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Posts tagged ‘South Carolina’

Mar 13

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New medical study confirms what TIGC has been saying for a year now. You’re welcome.

The American Journal of Preventive Medicine (AJPM) earlier this week published a new statistical study which basically found that American states led by Democratic governors have fared better through the worst of the pandemic than those governed by Republicans.

Opined the authors: “Gubernatorial party affiliation may drive policy decisions that impact COVID-19 infections and deaths across the U.S. Future policy decisions should be guided by public health considerations rather than political ideology.”

Gee, you think?

Actually, I’m glad to see this kind of big academic study. As eye-glazing as it can be in places, it reinforces a lot of the observations I’ve made here at Trouble in God’s Country since Covid-19 rolled in a year ago. Early on, I started noticing differences between between Georgia, where Republican Governor Brian Kemp was famously loathe to impose restrictions because of the pandemic, and North Carolina, where Democratic Governor Roy Cooper acted pretty quickly and decisively to begin closing down his state.

The two states have a lot in common, including demographics, economics, educational levels, and population size. Pretty much from the get-go, North Carolina was performing more Covid-19 tests and reporting more confirmed cases but fewer deaths.

Based on the latest data available from the CDC’s COVID Data Tracker, North Carolina has since significantly out-performed Georgia. As of Thursday, March 11, Georgia, with a population of 10.6 million, had more than a million confirmed and probable cases and 18,117 Covid-19 deaths; North Carolina, whose population is only slightly smaller at 10.4 million, has recorded 879,825 such cases and 11,622 deaths.

A week or so after that first Georgia-North Carolina comparison last March, I posted a new piece that broadened the focus and compared a half-dozen Old South states led by proudly conservative Republicans (Alabama, Florida, Georgia, Mississippi, South Carolina and Tennessee) to three deep blue West Coast states led by liberal Democratic governors (California, Oregon and Washington).

The two regions had very comparable populations — 51.4 million for the three West Coast states versus 51.9 million for the six Old South states. But the regions’ governors were taking very different approaches in fighting the virus. The governors on the West Coast, which bore the brunt of the virus’s initial attack, took early, dramatic actions to shut down their states and limit the virus’s spread, while the Old South’s GOP governors were openly resisting most public health-driven actions.

At the time of that initial report — not even a month into the pandemic — the West Coast had suffered 543 deaths versus 500 for the Old South, but the Old South was already piling up more cases: more than 24,000 versus just over 18,500 for the West Coast.

I pulled fresh numbers from the CDC’s Covid-19 Data Tracking website on Friday, and the Old South’s performance now looks much worse in comparison to the West Coast (where, again, the virus initially turned Seattle into the public health equivalent of Chernobyl and has continued to savage the California coast) than it did last April. The Old South states have racked up 25,000 more deaths than the West Coast and a million more confirmed and probable cases, as this table details:

The AJPM study found that the Republican-led states had lower case and death rates for the first several months of the pandemic, but that those trend lines crossed — on June 3, 2020, for case rates and a month later, on July 4, for death rates.

That’s generally in line with another TIGC observation. I tracked county-level case and death rates on an almost daily basis for the first several months of the pandemic by the political party each county sided with in the 2018 Georgia gubernatorial election. Early on, the virus did most of its damage in urban areas that were heavily populated and largely Democratic, such as Metro Atlanta; the virus was indeed slow to show up in sparsely-populated rural areas of Georgia that largely sided with Governor Kemp and other Republicans.

But it did get there — and, just as the authors of the AJPM study found, the trend lines eventually crossed. By my calculations, the death rate in counties that went for Democratic gubernatorial nominee Stacey Abrams had been higher — that is, worse — from the opening days of the pandemic through most of August; they crossed on August 25, 2020. The case rate trend lines were a little slower to intersect, but finally crossed on September 9.

11-3-covid-data-table.jpg (328×125)

I took another look at this phenomenon following last year’s presidential election and found the same pattern, as this table to the right shows. By election day, President Donald J. Trump’s Georgia counties had significantly worse case rates, death rates and 14-day case rates than his then-Democratic challenger, Joe Biden.

The authors of the AJPM study were careful to avoid asserting causality in the statistical relationship between the governors’ party affiliation and their states’ Covid-19 results. And, indeed, there are a variety of factors other than politics that probably contribute to different outcomes. In an early piece speculating that rural Georgia might eventually be harder hit than the state’s urban areas, I cited the facts that rural Georgians were generally in poorer health than their city cousins and had access to much frailer health care delivery systems. At that point, the political differences were just beginning to come into focus.

But, statistical limitations aside, it now seems silly to ignore the obvious political relationships and implications. It’s often said that the 50 states function as laboratories for American democracy. For a year now, that’s clearly been the case where America’s response to Covid-19 is concerned. But it’s a shame we all wound up being used as human guinea pigs.

(c) Copyright Trouble in God’s Country 2021

Long-time friend and long-ago colleague Terry L. Wells contributed to this article. He first spotted and posted to Facebook an article about the AJPM study, without which I probably would have missed the whole thing.

Apr 10

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Old South-West Coast update

A quick update on the analysis I posted last Saturday comparing the COVID-19 performance of six Republican-led Old South states with the three West Coast states led by Democratic governors:

A week ago, the regional comparison looked like this:

Old South West Coast Summary

Today, based on the latest data available from all nine states’ public health websites, the regional comparison looks like this:

4.10 Old South West Coast Consolidation Update

A week ago, the Old South states already had nearly 6,000 more confirmed cases than the West Coast, but still had fewer deaths.  In the six days since I pulled that first batch of data, the numbers of confirmed cases and deaths have increased at a much more rapid pace in the Old South than on the West Coast, which bore the initial brunt of the COVID-19 onslaught.

Confirmed cases are up 74.4 percent across the Old South states versus 54.4 percent on the West Coast.  But the change in the death counts is even more dramatic.  A week ago, the Old South still trailed the West Coast in that category, but since then COVID-19 deaths across the south have shot up by 121.4 percent versus 80.8 percent in the west; as a result, the Old South now has significantly more deaths than the West Coast.

As I acknowledged in last week’s report, there are several obvious differences between the two regions and their various states.  The Old South is both less healthy and more religious than the West Coast; it is plagued by comorbidities that constitute the kind of underlying medical conditions that make people more vulnerable to the virus, and its residents have been slower to give up the kind of large religious gatherings that are now recognized as breeding grounds for COVID-19.

Another obvious difference, though, has been in the public policy approach to tackling the virus.  The Democratic governors on the West Coast acted earlier and more decisively than their Republican Old South counterparts to shut down their states, as I detailed in last week’s post.

The current state-by-state results look like this:

4.10 All states Update

Georgia now has the highest COVID-19 infection and mortality rate of any of the Old South states, and is second only to Washington, whose Seattle outbreak was one of the nation’s first epicenters, among the nine states.  Georgia’s poor numbers are driven in significant measure by the degree to which the virus has ravaged nearly a dozen counties in deep southwest Georgia.

I hope to flesh out the Georgia situation in another post over the weekend.

 

 

Apr 4

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A tale of two regions: the Old South and the West Coast tackle COVID-19

It’s probably a little early for this kind of analysis, but our nation’s every-state-for-itself approach to dealing with the COVID-19 pandemic is already generating some interesting contrasts between different states and even regions of the country.

I’ve been following the differences between Georgia and North Carolina, neighboring southeastern states with nearly identical populations but very different COVID-19 results.  North Carolina continues to have substantially fewer confirmed cases, hospitalizations and deaths — despite performing a great many more tests than Georgia. The principal difference between the two states appears to be political: North Carolina’s Democratic governor, Roy Cooper, acted earlier and more decisively to begin closing down his state than his Republican counterpart, Brian Kemp, here in Georgia.

Today I decided to expand that analysis and look at two regions of the country: the West Coast (made up of California, Oregon and Washington) and the Old South (comprised in this analysis of Alabama, Florida, Georgia, Mississippi, South Carolina and Tennessee).  As it happens, these two regions also have very comparable populations: 52.0 million in the Old South versus 51.4 million on the West Coast.

This comparison also gives us the same political split.  The West Coast is famously deep blue; all three states have liberal Democratic governors.  The Old South is bright red and governed by proudly right-wing politicians.

So how are they doing?  Let’s look first at the regional numbers.

Old South West Coast Summary

The state-by-state numbers look like this:

Old South West Coast State by State Detail

The West Coast, which suffered the country’s first COVID-19 blows as the virus moved in from China, has actually (as of the numbers available this morning on state websites today) recorded 43 more deaths than the Old South — but significantly fewer confirmed cases.  The Old South may have recorded 8.6 percent fewer deaths than the West Coast, but it’s posted 22.6 percent more infections.

Perhaps more telling are the COVID-19 infection and mortality rates, which I’ve calculated using a standard formula: [(Confirmed Cases or Deaths/Population)*100,000].

This is, of course, a complex situation, with a great many variables at work.  The Old South starts at a disadvantage to its West Coast counterparts because it is both less healthy and more religious.  The higher percentages of comorbidities such as obesity, diabetes and heart disease constitute the kinds of “underlying medical conditions” that make people more vulnerable to COVID-19, and places of worship are among the mass gatherings that are now recognized as natural breeding grounds for the bug.  (I’ll try to flesh out these points in a later post, but you can find good rankings on health and religiosity here and here.)

That said, it seems increasingly difficult to argue that politics and public policy choices aren’t playing a significant role in how different parts of the country fare in the face of the COVID-19 pandemic.

The West Coast governors acted well ahead of their Old South counterparts to begin shutting down their states.  Indeed, probably the first major American politician to take such action was San Francisco Mayor London Breed; she imposed a shelter-in-place order on March 13 and was joined by other Northern California officials three days later.  California Governor Gavin Newsom followed suit on March 19.  Washington Governor Jay Inslee, who was confronted with the nation’s first major outbreak in Seattle, banned major gatherings in heavily-populated counties on March 11, and then imposed a full shelter-in-place order on March 23.  Governor Kate Brown of Oregon came on board the next day.

Meanwhile, the Old South governors lagged well behind their West Coast counterparts and to a great extent deferred to local officials (only, once they did act, to upend many of the local actions).  Mississippi Governor Tate Reeves initially said he had no plans to issue a statewide order but did take to Facebook Live to conduct a prayer session on March 22.  Today, his state has among the nation’s highest COVID-19 infection, hospitalization and mortality rates.

Ditto Alabama.  There, as the West Coast governors were shutting down their states, Governor Kaye Ivey announced on March 24 she had no plans to issue a statewide order.  “We’re not California, we’re not New York, we aren’t even Louisiana,” she said.

Today, her state’s COVID-19 infection and mortality rates are worse than California’s.  Both she and Reeves threw in the towel late last week and issued statewide shelter-in-place orders.  As did the governors of Florida, Georgia and Tennessee.  At this point, South Carolina is the only Old South hold-out.

Notably, the reluctant and belated actions by the southern governors have sowed widespread confusion.  Here in Georgia, Governor Brian Kemp justified his turnaround decision to issue a shelter-in-place order with the dubious claim that he had only learned the day before that asymptomatic COVID-19 victims could spread the virus — even though public health officials had been saying as much since February.

That explanation earned him national media scorn (“Georgia Gov. Shows Just How Far Behind The World He Is On Coronavirus,” blared a HuffPost headline), but his shelter-in-place order may have done him at least as much local political damage.  One presumably unintended consequence of his order was that — by superseding local ordinances — it reopened Georgia’s Atlantic beaches, including Tybee Island, Jekyll Island and St. Simons.

According to a story in today’s Atlanta Journal-Constitution, a Republican member of the Glynn County Commission, Peter Murphy, reacted thusly: “We had carefully considered ways to keep people safe here and the governor’s order has undermined everything we were doing.”  Murphy, a retired physician, had led the push to close down the local beaches.

Up the road at Tybee Island, an obviously peeved Mayor Shirley Sessions issued a statement that opened on a decidedly undiplomatic note: “As the Pentagon ordered 100,000 body bags to store the corpses of Americans killed by the Coronavirus, Governor Brian Kemp dictated that Georgia beaches must reopen, and declared any decision-makers who refused to follow these orders would face prison and/or fines.”

Mayor Sessions went on to say bluntly that she and the Tybee Island City Council “do not support” Kemp’s decision and to make clear that — while the beaches themselves might be open — the town-controlled access points and parking lots would remain closed.  “At no time,” she said, “has the state designated a single point of contact to orchestrate the implementation of the Governor’s plan.”

In Florida, Governor Ron DeSantis fared little better when he finally issued a stay-at-home order on Wednesday.  Hours after signing that first order, The Tampa Bay Times reported that he “quietly signed another one that appeared to override restrictions put in place by local governments to halt the spread of coronavirus.  However, DeSantis on Thursday said the amendment he signed does the reverse, instigating another round of confusion over the intent of his directives.”

Is all this definitive?  Probably not.  Again, it’s arguably a little early for this kind of analysis.  But the data that’s already in is a little hard to ignore.

Watch this space.

Mar 30

Covid-19 seems to be hitting Georgia harder than its neighboring states

Over the weekend I published a post comparing Georgia’s Covid-19 performance with North Carolina’s and wondering out loud why the differences are so dramatic.  Today I’ve cast a wider net and put together this table comparing Georgia with its neighboring states.

March 30 SE Covid Table

Clearly, Georgia — at least so far — is being harder hit than its five contiguous neighbors.  Only Tennessee has a slightly higher Covid-19 infection rate, and Georgia leads the region in both Covid-19 deaths and hospitalizations; even Florida, with twice Georgia’s population, trails Georgia in both those categories.

The question is why?  There are obviously a great many variables at work in this situation, but at this point there’s enough data in the pot to warrant a little head-scratching.  Even if these southern states are using different protocols to determine who gets tested, we’re left with the fact that Georgia is outpacing its neighbors so dramatically in deaths and hospitalizations.

I’ve got lines out to several contacts in the public health world and hope to gather some informed answers to these questions over the next day or so.

[A note about the data above: The population numbers are 2019 Census Bureau estimates.  The raw Covid-19 data came from each state’s respective public health website as of about mid-day today.  The infection and mortality rates were calculated by dividing the number of positives or the number of deaths by the population and multiplying the result by 100,000.]

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Another interesting chunk of Covid-19 data comes from the Institute of Health Metrics and Evaluation (IHME) at the University of Washington.  It’s now out with state-by-state projections of how the now infamous Coronavirus curve — or wave — is likely to move across each state and its healthcare system.  IHME has developed a computer model that stirs together data on available healthcare resources with testing and mortality rates to date.

The projections for Georgia are grim.  IHME’s model predicts that Georgia will hit its “peak resource use” on April 22, when it calculates that the state will be short 755 ICU beds and 1,075 ventilators.  It also projects our “deaths per day” will peak the following day, April 23, at 84, and that the state will suffer a total of 2,777 deaths by August 4, 2020.

These projections are generally in line with the performance numbers posted above.  North Carolina is projected to hit its peak resource demand on the same day, April 22, but will only be short 278 beds and 676 ventilators; its “deaths per day” are projected to peak at 56, and total deaths by August 4 are forecast at 1,721.

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Meanwhile, the Economic Innovation Group, whose work I’ve cited on a number of occasions, is out with a new report focusing on the challenges Covid-19 poses for the country’s most “distressed communities,” many of which are rural.  Indeed, the new EIG report echoes and puts meat on the bones of an argument I started making nearly two weeks ago — namely, that Covid-19 represented a “perfect storm” for rural Georgia.

EIG annually assigns “Distressed Community Index” scores to all 3,000-plus counties in the nation, as well as all cities with populations of 50,000 or more.  It does this using a formula based on seven socioeconomic factors; a few years back, it named Albany one of the 10 most distressed mid-sized cities in the country.

This new EIG report offers four key takeaways:

  1. The uninsured rate for residents of distressed counties is much higher than those living elsewhere.
  2. Residents of distressed counties are more likely to be elderly and susceptible to complications resulting from coronavirus infection.
  3. Life-threatening health disorders are more prevalent and more dangerous in distressed areas.
  4. Life expectancy is already significantly shorter in economically distressed places.

After fleshing out each of those points, EIG then turns its attention to the state of healthcare systems in distressed communities.  It reports that it had analyzed more than a decade’s worth of American Hospital Association (AHA) data and found that distressed communities had seen a 16 percent reduction in the number of hospital beds between 2006 and 2017.  This report doesn’t offer a state- or county-level breakdown, but rural Georgia has almost certainly suffered that level of loss of beds over the past decade or so.