, red counties in California have also seen more illness and death than other parts of the state.

In San Bernardino County, which has a population just 200,000 larger than that of Santa Clara County, 5,158 people have died from COVID-19, with 51 just in the last week. In Santa Clara County, which has had strict mask mandates and where residents have abided by most public health orders, 1,807 pandemic deaths have occurred — one-third as many as in San Bernardino County. Vaccination rates in the two counties are also starkly different, with 57.4% of the eligible San Bernardino population now vaccinated, compared to over 84% in Santa Clara County.

As the New York Times reports, Lassen County in Northern California now has a vaccination rate lower than that of the lowest rate of any state, West Virginia. Only 35% of Lassen County residents ages 12 and up have been vaccinated, compared to 47% in West Virginia. Meanwhile, Marin County can boast 87% of eligible residents getting vaccines, and in San Francisco it's 83% — with 88% having received at least one dose.

Even Republican-leaning San Diego County is doing pretty well, with over 79% of residents 12 and up now fully vaccinated.

A map showing vaccination percentages by zip code via the state.
Map of vaccination percentages by county, via the New York Times.

Lack of trust in government, science, and public health measures essentially amounts to its own disorder now, and this is contributing to COVID infections, crowded rural ICUs, and continuing deaths.

Kevin Malotte, a professor emeritus of epidemiology at Cal State Long Beach, told the Times back in August that there is a snowball effect coming from people who still don't accept that the coronavirus is dangerous, and who therefore engage in riskier activities more often and don't wear masks.

"Lack of mask measures, lack of worry about it, lack of vaccination are all kind of the syndrome, and I think that’s what we’re seeing correlate with the high rates," Malotte said.

Some data shows that unvaccinated Californians are eight times more likely to get COVID-19 and 16 times more likely to die from it than those who are vaccinated.

But, as Malotte says, counties like Lassen and San Bernardino still have low vaccination rates "because they don’t believe it’s that serious, so they’re not doing other mitigation measures either."

It will be all the more depressing if, as we enter another pandemic holiday season, most of urban California has returned to relative normalcy while hospitals in Lassen County and elsewhere are overrun with unvaccinated COVID patients.

Meanwhile, vaccine mandates are proliferating, with Los Angeles joining San Francisco in requiring proof of vaccination to enter all indoor restaurants, movie theaters, gyms, and hair salons, starting next month.