RED BLUFF –  Jeremiah Fears sat beneath an elk head mounted on the wall of the volunteer fire department in his little city and rolled up his sleeve for what he hopes is a step toward normality: his first dose of Moderna’s COVID-19 vaccine.

“If we can get vaccinated and do our thing to protect one another and ourselves, we can hurry up and open and go from there,” said Fears, chief of the Corning Police Department. “I know there’s controversy behind it. But it is what it is.”

Fears had come to a vaccination clinic in Corning – population 7,600 – aimed at firefighters and police officers. But in that fire station was a hint of the pandemic skepticism that runs deep in rural Northern California: two elderly people, both on dialysis, who were coming to get their shots.

They had been put on standby because Tehama County health officials, who only brought two small vials containing 20 doses, suspected they might not attract enough firefighters or police officers to use them all.

In the battle against COVID-19, health officials in Northern California face the daunting task of vaccinating more than 683,300 people spread across a mountainous, heavily forested region where calamity – either from illness or physical trauma – can mean hourslong drives to the nearest medical facility.

Among their biggest obstacles: overcoming widespread skepticism that the virus is a serious threat in far-flung towns, fear that the new vaccine is unsafe, and open rebellion against health orders. The pushback in rural parts of California is emblematic of the challenge in many parts of the United States, particularly outside more liberal urban centers.

“We’re getting very frustrated here in Northern California,” said Dr. Richard Wickenheiser, the Tehama County health officer. “We have a lot of anti-vaxxers and a lot of independent people who just feel that COVID was a hoax, that it was going to go away when the election was over. And that didn’t happen. ... The excuses just go on and on.”

Public health messaging, he said, “isn’t working.”

In Shasta County, some speakers at supervisors’ meetings have compared mask mandates to Nazis forcing Jewish people to wear a yellow Star of David and spouted conspiracy theories about vaccines containing tracking devices. The county health officer has been threatened repeatedly.

In Tehama County, where indoor dining is banned by the state, restaurants were still seating maskless customers in recent days. In downtown Red Bluff, signs in store windows read: “Please respect everyone’s personal space. ... Masks are welcome, but not required” and “Due to pre-existing health conditions, some of the staff are not wearing a face mask” and “MASKS OK.”

There is skepticism and defiance across the Golden State. But in California’s conservative northern counties – where a sense of rural abandonment by the state government has long had residents wanting to form a new state called Jefferson – the region is, in some ways, now a victim of its own early luck in the pandemic.

The virus was slower to spread in Northern California than densely populated urban locales farther south, and residents said the state was cracking down too hard on rural communities. In Modoc County, the first coronavirus case was not confirmed until late July. Its first death wasn’t until last month.

The Northern California region – which includes Del Norte, Glenn, Humboldt, Lake, Lassen, Mendocino, Modoc, Shasta, Siskiyou, Tehama and Trinity counties – has been the only one of the five state-designated regions to not be placed under a stay-at-home order based on hospitals’ intensive care unit availability.

But now the area, like the rest of the state, is seeing a postholiday surge in coronavirus infections. The region has 122 intensive care beds; as of Sunday, ICU bed availability was 24%.

If its ICU availability drops to 15% – which would trigger a stay-at-home order – that would mean there are only 18 beds across an area roughly the size of Indiana, not just for COVID-19 patients, but also for people suffering from heart attacks, strokes and trauma.

Four counties have no ICU beds at all: Glenn, Lassen, Modoc and Trinity.

“In the beginning, it was harder for people to appreciate the real risks to themselves because it seemed so far away in New York and L.A., but that’s not the case anymore,” said Dr. Gary Pace, the Lake County public health officer. “The numbers are up all around.”

In October, Lake County averaged about 33 new cases a week. In December, it averaged around 200.

For the two small hospitals there, the goal is often to stabilize patients needing specialized care before transporting them to bigger facilities, mostly in the San Francisco Bay Area, Pace said. 

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