The coronavirus outbreak first broke out in the United States in Washington State, and although New York has become the U.S. epicenter of the pandemic, Covid-19 has been reported in all 50 states.
The pathogen spreads across the country, along with positive tests and death rates. Taking control of the outbreak depends on each state’s ability to develop an effective response, slow the virus, and eventually contain it. What physical distance plans are in place – and how well are they followed? Can the state’s health system survive an influx of infected patients?
“Each region has its own socio-cultural reasons that contribute to the spread rate and its own approach to dealing with that spread rate,” said Carl Bergstrom, professor of biology at the University of Washington, who has developed models for infectious disease outbreaks . for 20 years.
For the time being, the coronavirus appears to be more concentrated in urban centers, especially in New York City and the surrounding suburbs. It could thrive in those places because they are packed with people, exposing them to a covert virus that takes several days for symptoms to appear. Metro centers across the U.S. – Detroit, New Orleans, Miami, and many more – are seeing increasing numbers of coronavirus.
At the same time, the US is still almost certainly doing it in other parts of the country. For example, Connecticut has about twice as many per capita tests as Texas and Georgia. Still, all three states have about the same number of positive test results, despite the last two tests testing far fewer people per capita. Such a high positive test rate suggests that the actual number of cases may be much larger than the official number.
On May 4, New York has the most confirmed cases (about 316,000) and it also performed the second most tests per million people (about 50,000) as it has only recently been surpassed by Rhode Island.
Here’s how states, territories and Washington, DC compare based on the number of confirmed cases and deaths, and the number of people tested, according to data from the Covid Tracking Project. Using the latest available Census Bureau numbers, we also calculated the number of tests per million people in a population to better understand a state’s efforts to track the disease.
(Note: We’ve updated the chart to show “ tests performed ” instead of “ people tested, ” as some states report a rough count of the number of tests performed, which may include multiple tests for the same person.)
State health systems have different capacities to handle the wave of Covid-19 cases. Some started the crisis with higher uninsured rates, especially in the South, for refusing to extend Medicaid through the Affordable Care Act. Now millions of workers are unemployed again as the economic crisis of the corona virus arrives, suddenly uninsured during a public health emergency. Some states have a younger and healthier population; others are older. Certain states have more hospital beds per capita than their neighbors, and public health funding varies significantly by state.
“One thing I always notice about the US system is that there are actually 51 US systems,” Ellen Nolte, a professor of health services and systems research at the London School of Hygiene and Tropical Medicine, told Vox last year.
The coronavirus pandemic has been an unprecedented challenge for states
New York, Washington and California were forced early to take measures to contain the Covid-19 outbreak, and some states quickly followed suit. Others were reluctant to impose strict distance guidelines, concerned about imposing on everyday life and especially on companies.
Gov. Andrew Cuomo of New York moved to expand hospital capacity in his state; He also waived health insurance out-of-pocket costs, and the state called on retired physicians to offer their services to avoid a shortage of hospital staff. New York set up “Containment Zones” to include local hotspots, where all schools in the area were closed, and religious and other large gatherings were discontinued. The state has also radically reorganized its hospitals into an effective single state-wide system, hoping to better manage staff, supplies and patients. However, New York, like many other states, was initially reluctant to issue the “stay at home” directive before its implementation on March 22.
Washington Governor Jay Inslee ordered the state schools to be closed quickly until the last week of April after the outbreak of the nursing home in Everett. He also seemed to be uncomfortable with issuing a “stay at home” statewide order, although he has since. California Governor Gavin Newsom was the first governor to issue such an order (after several major metropolitan areas in his state took the step), and helped convince some of the major tech companies in his state to have much-needed protective donate masks to medical staff.
At least initially, other governors took a more lax attitude to the crisis. Oklahoma Governor Kevin Stitt tweeted (and then deleted) a photo of him and his family eating at a restaurant, even though other states started closing nonessential businesses. Florida government Ron DeSantis initially Shrugged calls to place a home order after photos of beachgoers in his state raised fears that they would become vectors for the spread of a virus that is generally milder to young people. On April 1, he changed his mind and finally issued a home stay order for the entire state.
At the end of April, more than 40 states had issued home warrants, but some have now started easing those measures from a social distance. Georgia, South Carolina, and Tennessee have initiated a phased reopening plan, as Vox’s Katelyn Burns reported. Florida does the same. Other states, such as Washington, are expected to be more cautious as they lift the restrictions that public health experts admit to curb the spread of Covid-19.
Hospitals rely on states to increase the capacity of hospital beds, ICUs and respirators, as well as staff to staff them. States, in turn, will need support from the federal government as their tax revenues take a hit in the economic downturn. The stimulus law passed by Congress provides money to hospitals and funding for states, although experts say much more is needed.
Relations between the states and the White House were hit and miss during the crisis. President Donald Trump has insisted that states should treat his government kindly to get more federal support. Governors have contradicted Trump about his speculation in mid-March that Americans could soon return to normal lives; he has somewhat endorsed such claims. And many states say they still don’t get enough supplies from the federal government to make up for the expected shortages.
States also depend on federal aid to increase testing capacity so that they can actually track the outbreak. New York is testing people at the fastest rate of any state so far, while there are other states with a growing number of cases (such as Texas and Georgia) where test rates are still low.