Even as Donald Trump trots off to Florida and threatens to practice germ warfare in the worst possible way by “kissing everyone in that audience,” 17 states hit new highs for COVID-19 cases. And they did so even though many of those same states are actually testing at a much lower level than they were a few weeks ago. On Monday, five states had a rate of positive test results greater than 20%, reflecting a testing rate that is all but worthless in helping to control the spread of the disease. Mississippi even achieved something truly unusual; it tested at such a low rate that 100% of the tests that were conducted—all 296 of them in a state with a population of 3.15 million—were positive.
While the biggest surge in new cases took place in the Midwest, that certainly wasn’t the only area seeing an increase. Nationally, the number of cases reported on Saturday was higher than any day since the second week of August. In fact, 39 states had more cases in the last week than in the previous week. It wasn’t just new cases that were up, because hospitalizations and deaths, which had been on a slow decline for some weeks, reversed that trend. What might be most alarming is that two states that have actually increased their testing rates sharply over the last two weeks—Idaho and South Dakota—are still seeing rates of positive tests that indicate nearly unchecked spread of COVID-19.
The story of how the pandemic hit the United States has changed enormously over time. The initial wave hit exactly where it might have been expected, in the largest cities where there was dense population and high levels of international travel. But while that first phase of the disease was devastating over March and April, the number of new cases being reported over that period peaked at under 37,000 cases in a day. As more testing came on line, those numbers actually declined through May and June as state-level social distancing rules applied the brakes to the outbreaks in the Northeast.
The total number of deaths in the United States by the end of May was devastating … but what has happened since then is worse in every way. That number has more than doubled. And there’s every indication that it could double again.
Over time, the list of states with the most cases has come to resemble the list of states by population. But there are some very notable differences.
Population Ranking / COVID-19 Ranking
State |
Rank by Population |
Rank by COVID-19 cases |
|
California |
1 |
1 |
|
Texas |
2 |
2 |
|
Florida |
3 |
3 |
|
New York |
4 |
4 |
|
Pennsylania |
5 |
11 |
|
Illinois |
6 |
6 |
|
Ohio |
7 |
13 |
|
Georgia |
8 |
5 |
|
North Carolina |
9 |
7 |
|
Michigan |
10 |
18 |
|
The top of the chart—again, reflecting those large population centers—may be a close match, but things fall apart down the list. States like Arizona, which is No. 14 by population, is No. 8 in COVID-19 cases. Georgia and North Carolina also show up higher on the list when it comes to COVID-19 than they do when just looking at population. Meanwhile, states like Pennsylvania and Michigan actually have much lower numbers of COVID-19 cases than their populations might predict.
That’s because, even nine months into the outbreak in the United States and despite a lack of restrictions on travel, cases of the disease are not spread anything like evenly across the nation. Decisions made at a state and local level are having huge effects on state and regional outcomes.
As summer came on, pressure from Trump to “reopen” states—and Republican governors eager to obey—generated a new, even larger spike across the South. Florida and Texas, which had until then suffered relatively lightly from the coronavirus, shot up the charts. While most states had initiated some form of stay-at-home order or mandated social distancing in April, states like Florida and Missouri quickly dropped any pretense of placing restrictions on businesses. That willingness to follow Trump’s orders appeared in the disease statistics within a few weeks. In terms of cases per population, New York moved from the top position all the way down to No. 18. Of the top 10 states in terms of cases per population, only a single state—Louisiana—has a Democratic governor.
With the end of summer, Trump insisted on reopening schools. Again, Republican governors and local politicians dutifully fell in line despite every study showing that children transmit COVID-19 at least as well as adults. As fall begins, that’s generating predictable results.
North Dakota was not alone. It was joined on Monday by South Dakota, Idaho, New Mexico, Oklahoma, Colorado, Kansas, Wisconsin, Nebraska, West Virginia, Indiana, Ohio, Illinois, Wyoming, Montana, and Kentucky. Some of those states, like Kentucky and New Mexico, have Democratic governors who have until this point done a good job in protecting state citizens. Kentucky is No. 35 when it comes to cases per population. New Mexico is No. 38.
The fact that these states are having record weeks is certainly concerning, but it’s a lot less concerning than a record week in South Dakota, where Trump held his July 4 mask-free spreading event at Mt. Rushmore. That state is No. 6 in terms of cases by population. North Dakota is No. 2. It looks set to take over as No. 1—which will surely be a proud achievement for Republican Gov. Doug Burgum. There are 12 states where the number of people testing positive has exceeded 3% of the total population. 11 of those states have Republican leadership.
As the numbers are climbing, a new report in the Journal of the American Medical Association makes the same kind of analysis that was made on Daily Kos in September by comparing Trump’s effectiveness to that of leaders in other nations. And it comes to the same conclusions.
If the US death rates were comparable to Australia, the US would have had 187,661 fewer COVID-19 deaths (94% of reported deaths), and if comparable with Canada, 117 622 fewer deaths (59%).
Had Donald Trump actually instituted national social distancing restrictions, implemented a federal testing and contact tracing system, and followed up with a national mask mandate, the number of American dead would be a fraction of what Americans have actually experienced. The loss of lives, the destruction of the economy, the damage to the nation’s reputation, the demolishing of institutions and loss of trust … all of it was absolutely avoidable, and remains utterly unforgivable.