Since the beginning of the COVID19 epidemic in the United States it’s been clear that there’s no single epidemic in the United States. There is more a series of urban and regional epidemics unfolding at different times and with different intensities. To a degree this is true for every country. But it is especially so for the US since the country is so large, both in terms of geography and population. More specifically or at least for now there is a New York epidemic and the rest of the country.
I’ve put together a series of graphs illustrating these two epidemics, which I’ve published here. But really it’s not New York State but rather the New York City metropolitan region which includes large population centers in New Jersey and Connecticut. The NYC metro may be in three state jurisdictions but it’s a single population, commuter and economic region and thus a single epidemiological region.
I’m not able to carve up the numbers for the NYC metro. But what I’ve done below is take the number of COVID19 positive cases and fatalities for all three states and compare them to the rest of the country excluding those three states. It gives us a much clearer sense of what it happening in the country as a whole outside this one urban region.
As you can see, the trend lines are significantly different.
It is important to note that the number of tests being conducted every day started rising about ten days ago and seemed to hit a new plateau about a week ago. Some of the rising number of cases nationwide is driven by doing more tests. But they’re doing more tests in the NYC metro too, though the rise isn’t as big. The outbreak appears to be growing nationwide even when you take increased testing into account.
There’s an argument that the mortality numbers are a better gauge of the difference between the epicenter region and the rest of the country since they partly remove testing from the equation. But they don’t remove it entirely. That’s what make a death a COVID19 death – a lab positive test. But it’s not just that. There are also reasons to believe that the states outside the NYC metro are capturing fewer of their COVID19 deaths in their health reporting systems than these three states.
Those are questions for further study. What’s clear even on the basis of this very broad strokes data is that you can’t make sense of the national trends – especially for the ‘opening up’ debate – without looking at the numbers in and outside of the epicenter of New York City and the surrounding suburbs and exurbs.