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Amid peak cases and hospitalizations, with new restrictions on the way, Californians can be forgiven for wondering if our efforts were worth it. We’ve been masking and social distancing for months now, and all we hear is how things are getting worse.
But in truth, the latest figures show that California, happy with the shutdown, continues to fight the coronavirus better – on a relative basis – than most other states.
California is the only state with a grim record of 20,000 cases in one day – twice last week – but that doesn’t take into account the overwhelming number of people who live here. In fact, 38 states reported more infections, as a proportion of their population, than California over the past week. As for deaths from the coronavirus? We’re in 48th place – just two others reported a lower total of seven days of death per capita.
“I think we have to pay tribute to California for keeping things relatively under control,” said Dr. George Rutherford, an infectious disease specialist at UC San Francisco. “It’s not under control at all now.”
It’s also a point of pride for Governor Gavin Newsom, even though he calls on Californians to curl up and control the current outbreak.
“It’s important to put California as a state in perspective against other states,” Newsom said recently, highlighting per capita infection rates. “We are doing better, relatively speaking, than the overwhelming majority of states.
“Having said that, the alarming concern is the rate of growth.”
Indeed, intensive care hospitalizations and intubations are increasing rapidly in California, a known precursor to an increase in deaths that has led six-county Bay Area health officials to stack restrictions on top of our existing restrictions Friday. But state-to-state comparisons suggest that these restrictions do help. States with the worst rates, in general, have had the fewest rules.
So how exactly does the Golden State stack up against its 49 peers?
- Case: 42.4 per day per 100,000 in the last seven days (39th at most)
- Death: 1.4 per 100,000 in the past week (48th at most)
- Hospitalizations: 24.6 per 100,000 as of Friday (37th at most)
Where is the pandemic worse than in California?
South Dakota
- Daily cases per 100,000: 116.4 (1st), -20% vs 2 weeks ago
- Weekly deaths per 100,000: 21 (1st), + 33%
- Active hospitalizations per 100,000: 60.8 (1st), -7%
Throughout the spring and summer, as cases increased in the northeast and then the south, COVID-19 remained out of the sparsely populated South Dakota. Scolding health experts, Governor Kristi Noem never implemented a mask mandate and chose to keep schools and businesses open, becoming a popular hero for the anti-restriction mob.
But in August, more than 400,000 bikers descended on tiny Sturgis, SD, for its famous annual rally. Noem welcomed them all. In the coming months, as many as 250,000 cases in multiple states have been linked to the 10-day rally, according to a study.
Since the start of September, South Dakota has been competing with its northern neighbor for the highest per capita infection rate in the country. This week, the state recorded its 1,000th death from COVID-19, half of which has occurred since early November.
Noem continues to describe wearing a mask as a “personal choice” and has said she will not apply for a national mandate, as proposed by President-elect Joe Biden. Yet while schools have remained open, some districts have recently switched to distance learning after too many staff were called in sick.
In North Dakota, the infection rate peaked higher than in South Dakota, but also fell further, to around 87.4 / 100K, seventh nationally. There, more than one in ten inhabitants has been infected; in South Dakota, it’s just under one in 10. In California, about one in 30 people have been infected during the pandemic, and in the Bay Area, it’s closer to one in 50.
“They’ve had a lot of illnesses,” Rutherford said. “At least in some places they can have a bit of herd immunity.”
Wisconsin
- Daily cases per 100,000: 69.8 (22nd), -41%
- Weekly deaths per 100,000: 6.0 (16th), -11%
- Active hospitalizations per 100,000: 30.1 (34th), -17%
In Wisconsin, the infection rate has dropped by almost half from its peak two weeks ago. Still, it remains 65% higher than the rate in California, which has skyrocketed over the same period.
Newsom has been subject to judicial review for his COVID plans, but has nothing on Governor Tony Evers. Wisconsin’s top elected officials are awaiting a state Supreme Court ruling on his statewide mask tenure, which in May overturned the governor’s original decision to stay at home. In October, Evers attempted to reduce capacity at public indoor gatherings, but that order was also quickly challenged and overturned by the High Court.
When Evers issued the October order, the state was processing an average of nearly 2,500 cases per day. Almost a month after that, with the Evers public rally rule, Wisconsin’s infection rate peaked at 7,000 per day. That’s a per capita rate of over 120 infections per day per 100,000 inhabitants.
Today in Wisconsin, about one in 14 residents has been infected. Almost everyone knows someone who has been sick. And yet, even without further restrictions, cases are finally falling.
It’s possible that all of the publicity about the high-profile brawl was enough to change people’s behavior, Rutherford said, drawing a comparison to the HIV / AIDS epidemic in San Francisco.
“One of the things we learned very early on from AIDS was that where HIV transmission declined, people had personal knowledge of someone who had AIDS or who died of AIDS,” Rutherford said. “And that’s where behaviors started to change.”
Where is the pandemic better than in California?
Maine
- Daily cases per 100,000: 13.7 (49th), -4%
- Weekly deaths per 100,000: 2.2 (41st), + 150%
- Active hospitalizations per 100,000: 10.3 (48th), + 58%
Heralded as the biggest achievement in the contiguous United States, Maine is starting to take on a darker tone these days.
Even with the second-lowest infection rate in the country, the state this week reported its highest single-day case total since the start of the pandemic. That was a whopping 325, a number surpassed in a day by any county in the Bay Area recently. Per capita, the current rate in Maine is just a quarter of that in California. But that shouldn’t sound too foreign to residents of the Bay Area: our area’s case rates were lower than that as recently as the end of October.
Maine’s policies may also sound familiar: Governor Janet Mills made a mandatory quarantine for inbound travelers long before there were any in Los Angeles or Santa Clara County. And like her counterparts here, she keeps the pressure on. As cases escalated in early November, Mills slashed plans to open indoor service in bars, put in place a curfew for foreign service, and changed the mask’s mandate to l statewide to require a face mask in all public settings.
Hawaii
- Daily cases per 100,000: 5.8 (50th), + 12%
- Weekly death per 100,000: 0.6 (50th)
- Active hospitalizations per 100,000: 4.0 (50th), -26%
Nine months after the start of the pandemic, Hawaii has controlled the virus better than any other state, but it has beaten its tourism industry to do so. Now restrictions have eased, but the wave of infections sweeping the country has yet to hit its pristine beaches.
When the pandemic struck, Hawaii was faced with a difficult question: How does a tourist destination, cut off from the mainland, prevent visitors from causing disease to its shores?
By applying its strictest restrictions to anyone visiting the islands.
In March, shortly after the first decision to stay at home in the Bay Area, Governor David Ige also took a bold step: In addition to closing bars and relegating take-out-only restaurants, he also asked tourists to stay away for the next 30 days. Then he implemented the country’s first mandatory quarantine for anyone arriving on the islands, liable to heavy fines.
In October, tourists finally began to return, the first pre-arrival testing program from Hawaii allowing travelers to evade quarantine. In November, the first international visitors returned to the islands as part of the expanded testing program.
So far, the resumption of tourism has not triggered a significant increase in cases on the islands.
But what about real California peers?
The country’s four most populous states have taken divergent approaches to tackling the virus.
Molded by the early pushes and Democratic leadership, California and New York locked up more Americans than any other state. Meanwhile, the Republican governors of Texas and Florida, who both escaped the first wave of infections in the spring, have opted for hands-off approaches.
Yet nine months into this story, the per capita infection rates last week in California and Texas were almost identical. In Florida there were about 5% more infections per capita and in New York City about 5% less than in California over the past week. Which give?
A closer look at the numbers indicates that California is indeed doing better than the other major states in the country, restrictions or not. A single data point:
About 50 Californians in 100,000 have died since the start of the pandemic. In Texas, Florida and New York City, per capita death rates are each at least 50% higher.
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