The Coronavirus Isn’t Just A Blue State Problem

Washington state was the initial epicenter of the coronavirus outbreak in the United States. And New York is now the hardest-hit part of the country so far, with hospitalizations increasing at rapid rates — more than 37,000 people had been diagnosed with the coronavirus in New York as of late Thursday afternoon.

Because COVID-19 hit blue, coastal states first, and because politics is politics, the response to the pandemic hasn’t exactly been apolitical.

But blue states are hardly alone in what is becoming a nationwide epidemic. Jefferson Parish, Louisiana — which went for Trump by 15 percentage points in 2016 — has a death rate about equal to that of Manhattan. And as terrifying as the hospital situation is in New York City, hospital capacity is also under strain in states such as Michigan and Georgia.

Overall, although the number of detected cases is higher in blue states, the number is increasing at a more rapid rate in red states.¹ Moreover, blue states have conducted more tests per capita than red states, so — given that the large majority of coronavirus cases remain undetected — the lower rate of cases in red states may partially be an artifact of less testing.

Here is the data as of late Thursday afternoon, with states sorted by the increase in confirmed COVID-19 cases between Monday (March 23) and Thursday (March 26).² All data is taken from the invaluable COVID Tracking Project.

Nine of the 10 states that have seen the most rapid increase in coronavirus from Monday to Thursday are states that voted for Trump in 2016, led by Texas, where the number of reported cases increased by 297 percent.

On average, states that voted for Trump saw a 119 percent increase in cases over this 3-day period, as compared to an 88 percent increase in states that voted for Hillary Clinton (plus the District of Columbia). Weighted by state populations, the difference is slightly larger: 141 percent in states Trump won and 88 percent in states Clinton won.

For now, states Clinton won do have considerably more total reported cases. As of Thursday, Clinton states had 4.29 positive tests per 10,000 people, as compared to 1.13 per 10,000 people in Trump states. A lot of that difference is attributable to New York; without New York, Clinton states have 1.89 cases per 10,000 people.

But the nature of exponential growth is such that these differences could evaporate in a hurry. If reported cases in Trump states continued to increase at 119 percent every three days (about 30 percent per day) while reported cases in Clinton states increased by 88 percent every three days (about 23 percent per day), then the per capita case count in Trump states would surpass that in Clinton states within about 30 days, or by late April.

Hopefully, the rate of increase will slow in both types of states as we begin to see further effects of social distancing measures in the data. However, these measures were generally enacted earlier and have been more forceful in blue states. That means the rate at which new cases are being diagnosed could slow down faster in blue states than in red states, meaning that red states would catch up earlier.

Blue states have also conducted more testing than red states. In states with reliable estimates of the number of positive and negative tests as of Thursday night,³ Clinton states had conducted 21.8 tests per 10,000 people as compared to 12.5 tests per 10,000 people in Trump states.⁴

That means the true gap in the number of cases may not be as large as the roughly fourfold difference in reported cases between blue states and red states right now. States such as Louisiana have discovered they have far more cases than they originally realized as they’ve ramped up testing over the past week, and other red states (and blue states) could follow.

COVID-19 has also led to a slightly higher case fatality rate (the number of deaths as a share of the number of known cases) in red states so far. As of Thursday evening, the death rate per case was 1.7 percent in Trump states as compared to 1.3 percent in Clinton states. This could reflect a variety of factors, including potential underreporting of cases in Trump states,⁵ the age and health of the populations in each set of states, or the efficacy of responses by local health care systems.

However, the higher fatality rate it is a somewhat troubling sign for red states given that many of them are generally at an earlier point in their epidemic curves, meaning that many people who have acquired COVID-19 in those states have done so recently and have not yet developed the most serious symptoms that could lead to long-term hospitalization or death.