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With about 114 deaths per 100,000 people, the state has about half the rate of New York, New Jersey, Massachusetts or Mississippi. The disparity between New York and California could be even greater when taking into account the likelihood that New York undercounted deaths in the pandemic’s frenetic early stages because virus testing was so limited.

Yet these mitigating statistics mean little to the families of the more than 44,900 people killed by the virus in California. Nor do the numbers mean much to chaplains like Ms. Michealsen, who on that day in January when the picture was taken by an Associated Press photographer had already watched two other patients die. Often, she is the only other person in the room when death comes. Sometimes, a nurse holds the other hand of the dying patient.

“When we come into this world, we are immediately surrounded by people — we have human touch,” Ms. Michealsen said last week from the Providence Holy Cross Medical Center in Los Angeles. “I just think that when we leave this world, we should have the same.”

The pandemic has taken an uneven toll in California, with people in the south and agricultural Central Valley much harder hit than those in the north.

In San Francisco, where almost 350 people have died from the virus, the cruelty of the pandemic — the inability of families to surround their dying relatives, the interruption of age-old rituals of mourning — is wearing.