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I thought I was done with poring over COVID case data. Things change.

I took a look at what is happening in the US on a state by state basis. It’s stunning to see. The best metric for prevalence of COVID is number of cases adjusted for population. Specifically, I’m looking at the number of new cases over a seven day period per 100,000 residents. Through this prism the crisis is overwhelmingly concentrated in three contiguous states along the Mississippi River: Missouri, Arkansas and Louisiana. Plus Florida.

Florida bulks larger in the actual toll of the disease because it’s a much larger state. But the per capita metric is very similar in all four states. Missouri (245), Arkansas (267), Louisiana (228), Florida (264).

As you can see from this CDC infographic, Nevada and Mississippi looks pretty close. But they’re not that close. 181 and 165, respectively. Those four states are really in a category of their own.

The case rates track broadly with levels of vaccination. The Deep South has some of the lowest rates of vaccination and they’re getting hit the hardest. Meanwhile rates in the Northeast are about 1/10th what they are in Florida and those three Mississippi River states. But this shouldn’t prompt either a sense of superiority or relative safety. California is only a bit behind New York on vaccinations but their case rates are much higher. Florida’s rate of vaccination isn’t as low as you might think, certainly not so low as to explain the high case load on its own. Clearly there’s an interplay of vaccination density, mitigation and regionality.

It’s also true that in the mass vaccination era cases no longer track with disease severity and mortality. But in the hard hit states deaths are mounting rapidly.

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