Public Health Director Barbara Ferrer Makes the Case to Mandate by Wealth Rather than Vaccine Status

February 25, 2022 - At her weekly press briefing on Thursday, Dr. Barbara Ferrer, PhD, MPH, MEd, Director of Public Health for the County of Los Angeles made the case that wealth, rather than vaccine status, appeared to be a causal factor regarding Covid-19 case rates, hospitalizations, and deaths.

In a series of three stunning slides, Ferrer showed that unvaccinated wealthy people were less likely to catch Covid, get hospitalized, or die compared to fully vaccinated poor people.

An unvaccinated wealthy person, defined as someone who lives in an area with less than 10% poverty, only caught Covid at a 7-day age-adjusted rate of 221 per 100k people. An unvaccinated poor person, defined as someone who lives in an area of 30-100% poverty, caught Covid at 1,956 per 100k people. But the real kicker is that a fully vaxxed and boosted poor person caught Covid at a rate nearly comparable to the unvaxxed wealthy person, at 212 per 100k.

So wouldn't it make as much sense to mandate wealth rather than vaccines in order to slow the spread?

The unvaxxed wealthy person was hospitalized at a 7-day age-adjusted rate of 9 per 100k. The fully boosted poor person was hospitalized at a rate of 8 per 100k. Nearly the same.

Wealth was somewhat less of a factor than vaccines when it comes to death, although it still plays a role. The unvaxxed wealthy person died at a 7-day age-adjusted rate of 8 per 100k. The boosted poor person died at a rate of 3, which is far lower than the unvaxxed wealthy person, but three times higher than the boosted wealthy person, who died at a rate of 1 per 100k. The unvaxxed poor person died at a rate of 76 per 100k.

The slides made a strong case that wealth, and whatever benefits that might bring, such as being able to work from home or having better access to health care, had as much, if not more of an effect on Covid-19 transmission numbers and hospitalizations than vaccines did. Vaccines "are not an equalizer," Ferrer said.

While Ferrer's slides show that vaccines can help in preventing hospitalizations and deaths even for poor people, they also indicated that her main rationale for instituting vaccine mandates makes no sense. Her goal is to slow transmission because she thinks that is where variants of concern might arise (not in South Africa, for example.) But even if the poor got vaccinated, there is still going to be a great deal of transmission in poor neighborhoods, either because people in these neighborhoods have jobs that require a great deal of exposure to others or for other reasons. As she said herself, vaccines aren't going to do the job.

So many other factors play into the transmissibility of Covid-19 than whether or not one is vaccinated, and vaccines are statistically proven to do little to prevent transmission. So unless Ferrer wants to exclude people who come from neighborhoods with more than 30% poverty, she should give up on any sort of mandates at all. They are ineffective, costly, and damaging to our social fabric.