Last year, more people in San Francisco died of overdoses than of Covid-19

https://www.economist.com/united-states/2021/05/15/last-year-more-people-in-san-francisco-died-of-overdoses-than-of-covid-19

by rblion • 5 years ago

129 156 5 years ago

economist.com

reidjs• 5 years ago

Social distancing works then? Seriously, I don’t think anyone doubted that heart disease/car accidents/opioids are more life threatening than covid. It’s just the devil we don’t know.

rblion2• 5 years ago

I think the bigger conversation is the rising number of displaced people in our society who turn to drugs and crime to cope with life.

I grew up in Atlanta and it's getting out of control here too. I have a friend who models in LA, she is telling the same thing PLUS the rise of sex trafficking and Instagram escorts.

I'm 31 and I'm asking the Big Questions again. Something needs to change or the mental health crisis will become a much bigger stressor on society as a whole.

baby2• 5 years ago

I live here and to anyone who doesn’t know san francisco this might help explain why I am not surprised (and probably anyone living here isn’t as well):

- Everybody wears a mask here. Everyone. Even vaccinated people and children. It’s taken extremely seriously. And I’m not even talking about social distancing. Everything has been closed since the beginning of the virus and indoor dining is merely re-opening.

- san francisco has the largest homeless population I’ve seen in the world (and I’ve traveled and lived in a bit everywhere in the world including many poor countries). On top of that, drug is hitting homeless people hard. It’s extremely common to see someone shooting themselves with a syringe here.

jmcgough2• 5 years ago

Most people dying from drug overdoses aren't homeless.

shoto_io• 5 years ago

Isn't it interesting how our perception of reality is shaped by what we observe daily?

StavrosK4• 5 years ago

I don't know about SF specifically, but according to [1], California is doing about average for the US and is at the world's top 30 (higher is worse) for deaths per million, so I'd guess it's more #2 than #1.

Is SF doing significantly better than the rest of California, in general? Hopefully now enough people are vaccinated that the rates have dropped.

jmcgough2• 5 years ago

The cases per capita in SF were about 1/10 those in LA at its peak, so the pandemic in california was really focused in socal.

awb4• 5 years ago

I don’t know what’s going on here either with masks.

30-50 year old adults outside, alone, in direct sunlight, exercising, dozens of feet away from anyone else are still wearing masks. No doubt they’re fully vaccinated by now as well.

And multiple times a day you see people driving alone in cars wearing masks.

Just the other week, we overheard a young girl commenting on a woman not wearing a mask, “she’s a bad person, isn’t she mommy?” “No, she’s not a bad person, just inconsiderate”, the mother replied. This was in response to a fully vaccinated adult walking in a state park alone, in broad daylight, 3-4x father away than social distancing guidelines require.

I’m glad we took COVID seriously here earlier and longer than most states, but now that several states are reporting 0 deaths and vaccination rates are climbing the fear of an explosion of cases should hopefully be subsiding.

In the beginning comparing mental health to a potentially uncontrolled global pandemic I think was a serious misunderstanding of how exponential growth works, but now that the pandemic is getting under control it makes sense to weigh mental health more heavily.

ianlevesque• 5 years ago

So how do we get the rest of the country to do this?

viraptor3• 5 years ago

When the mask enforcement was lowered in Australia I found myself wearing a mask where I didn't have to. It's such a small thing it wasn't worth taking it off while driving for a few minutes alone, or sitting somewhere away from people. I don't find people going further than necessary weird.

a fully vaccinated adult

Being vaccinated isn't a perfect protection. I'd probably opt to wear a mask anyway if unvaccinated people around were forced to wear one. Wouldn't describe people not doing that as inconsiderate though.

zpeti5• 5 years ago

This is what you get when things like mask wearing start to become more of a social display than a rational decision. Most of the actual evidence shows outdoor infection to be close to zero, unless you’re close up at a concert or bus stop.

But now mask wearing is some sort of way of displaying that you are a good person. It’s also a way for frustrated people who want to control others and be outraged to be able to vent their frustration at other people, in a socially acceptable way.

It’s not good. And I say this as someone who’s worn a mask for a year now. I’m not against them. But they’re not being worn for rational reasons any more.

vidoc• 5 years ago

I don’t know what’s going on here either with masks.

I live there too, and I share your feeling big time. Just to give you a little idea of the local mentality with regards to covid: https://www.kqed.org/forum/2010101883465/vaccinated-dont-nee...

2muchcoffeeman• 5 years ago

Singapore had an outbreak originating with a fully vaccinated (2 doses) nurse.

Your examples are extreme but I’m not sure how to get people to act sanely. Restrictions are eased in Sydney and everyone just stopped doing anything even in crowded spaces. And we had a case that was traced to a person in quarantine, but we can’t find all the links back to the source.

drusepth• 5 years ago

And multiple times a day you see people driving alone in cars wearing masks.

I don't live in SF but I drive alone with a mask (and I'm fully vaccinated!). I generally put it on before leaving the house and keep it on until I get home so I don't risk contaminating the inside when taking it off, putting it back on, taking it off, putting it back on, etc. It's just a zero-effort bonus to mask efficacy and extra peace of mind, IMO.

DyslexicAtheist• 5 years ago

but now that the pandemic is getting under control it makes sense to weigh mental health more heavily.

I don't quite understand where is the link between wearing masks and mental health? I lived many years in Singapore, Tokyo, Bangkok, have a Japanese wife and in many of these places wearing a mask is just a sign of being considerate towards others. Coming from the country myself it looks maybe odd at first but this makes sense in dense urban places where you need some rules for how to share this public space.

refurb5• 5 years ago

Wearing a mask has become another way to identify yourself as the “in group”. Health benefits are a far second to the signaling that you “follow the science” and “are willing to sacrifice for the greater good” - your one of the good people.

My buddy told me his Bay Area company did a story about “the story behind people’s masks”. They literally interviewed people and asked them to share “what their mask represents”.

It’s really bizarre how much people’s egos and identity are wrapped up in it now.

(And that applies to people willing to make a public stand against masks as well - it’s become a core part of who they are).

kelnos• 5 years ago

No doubt they’re fully vaccinated by now as well.

Why would you assume that? Statewide, it looks like CA is just shy of 50% vaccinated, and in SF it looks like (eyeballing the by-age graph) around 60% of adults are fully vaccinated (and 30% of kids)[0]. So around 40% of the adults (and 70% of the kids) you run into in SF are not fully vaccinated.

You might think it's not a big deal, and we don't need to wait out the full two weeks past the final dose, but many of us don't think wearing a mask in public for a couple more weeks is a big deal after we've been doing it for a year already. Even if the risk is low, why take that risk just to take the mask off a couple weeks early?

... but now that the pandemic is getting under control it makes sense to weigh mental health more heavily.

And that's exactly what the state has done (whether intentionally or otherwise). If people still choose to wear a mask, that's up to them, and we should respect their choices. But I agree that out-loud recriminations directed toward random people who are distancing but maskless, and may even be fully vaccinated is ridiculous and goes too far.

you see people driving alone in cars wearing masks.

Sometimes I do this by accident, just forgetting to take it off when I get in the car. Maybe that's common?

[0] https://covid19.ca.gov/vaccination-progress-data/

dshpala• 5 years ago

People are weak - and if they see more examples that masks are not necessary, they'll follow. So I'm trying to not wear mask unless absolutely necessary, but it's hard, the pressure is real.

Not to mention kids - masked kids on playgrounds break my heart.

ralusek• 5 years ago

I think that the amount of political/social information that people seem to divine from observing maskers/non-maskers, as well as the signal that people think that they are sending by being one or the other, is one of the strangest things I've ever been made aware of.

When I leave my house, I grab a mask, and I wear it basically the whole time I'm out and about. I don't notice it, it's just a non-entity to me. I genuinely barely notice whether other people are wearing masks or not, and therefore obviously don't make any judgements about them.

If I'm walking alone outside during the day with a mask on, I'm not saying "I believe that this outdoor environment poses a legitimate risk to me, and based off of my 99.99+% survival chance from COVID, I'm still terrified that I'm going to catch it from some long distance passerby." When I wear a mask, my thought process is "I don't notice this thing, and if it helps mitigate the chance that I'll get sick or make someone else sick, I'll mostly wear it when I'm not in my home." I'm not constantly putting it on or taking it off based off of my immediate surroundings; I find that to be far more of a nuisance than just wearing it.

kleiba2• 5 years ago

you see people driving alone in cars wearing masks

Off-topic fun fact: in Germany, that is verboten.

anarazel• 5 years ago

Many, if not most, people in that age group actually aren't yet fully vaccinated - the general availability was April 14th in SF. 21 days between vaccines plus two weeks of waiting. Plus a few days to find a slot maybe. So a few more days...

I think it's fine to still not wear a mask in the scenario you describe, but...

Fwiw, around here (inner Richmond), there's plenty people without masks. The cafe I can see from my office (if I peek above the screen at least :() has unmasked people eating outside without conflicts for months.

Golden gate park is full of unmasked people lounging around.

dguaraglia• 5 years ago

The only people whose mental health I'm really concerned about are those who are obsessed with trying to get rid of masks.

If you are vaccinated and feel comfortable not using a mask, don't wear one. If you don't feel comfortable, then wear one. I literally have yet to hear someone complaining about someone not wearing a mask outside, but all you need to do is read this thread to see tons of comments complaining about people wearing masks.

Let people make their own decisions. They aren't cattle.

cameldrv4• 5 years ago

733 people died yesterday in the U.S. from COVID. On an annualized basis, that would be 267,545 deaths per year. On the other hand, 36,120 people die in car accidents per year.

If you saw someone wearing a seatbelt when they were stopped at a red light, would you make fun of them due to the relative safety of that situation?

If you had a friend that refused to drive after drinking any alcohol at all, would you make fun of him?

Perhaps some people do more to protect themselves and others against COVID than is necessary, but perhaps we should appreciate their conscientiousness by contrast with the very large number of people who took unnecessary risks, downplayed the problem, got infected, infected others, and ultimately led to 33 million people getting sick and 600,000 dying.

trainsplanes• 5 years ago

30-50 year old adults outside, alone, in direct sunlight, exercising, dozens of feet away from anyone else are still wearing masks.

This is how it's been in East Asia and spread has been fairly limited compared to the west.

Mask wearing and not clustering in tight groups here isn't really a mental health issue. It's just a hygiene issue, like washing hands. I think most people here grimace when we see someone walk out of a stall and leave without even wetting their hands.

Mauricebranagh• 5 years ago

Even last year if I was out in the open air I didn't wear a mask only when say queuing for public transport.

And I am an immunosuppressed solid organ transplant patient.

watwut2• 5 years ago

I don’t know what’s going on here either with masks. And multiple times a day you see people driving alone in cars wearing masks.

I drove car with mask, because I did not bothered to put it down when I entered. That was all there was to it. I always assumed other people are like that too. There is a lot of judgement and reading on people who leave their masks on.

This was in response to a fully vaccinated adult walking in a state park alone, in broad daylight, 3-4x father away than social distancing guidelines require.

Out of curiosity, how do you know woman was fully vaccinated?

I mean, inconsiderate is quite mild qualification? I dont know why mom thought it is inconsiderate, but it is not like she would go on full on bashing vent or something. Like, I dont find the whole discussion horrifying and I pretty often dont wear mask when I am alone.

74d-fe6-2c6• 5 years ago

30-50 year old adults outside, alone, in direct sunlight, exercising, dozens of feet away from anyone else are still wearing masks. No doubt they’re fully vaccinated by now as well.

It's virtue signalling, I'd say. It means you're one of the good people.

wkrsz• 5 years ago

When I'm going from one shared indoor space to another, I don't remove my mask unless the walk is more than 10 minutes. I suppose the mask doesn't bother me that much and I don't want to touch it too much.

Going for a walk outside - that's another story.

annexrichmond• 5 years ago

I’m not sure why you cite consistent mask usage as the primary reason.

What I imagine to be a more likely cause is that there is a large proportion of SF’s population (esp compared to other cities) that are professionals who have the privilege to be able to work from home without worrying about losing their jobs. Couple that with vast grocery and food delivery services. So staying home is more convenient than most places

refurb5• 5 years ago

Your bubble is showing. SF has massive swaths of people who aren’t in white collar jobs and have been working the entire time. They actually make up a lot of the cases that did happen.

cozos• 5 years ago

I live in San Francisco. I look at pictures of (maskless) people on billboards and have to stop myself from judging them.

te_chris• 5 years ago

Find it strange the way the US has gone all in for masks while in the UK it's only inside.

blumomo• 5 years ago

To say "Mask mandates are useful b/c we have more drug dead than covid dead" is not logically plausible. The fact that measure have been useful rather shows wishful thinking to me.

threatofrain• 5 years ago

Don’t SJ and LA have bigger homeless pop?

StavrosK4• 5 years ago

Yes but that's a poor people problem, so who cares?

I don't think it's possible for these things to be solved at any level lower than the federal, you can apply some band-aids but ultimately you need a stronger social safety net, which the US seems culturally averse to.

baby2• 5 years ago

You are absolutely right. SF is just the symptom of a national homeless crisis in the US. As long as the US isn’t willing to help its people, more liberal cities like SF will lay the price.

dehrmann2• 5 years ago

more liberal cities like SF will lay the price

This is a tricky problem because housing people isn't free (there is an argument that it saves money on ER bills), housing homeless people in SF is an incredibly inefficient use of money, but at the same time, you don't want cities to be bastions of wealth that outsource their poverty. Action also has to be done at the regional level, or else you'll get a TL situation where homelessness is isolated to one area. Even regional alignment isn't enough, though; the fact that the Bay Area has relatively good homeless services attracts more homeless. Federal housing projects aren't a good answer, either, and least not in the US, because of their history.

gogopuppygogo• 5 years ago

End local nimbyism laws with a state level mandate to build and reverse prop13. The USA doesn’t have the California homeless problem. Texas and florida don’t have the homeless problem and their weather is also good all year.

California has created this mess and California can solve it.

Gibbon12• 5 years ago

After the real estate bubble crashed in 2008 policy makers decided to try to reinflate the bubble and at the same time limit the supply of housing to make sure it stayed inflated. They succeeded, prices are higher than the last bubble and we're short a couple million units of housing.

The able bodied people living in tents in major cities the the victims of that success.

rblion2• 5 years ago

Another bubble is on the horizon and this one will be bigger than 2008 in my opinion. There are several vectors converging here.

I'm grateful to have a nice room by the beach in Maui. All I need is wifi and I can get by. Learning how to grow food now too as I save up for a farm.

The real estate market out here is INSANE. Housing shortage too. I got lucky because the people I live with now see potential in me. Wouldn't have happened without lurking on HN for 11 years.

fallingknife• 5 years ago

2% of my HS class has died of drug overdoses, and it is the opposite of poor. OK, small sample size, but it's safe to conclude that it's not a "poor people problem."

chrischen• 5 years ago

Pretty sure he was being sarcastic, if you read the second part of his comment.

hhjinks2• 5 years ago

For 2% to work, you'd need like 50 people in your HS class. Was your HS class really that large? That's insane.

worik• 5 years ago

Better drugs would be a good start.

Better drug laws would help that

StavrosK4• 5 years ago

The war on drugs has indeed claimed many more lives than it has saved. I think we're long overdue for more sensible drug policies that treat addicts with compassion instead of vengeance.

dehrmann2• 5 years ago

For an article that doesn't focus on SF, that's an odd headline, and not a big surprise for anyone who's seen the Civic Center Bart station: https://www.youtube.com/watch?v=5gT5NULvRSk

SF is an oddity because of its homeless problem, open-air drug market, not being too concerned with either, but being incredibly concerned over covid, so this outcome isn't surprising.

mathieubordere• 5 years ago

Are prescription opioids still being widely prescribed as a painkiller these days in the US?

WesleyHale• 5 years ago

Anecdotal, but ~a week after my surgery 3 years ago I told my doctor I quit taking my pain meds 2 days post-op as I wasn't in pain anymore and don't like pills. I was initially given a 14 day supply. Upon hearing this he asked me if I needed more or would like a stronger variant.

This was at a higher tier facility that works on professional athletes in the NFL and MLB.

the_only_law• 5 years ago

I got out of surgery last year after a deep cut following a fall. It was indeed painful as hell for some weeks afterwards, but I didn’t particularly ask for anything. I honestly just wanted to get out of the hospital and was annoyed they kept me overnight. But I walked out with a prescription for... guess what.

WarOnPrivacy• 5 years ago

Depends on the state. Many (if not most) have declared some sort of war on pain relief. In the worst, effective pain meds are all but impossible to get.

My adult son was recently cycling and sent flying by a jeep. He's in tons of pain but none of the injuries are serious. The ER isn't willing to Rx anything stronger than ibuprofen.

I recent had abdominal surgery. I had to beg just to get Tramadol. I've a friend with crippling arthritis, who'd responsibly taken opioids for years and was cut off after the state passed draconian anti-opioid laws. This is forcing him to consider actually risky drugs just so he can function at minimal levels.

At some point we need to give a crap about the millions who've lost their quality of life due to anti-opioid hysteria.

We are WAY past time to stop conflating typical Rx pain meds with blackmarket fentanyl. The bulk of the pill mill problem was tackled a decade ago. News reporting on opioid overdoses that infers Rxs are the major current driver is patently false.

wodenokoto• 5 years ago

Overdoses aren’t contagious.

We are not really afraid of the current levels of COVID, we are afraid of the potential spread of COVID that can happen so rapidly that hospitals and other critical infrastructure will have to close because everybody is sick.

It’s not even the mortality rate of COVID that has caused a global lockdown.

TheOtherHobbes3• 5 years ago

Political and social conditions that contribute to overdoses and other forms of suicide are contagious - socially and politically.

But they require political and social solutions, and vaccines can't provide those.

Red_Leaves_Flyy2• 5 years ago

Overdoses aren’t contagious.

But they do tend to cluster. Many people overdose because their supply is unusually strong, or they're clean and use what they would've taken at their previous tolerance. Knowing this we can expect more overdoses to happen in black markets, and the recently released (from rehab, prison, hospital, etc).

krankthat• 5 years ago

Is this evidence of the effectiveness of following CDC guidelines, or evidence that opiates are still a bigger problem?

SergeAx• 5 years ago

more people in San Francisco died of overdoses than of covid-19

Maybe this is because anti-covid measures were more efficient than anti-overdosing ones? Regarding the obvious question "Should San-Francisco pay more attention to overdosing" - I don't know, looks like much more people are at risk of dying because of covid than because of overdosing.

Last year, more people in San Francisco died of overdoses than of Covid-19

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