AILSA CHANG, HOST:
It once felt unimaginable, but we've known it was coming.
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UNIDENTIFIED JOURNALIST #1: One million lives lost here in the U.S. to COVID.
UNIDENTIFIED JOURNALIST #2: More than a million lives cut short across America.
UNIDENTIFIED JOURNALIST #3: More than 1 million lives lost.
CHANG: Today, the Biden administration will mark 1 million lives that have been lost to COVID. It's hard to grasp - right? - this idea of a million people gone in this country alone from the coronavirus.
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PRESIDENT JOE BIDEN: One million empty chairs around the family dinner table, each irreplaceable, irreplaceable losses.
CHANG: President Biden marked this moment last week at a White House ceremony. But it wasn't until today that the Johns Hopkins University COVID-19 tracker hit 1 million deaths. NPR and many other news outlets have been relying on this tracker during this pandemic. Individual families have been marking these deaths every single day, like Mary Kim (ph) talking about her late husband, Aaron (ph).
MARY KIM: I think he developed a personality of laughter and fun to try to avoid the the situation that he didn't speak really good English. And then it just - he just developed into that man. You know, I am happy, and you're going to be happy. And we're going to be friends.
CHANG: Or Ronald Hardy (ph) remembering his wife, Robin (ph).
RONALD HARDY: She will always have a place in my heart. And if I had to search all over again, if I had to choose a woman to be my bride, I would search for her.
CHANG: Researchers like Stefanie Friedhoff, professor at Brown University, say this staggering amount of loss didn't have to be this big.
STEFANIE FRIEDHOFF: If more people had showed up to get shots, we would have saved 320,000 lives.
CHANG: And even though more people are feeling safer with getting back to normal because of vaccines and treatments, Harvard epidemiologist William Hanage says there's no question we are still in a pandemic.
WILLIAM HANAGE: It's shocking to me that so many people have accepted a million dead. This is not a trivial number. That's a million human beings. And the fact that we have taken this appalling toll and folks are so keen to move on from it and not examine how we got there is deeply depressing.
CHANG: CONSIDER THIS - we know the pandemic is not over, and unvaccinated people are now the ones largely dying from COVID. But 1 in 6 Americans say they will never get the vaccine.
FAYE: I just - I don't believe in the vaccination. It scares me too much.
CHANG: From NPR, I'm Ailsa Chang. It's Tuesday, May 17.
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CHANG: It's CONSIDER THIS FROM NPR. If we want to understand how the million lives lost to COVID in the U.S. could have been prevented, then we've got to go back to January 2021. I know it feels like forever ago, but that is when vaccines started rolling out.
SELENA SIMMONS-DUFFIN, BYLINE: At first, supplies were limited, and priority groups like older people and health care workers got access. Demand was super high. You remember that time when everybody was talking about which grocery store to hang out with around closing time? It was kind of a zoo. But by the spring, supply had started to catch up to demand. There was a stretch where millions of people got shots across the country every day.
CHANG: That is NPR health policy correspondent Selena Simmons-Duffin.
SIMMONS-DUFFIN: Then the vaccine demand slowed, then it really slumped. So now, only 66% of the population is fully vaccinated, and only about half of the people who are eligible for boosters have gotten them. And because being up to date on vaccination is so good at protecting people from death, these numbers speak to why the death toll in this country is so high.
CHANG: Selena looked into new research that estimates how many people could have lived if vaccination had been more widely available.
SIMMONS-DUFFIN: So this was a team at the Brown University School of Public Health and Microsoft AI for Health. And I should say that Microsoft is an NPR funder. To explain how they did their calculations, let's use Kentucky as an example. So in real life, 67% of adults in Kentucky are fully vaccinated, and more than 12,000 people have died from COVID-19. To figure out how many of those deaths could have been averted, the researchers found the day that Kentucky vaccinated the most people ever and imagined a world in which that peak just continued all the way until 100% of adults were fully vaccinated, and then, when those people became eligible for a booster, they got their booster right away.
If that had happened, according to this analysis, 7,000 deaths in Kentucky could have been averted. The researchers did these same calculations for all states, and they made an interactive dashboard so you can look up and see this data for your state.
CHANG: So how do those numbers add up nationwide?
SIMMONS-DUFFIN: It's really stark. Around 640,000 people have died in the U.S. since vaccines became available, and half of them would still be alive if everyone had gotten vaccinated, according to this research. Here's Stefanie Friedhoff, a professor at Brown who co-authored the analysis.
FRIEDHOFF: If more people had showed up to get shots, we would have saved 320,000 lives. Every second person who died from COVID since early 2021 would still be alive if people had gotten vaccines.
SIMMONS-DUFFIN: Some states fared better than others, and there was a big political gap. The five places that had the fewest per capita preventable deaths leaned Democratic - Washington, D.C., Massachusetts, Puerto Rico, Vermont and Hawaii. The five states that had the most vaccine-preventable deaths per capita are all Republican states - West Virginia, Wyoming, Tennessee, Kentucky and Oklahoma.
CHANG: Interesting. Well, all of this is a pretty grim look back. But is there anything, Selena, here that could help change the picture going forward? - because the pandemic, it's still going on.
SIMMONS-DUFFIN: Absolutely. The researchers are really hoping this work provides the public and policy-makers with something concrete they can - that, you know, they can use to try to promote more vaccination. Of course, those efforts take funding. A senior Biden administration official told NPR on background that the White House knows - really wants Congress to fund more community-based vaccination efforts and education campaigns. But Congress does not appear to be close to a deal on the billions of dollars the White House has requested for pandemic relief, even though the time to start laying the groundwork for a fall vaccination campaign is really now.
CHANG: That was NPR health policy correspondent Selena Simmons-Duffin.
The CDC says the virus's mortality rate is being driven mainly by the unvaccinated. One in six Americans say they will definitely not get the vaccine. And NPR's John Burnett spoke to health care workers in Texas who are frustrated by the stubborn unvaccinated population.
CHANG: West Hansen is piloting his muddy Subaru through the industrial landscape in southeast Texas where he grew up, past silver refinery towers, Bible churches and doughnut shops. The longtime social worker says he's given up trying to tell his clients how safe the COVID vaccines are.
WEST HANSEN: Now I've grown weary of it. I've realized that, you know, there's no convincing somebody once they have their mind made up.
JOHN BURNETT, BYLINE: He parks in front of a ramshackle house and enters a living room overrun with cats and strewn with trash.
FAYE: Hi.
HANSEN: I'm West. I checked with your husband to see...
BURNETT: A husband and wife in bathrobes lie in recliners in front of a TV.
HANSEN: As I mentioned, I'm the social worker. And did you and the nurse talk about what services or benefits I might be able to help you with?
FAYE: Yes, but honestly, I don't remember what it was.
BURNETT: The woman, a 57-year-old retired graphic designer named Faye (ph), asks that her last name not be used because she was disabled by a stroke last year and wants her medical privacy. She went back to the hospital earlier this year with COVID, yet she still distrusts the vaccine.
FAYE: I just - I don't believe in the vaccination. It scares me too much. Yes, we have a polio vaccination from years and years ago, and it's worked fine. Measles - they worked fine. But I felt that the vaccination came out too quickly after COVID hit.
BURNETT: The next residents Hansen visits is a townhouse with a neatly trimmed yard. Donna and Danny Downes are waiting for him in the living room. She's a work-at-home office manager. He's a retired insurance salesman who's legally blind. They're devout Baptists. Donna says her sister died from COVID, but that hasn't changed their minds.
DONNA DOWNES: We don't like vaccines because we feel like if we live healthy, eat healthy and try to take care of ourselves, that we have more of a immune (ph) where we don't get it. And if we get it, we feel like that's God's will, and so we just leave it in his hands.
BURNETT: Her husband, Danny, adds...
DANNY DOWNES: We just think it's a big government thing where they're trying to control the public.
BURNETT: Later, Hansen visits Betty and Mike Spencer, a retired teacher and a truck driver, and their assortment of excitable dogs.
BETTY SPENCER: And this is Coco.
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BURNETT: The Spencers forthrightly declare they believe in conspiracy theories. Mike says he watches Alex Jones' Infowars, and Mike is of the opinion that the vaccine was designed as a depopulation tool.
MIKE SPENCER: I think there's malevolent stuff in them that has to do with nanotech and transhumanism and the internet of things making people - eventually with 6G, which is coming after the 5G - where you are biologically tuned into the internet at all times.
BURNETT: For the record, COVID-19 vaccines are FDA-approved and recommended by the CDC because they're safe and effective at preventing serious or fatal cases of the virus. But the skeptics abound, says Liz Hamel. She's vice president and director of public policy and survey research at KFF, the Kaiser Family Foundation.
LIZ HAMEL: I mean, one thing that has been really consistent in all of our surveys is the size of that group that says they're definitely not going to get vaccinated. It's been around 13- to 15% of the public, and that hasn't shifted in over a year.
BURNETT: According to a recent KFF COVID-19 vaccine monitor, partisanship and political ideology play a much larger role than scientific evidence in vaccination decisions. In the survey, 56% of Republicans and 92% of Democrats said they'd been vaccinated.
HAMEL: The people who have been most likely to say they're definitely not going to get a vaccine have been Republicans and people living in rural areas, as well as white evangelical Christians.
BURNETT: Their research overlays with the unvaccinated individuals quoted in this story who all said they voted GOP in the last election.
Not all of Hansen's clients distrust the needle. Elizabeth Yahr is a 78-year-old retired hairdresser who is vaccinated. When we arrive, she's sprawled on her La-Z-Boy watching TV.
ELIZABETH YAHR: I saw too many people dying of COVID, so it just seems stupid to me to not want to get the vaccine.
BURNETT: When the vaccines became available a year ago, West Hansen thought they were a godsend. So many of his clients were older with preexisting medical conditions. But as the vaccine became more and more politicized, he watched as many of his clients rejected them.
HANSEN: It's just shocking, you know? I mean, you're offering a drowning person a hand, and they slap it away, and they're kind of doubting that you can pull them ashore. It's very perplexing.
BURNETT: Hansen's frustration is shared by Kenneth Coleman, director of the Beaumont Public Health Department. In Jefferson County, where Beaumont is the largest city, a little over half the residents are fully vaccinated - a rate that trails the state in the nation. His office has been begging folks to get the vaccine.
KENNETH COLEMAN: Beaumont is not a really big town, so nowhere is too far in Beaumont. But for the ones who want it, have gotten it. And for the ones who haven't gotten it, just don't want it.
BURNETT: In his 30 years with the department, Coleman says he's never seen people so opposed to common-sense health practices. Today, he's worried not just about another deadly COVID variant, but about the fundamental loss of trust in public health services.
COLEMAN: I'm just afraid of what's going to happen when the next public health crisis appears because it's going to happen. It's just a matter of when and what.
BURNETT: What happens if there's an outbreak of measles or meningitis or tuberculosis?
COLEMAN: I have people calling me. It's like, well, I don't trust anything the CDC says. I say, well, when it comes to public health, there's no one left to trust because CDC is the Bible of public health.
BURNETT: Compound the vaccine reluctance with the fact that omicron numbers are far below last winter's peak, and Kenneth Coleman says his vaccination stations are lonely places.
CHANG: That was NPR national correspondent John Burnett. Other reporting in this episode was from NPR's Rob Stein. It's CONSIDER THIS FROM NPR. I'm Ailsa Chang.
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