Walter Egger reads a newspaper in the common area at St. Paul's Manor in San Diego's Bankers Hill neighborhood, March 24, 2020. Data show seniors are at higher risk of developing complications related to COVID-19. (Zoë Meyers/inewsource)
As novel coronavirus cases rise in the U.S., the Centers for Disease Control and Prevention has warned that certain populations are at higher risk of developing severe illness if they contract the respiratory virus.
inewsource teamed up with KPBS to produce an interactive map that shows where in San Diego County the highest concentrations of these populations are clustered, based on CDC and U.S. Census Bureau data. High-risk segments include those 65 and older, people with chronic lung disease or moderate to severe asthma, diabetics, people with serious heart conditions or severe obesity, and those with compromised immune systems.
Why this matters
As the coronavirus pandemic continues to rage, health data from federal agencies may help inform local governments and the public in their response to COVID-19.
The goal is to visualize for the public where these vulnerable populations live.
When asked if county health officials are using this kind of data to deploy resources, the county’s medical director for epidemiology and immunization services said they are working with organizations and agencies that deal with these high risk groups.
Dr. Eric McDonald added that no matter where these people live the message is the same: “You are at risk.”
“You should take extra precautions and be sure that you are very aware of your essential activities,” McDonald said.
People 65 and older
Data from South Korea, Spain, China and Italy show the bulk of their coronavirus-related fatalities were among seniors. The U.S. is no different. Current CDC data show that 80% of domestic COVID-19 deaths occurred among adults 65 years and older.
That’s because the human body’s immune system weaken with age, which makes it harder for seniors to fight off disease. More than half of COVID-19 intensive care unit admissions were from this population.
“COVID-19 has really set everybody on their ear,” said Cheryl Wilson, CEO of St. Paul’s Senior Services, a nonprofit that has operated in San Diego County for 60 years. St. Paul’s services include housing, personal and medical care, education, and advocacy.
“When all of this started to break about three weeks ago — prior to it really breaking in the United States — we all got together, realized what was going to happen and started putting our plans into place,” Wilson told inewsource on March 20.
Fe Deguzman brings groceries in for residents at St. Paul’s Manor in San Diego’s Bankers Hill neighborhood, March 24, 2020. Staff members are making grocery trips for residents to limit their exposure to others. (Zoë Meyers/inewsource)
St. Paul’s medical staff began monitoring residents and others who use their services for symptoms of the disease, Wilson said. They also surveyed their stock of personal protective equipment, started sanitizing at the door and offered food delivery, instead of takeout or communal meals.
The highest concentration of people 65 and older in San Diego lies immediately east of Interstate 15 in Rancho Bernardo. More than 75% of the roughly 2,500 people in the location fit that age profile.
Other high concentrations of seniors are in Oceanside and much of La Jolla.
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Wilson said although St. Paul’s has no confirmed COVID-19 cases among its residents, some are getting cabin fever — especially those with memory problems.
“That has been our greatest challenge,” she said. The people with Alzheimer’s disease or dementia don’t understand why they’re being sequestered.
St. Paul’s is looking for volunteers willing to call or email seniors to ease anxieties they may have at this time.
Wilson said all the volunteers have to do is strike up a conversation: “‘How are you doing this morning? Yes, this rain is terrible, isn’t it?”
People with diabetes
The CDC warns that diabetics, particularly those who don’t have the disease well controlled, could be at higher risk of developing complications from COVID-19.
An inewsource/KPBS data analysis shows South County has the highest concentrations of diabetics, which makes sense. The disease disproportionately affects minorities, and that region is home to a majority minority population.
Dr. Neelima Chu, chief of endocrinology at Sharp Rees-Stealy Medical Group, emailed inewsource what she’s seeing among her diabetic patients.
The data is limited and excludes San Diego County’s coastal cities, Imperial Beach, National City and other big populations.
Michael Wayne, a content management system project manager with KPBS, and inewsource created the maps using Mapbox.
“Patients are appropriately concerned, but we are reassuring them of the risks, symptoms and preventive measures,” Chu said.
She explained that when diabetics become ill with any disease their glucose levels increase. It’s important to address that with more insulin or other medicines, in addition to staying hydrated and continuing to exercise at home.
The good news is insulin companies aren’t reporting any issues with manufacturing or distribution, Chu said, and “patients are not having any issues acquiring their medicines.”
She does recommend diabetics check their medical supplies to make sure they have enough to last at least one month, monitor their glucose levels frequently and follow CDC guidelines.
People with asthma and chronic obstructive pulmonary disease
Dr. Jess Mandel, a pulmonologist and professor of medicine at UC San Diego, said he and his colleagues are “learning on the fly” about how COVID-19 affects people suffering from COPD or asthma.
“We believe that individuals with preexisting pulmonary conditions are at higher risk for a complicated course with COVID-19, but some of that is speculation, in particular with asthma,” Mandel said.
About this report
As the coronavirus spreads across the U.S. and in San Diego County, so does uncertainty. To provide you with accurate in-depth reporting on the pandemic, KPBS and inewsource are collaborating in their news coverage.
He said his focus “would probably be more on COPD patients just because they tend to be older and definitely more at risk.”
As with diabetics, large groups of asthmatics and COPD-sufferers are clustered in South County. El Cajon and pockets in Escondido, Oceanside and northern San Diego also have higher-than-average numbers, though overall San Diego County has one of the lowest rates of the disease in the country.
“Ultimately,” Mandel said, “we need to get the public health message out that: You’re sick, you’ve tested positive for COVID, overwhelming odds are you’re going to do fine, and in fact, we really don’t want you to come to the ER and clog the health system.
“And that, for most people, tea and Lifetime original movies will be all that’s required to get over it.”
People with heart disease
People with heart disease are scattered throughout San Diego County, but three locations have groups where more than 10% are living with the disease: Carlsbad, Oceanside and Rancho Bernardo.
“We look at our patients as kind of walking on a tightrope to begin with every day, and then this just knocks them out,” said Dr. Eric Adler, a UC San Diego cardiologist and professor of medicine.
Adler said doctors are learning that COVID-19 is highly inflammatory, and that’s causing people with heart problems to be more affected.
“Then what we’re seeing on top of that in select patients is COVID actually causing heart problems,” he said. “So we’re seeing some patients get a condition called myocarditis, which is an inflammatory condition of the heart. We’re seeing patients that are having cardiomyopathy — so the heart isn’t squeezing well.
“These are patients, some of them, who did not have heart conditions before the COVID who are developing complications as a consequence of the COVID.”
There is also debate about whether certain cardiac medications make a person more likely to contract COVID-19, Adler said. He recommended that patients with those concerns ask their doctor for an opinion.
One effect the pandemic has had on Adler and his colleagues is they realized that virtual conferencing “is kind of the future of medicine,” he said.
“Our older patients are doing great,” he said. “Many of them, if not all of them, have iPhones and Androids, and they use it to talk to their grandkids and their friends all the time.”
Michael Wayne with KPBS created the map for this story.
inewsource is a nonprofit, nonpartisan newsroom dedicated to improving lives in the San Diego region and beyond through impactful, data-based investigative and accountability journalism.
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Gender Identity
Gender Identity
Gender Identity
Women
80%
Women
82%
Women
75%
Men
20%
Men
18%
Men
25%
Sexual Orientation
Sexual Orientation
Sexual Orientation
Straight
87%
Straight
82%
Straight
100%
LGBTQ-identifying
7%
LGBTQ-identifying
7%
Not specified
7%
Not specified
7%
Speak a language beyond English at home
33%
Speak a language beyond English at home
18%
Speak a language beyond English at home
75%
Race/Ethnicity
Race/Ethnicity
Race/Ethnicity
White
67%
White
73%
White
50%
Hispanic or Latinx
20%
Two or more races
18%
Hispanic or Latinx
50%
Two or more races
13%
Hispanic or Latinx
9%
Age
Age
Age
20-29
40%
20-29
45%
20-29
25%
30-39
47%
30-39
45%
30-39
50%
60 or older
13%
60 or older
9%
60 or older
25%
* The percentages in the charts have been rounded and may not add up to 100.
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Lorie Hearn is the chief executive officer, editor and founder of inewsource. She founded inewsource in the summer of 2009, following a successful reporting and editing career in newspapers. She retired from The San Diego Union-Tribune, where she had been a reporter, Metro Editor and finally the senior editor for Metro and Watchdog Journalism. In addition to department oversight, Hearn personally managed a four-person watchdog team, composed of two data specialists and two investigative reporters. Hearn was a Nieman Foundation fellow at Harvard University in 1994-95. She focused on juvenile justice and drug control policy, a natural course to follow her years as a courts and legal affairs reporter at the San Diego Union and then the Union-Tribune.
Hearn became Metro Editor in 1999 and oversaw regional and city news coverage, which included the city of San Diego’s financial debacle and near bankruptcy. Reporters and editors on Metro during her tenure were part of the Pulitzer Prize-winning stories that exposed Congressman Randy “Duke” Cunningham and led to his imprisonment.
Hearn began her journalism career as a reporter for the Bucks County Courier Times, a small daily outside of Philadelphia, shortly after graduating from the University of Delaware. During the decades following, she moved through countless beats at five newspapers on both coasts.
High-profile coverage included the historic state Supreme Court election in 1986, when three sitting justices were ousted from the bench, and the 1992 execution of Robert Alton Harris. That gas chamber execution was the first time the death penalty was carried out in California in 25 years.
In her nine years as Metro Editor at the Union-Tribune, Hearn made watchdog reporting a priority. Her reporters produced award-winning investigations covering large and small local governments. The depth and breadth of their public service work was most evident in coverage of the wildfires of 2003 and then 2007, when more than half a million people were evacuated from their homes.
Laura Wingard is the managing editor at inewsource. She has been an editor in San Diego since 2002, working at The San Diego Union-Tribune, KPBS and now inewsource. At the Union-Tribune, she served in a variety of roles including as enterprise editor, government editor, public safety and legal affairs editor, and metro editor. She directed the newspaper’s award-winning coverage of the October 2007 wildfires and the 2010 disappearance of Poway teenager Chelsea King. She also oversaw reporting on San Diego’s pension crisis.
For two years, Wingard was news and digital editor at KPBS, overseeing a team of four multimedia reporters and two web producers. She also was the KPBS liaison with inewsource and collaborated with inewsource chief executive officer and editor Lorie Hearn on investigative work by both news organizations.
Wingard also worked at the Las Vegas Review-Journal as the city editor and as an award-winning reporter covering the environment and politics. She also was the assistant managing editor for metro at The Press-Enterprise in Riverside. She earned her bachelor’s degree at California State University, Fullerton, with a double major in communications/journalism and political science.
Brad Racino is the assistant editor and a senior reporter at inewsource. He has produced investigations for print, radio and TV on topics including political corruption, transportation, health, maritime, education and nonprofits.
His cross-platform reporting for inewsource has earned more than 50 awards since 2012, including back-to-back national medals from Investigative Reporters and Editors, two national Edward R. Murrow awards, a Meyer “Mike” Berger award from New York City’s Columbia Journalism School, the Sol Price Award for Responsible Journalism, San Diego SPJ’s First Amendment Award, and a national Emmy nomination.
In 2017, Racino was selected by the Institute for Nonprofit News as one of 10 “Emerging Leaders” in U.S. nonprofit journalism.
Racino has worked as a reporter and database analyst for News21; as a photographer, videographer and reporter for the Columbia Missourian; as a project coordinator for the National Freedom of Information Coalition and as a videographer and editor for Verizon Fios1 TV in New York. He received his master’s degree in journalism from the University of Missouri in 2012.
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Brad Racino is the assistant editor and senior investigative reporter at inewsource. He's a big fan of transparency, whistleblowers and government agencies forgetting to redact key information from FOIA requests.
Brad received his master’s degree in journalism from the University of Missouri...
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