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The United States combines a vast territory, a large population, and a decentralized government. Because of this, epidemiologists have a complex task ahead of them when attempting to draw all-encompassing recommendations or even to describe widespread trends in Coronavirus cases.

Across the country, infection and death rates are best analyzed on a state-by-state basis. Public health initiatives are always defined by the features of the local healthcare services, and by the characteristics and lifestyles of their users (El Sadr, 2020). 

In addition, local authorities have enforced specific policies at key moments of this pandemic. The effectiveness of each will likely be studied for years to come. At this point, the pandemic is still ongoing, but the figures that exist so far can allow experts to gain some insights.

Confirmed Case Rates per State

The following table lists all states by the amount of total confirmed cases per 100,000 people, as recorded by the Center for Disease Control and Prevention (2021). It has been arranged from highest to lowest. For reference, across the United States, the average case rate per 100,000 people is 9,866.

StateCase Rate per 100,000 people
North Dakota14,317
Rhode Island14,196
South Dakota13,976
Tennessee12,561
Utah12,549
Arizona11,987
Iowa11,703
Wisconsin11,497
Nebraska11,494
Oklahoma11,403
South Carolina11,393
New Jersey11,377
Arkansas11,223
New York City11,217
Alabama11,010
Delaware10,975
Indiana10,914
Illinois10,772
Kansas10,699
Idaho10,632
Mississippi10,574
Minnesota10,526
Georgia10,502
Florida10,461
Nevada10,407
Montana10,352
New York10,314
Wyoming10,208
Massachusetts10,178
Kentucky10,123
Texas10,068
Louisiana9,999
Michigan9,776
Connecticut9,676
Missouri9,666
New Mexico9,569
North Carolina9,443
Ohio9,327
California9,272
Pennsylvania9,257
Colorado9,222
Alaska9,115
West Virginia8,829
Virginia7,852
Maryland7,543
New Hampshire7,175
District of Columbia6,876
Washington5,550
Maine4,889
Oregon4,628
Puerto Rico4,279
Vermont3,822
Hawaii2,296

Mortality Rates per State

The number of confirmed Coronavirus cases per state only tells one side of the story. In each state, the direct spread of the virus has been directly addressed by local authorities in different manners. Further, testing rates have differed, which has also influenced the number of confirmed cases in each jurisdiction. 

The other side of this story is told by the people who have died. The socio-economic conditions of each state’s population, and the features of its healthcare system, have also affected the outcomes of those who became ill (Karmakar, Lantz, and Tipirmeni, 2021).

In the table below, the death rate per 100,000 people is shown, divided by state. Information was arranged from highest to lowest. For comparison, the average for the United States is 175 deaths per 100,000 people. As of May 17th, 2021, over 585,000 Americans have died due to COVID-19.

StateDeath Rate per 100,000 people
New York City392
New Jersey292
Massachusetts257
Rhode Island254
Mississippi243
Arizona239
Connecticut229
Alabama225
Louisiana225
South Dakota225
Pennsylvania208
Indiana200
Michigan198
North Dakota197
New Mexico196
Illinois195
Georgia193
Arkansas191
Iowa190
South Carolina187
Tennessee180
Nevada179
New York177
Oklahoma174
Kansas172
Texas172
Delaware169
Florida167
Ohio167
District of Columbia158
California155
West Virginia153
Montana149
Kentucky148
Maryland147
Missouri144
Wisconsin132
Minnesota130
Virginia129
Wyoming123
North Carolina122
Nebraska116
Idaho115
Colorado111
New Hampshire97
Guam83
Puerto Rico76
Washington73
Utah70
Oregon61
Maine59
Alaska47
Vermont40
Hawaii34

Current Spread and Fatality Trends

As can be gleaned from the figures above, the overall death rates for Coronavirus are still defined by the effects of the initial wave, between March and May 2020. Ever since localized surges have occurred in specific states at varying intervals. On a national scale, both cases and fatalities reached their highest peak during winter 2021.

New date reported per day
Figure 1 © Washington Post 2021

Beginning in March 2021, cases and fatalities began to diminish once again. Currently, the daily count for reported deaths has fallen by 14%, and the confirmed case count has fallen by 19.1%.

Yet, cases, hospitalizations, and deaths continue to increase in specific states. Over the past week, the following hotspots have been identified. 

Average daily cases
Figure 2 © Mayo Clinic 2021

The table below displays the states who have had the highest Coronavirus case and death rates (per 100,000 people) over the past 7 days.

State7-Day Case Rate per 100,000 people7-Day Death Rate per 100,000 people
Colorado150.91.5
Michigan1442.9
Maine1280.5
West Virginia124.41.7
Minnesota118.21.1
Washington114.10.8
Florida105.31.7
Oregon103.71.4
Pennsylvania100.31.7
Delaware951.5
New York City58.22.2.
Nebraska41.32.1
Puerto Rico43.3.2
Illinois93.11.8
New Jersey331.8

Vaccination Rollout

As of May 17th, the following states have fully vaccinated the largest percentages of their population:

StatePercentage of Total Population who is Fully Vaccinated
Connecticut48.7
Maine48.7
Vermont47.5
Massachusetts47.1
Rhode Island47.1
New Mexico44.6
New Jersey44.4
Hawaii44
New York State42.8
Maryland42.6

Meanwhile, vaccination rates remain the lowest in the following states:

StatePercentage of Total Population who is Fully Vaccinated
Wyoming30.4
Tennessee29.9
Georgia29.5
Louisiana29.5
Arkansas29.3
Utah29
Virgin Islands28.1
Alabama27.6
Mississippi25.8

Final Thoughts

The evolution of case counts and mortality rates has been influenced by varied factors. These include the presence of local measures, including partial lockdowns, mask mandates, and travel patterns. During the early months of 2021, the presence of more transmissible variants of concern has also played a role. 

The current respite seems to coincide with the beginning of the mass vaccination sites. Yet, it remains difficult to discern conclusive unifying patterns between new Coronavirus cases, mortality, and local circumstances.

References

Center for Disease Control and Prevention (2021). COVID Data Tracker. Accessed on May 16th, 2021 at https://covid.cdc.gov/covid-data-tracker/

El-Sadr W. M. (2020). What one pandemic can teach us in facing another. AIDS (London, England), 34(12), 1757–1759. https://doi.org/10.1097/QAD.0000000000002636

Karmakar, M., Lantz, P. M., & Tipirneni, R. (2021). Association of social and demographic factors with COVID-19 incidence and death rates in the US. JAMA network open, 4(1), e2036462-e2036462.

Mayo Clinic. (2021). U.S. coronavirus map: What do the trends mean for you?. Accessed on May 17th, 2021 at https://www.mayoclinic.org/coronavirus-covid-19/map (image)

The Washington Post. (2021) U.S. Coronavirus cases and state maps. Accessed on May 17th, 2021 at https://www.washingtonpost.com/graphics/2020/national/coronavirus-us-cases-deaths/  (image)


Jennifer Billings is the Medical Editor at National Coronavirus Hotline(NCH). She is an Integrated medical doctor who has been published on NCH Blog, Medium.com and is a regular contributor at MedCity News, Physician Family, and Psychology Today.