Good morning. On Covid, the U.S. looks increasingly like two different countries.

July 7, 2021

By David Leonhardt

Good morning. On Covid, the U.S. looks increasingly like two different countries.

A mobile vaccination crew in Jackson, Wyo.Ryan Dorgan/Jackson Hole News & Guide, via Associated Press

‘Please take this seriously’

The spread of the Delta variant in relatively unvaccinated parts of the U.S. is getting worse.

Nationwide, the number of new Covid-19 cases is holding steady. But that steadiness hides two dueling realities, in two different Americas.

In many urban and suburban communities, Covid continues to plummet. The rate of new daily cases has fallen below three per 100,000 residents in large cities like Atlanta, Boston, Chicago, Detroit, Houston, Minneapolis, New York, Philadelphia, San Francisco and Washington. As a point of comparison, the national rate of new daily cases peaked last winter above 75 per 100,000 people.

But in less populated areas — which tend to be more politically conservative and skeptical of vaccines — the virus is now surging, largely from the contagious Delta variant. The states with the worst outbreaks are Arkansas and Missouri (each with more than 16 new daily cases per 100,000 people) followed by Florida (10), Nevada (10), Wyoming (nine) and Utah (eight).

If these outbreaks were concentrated among younger people, it would be less worrisome, because Covid, including the Delta variant, is overwhelmingly mild for children and young adults. Yet even many middle-aged and older adults are not vaccinated in parts of the U.S. They are catching the virus as a result, and some are dying.

There is a clear relationship between a state’s Covid death rate over the past week and its overall vaccination rate:

By The New York Times | Sources: State and local health agencies, Centers for Disease Control and Prevention, U.S. Census Bureau

(You can look up any state’s data here.)

Preventable deaths

The biggest tragedy is that this situation is avoidable. Highly effective vaccines are available to virtually any American adult who wants one — a privilege that residents of many other countries do not have. Hundreds of U.S. clinics, including in rural communities, offer immediate, walk-in shots.

Still, only 54 percent of adults in rural areas have received at least one vaccine shot, according to the most recent Kaiser Family Foundation poll, compared with 72 percent of urban residents. Kaiser found that vaccination rates were also below average for Americans under 50; Black Americans; Republicans; and people without a college degree.

“It is the unvaccinated people who are dying,” Dr. Thomas Dobbs, Mississippi’s state health officer, said, according to the television station WLBT. “The unvaccinated people who are going to the hospital. The unvaccinated people who are getting diagnosed, for the most part.”

Tricia Jones, a 45-year-old mother of two in Grain Valley, a small city in western Missouri, did not get the vaccine because she was concerned about the side effects. Her mother, Deborah Carmichael, had felt sick after getting a shot, and Jones decided to wait.

This spring, Jones caught the virus. She was hospitalized May 13 and died June 9. Now, as Sherae Honeycutt of Fox4 in Kansas City writes:

Her family is praying people will see Tricia’s life as a call to action to get their vaccine — if not for themselves, for the ones they love. “Please take this seriously. You don’t want to see a family member you love go through this,” Carmichael said. “You have a way better chance of coming out OK than if you don’t.” “I really miss you. I miss you a lot,” Adriana [Jones’s 18-year-old daughter] said.

Marc Johnson, a University of Missouri immunologist, told The Missouri Independent that he expected the state’s outbreak to continue worsening for much of July. In some communities, the Delta variant has only recently arrived, suggesting a coming surge.

Despite the rise in caseloads and deaths, many Republican politicians have declined to offer a full-throated call for vaccination. Instead, state legislators in Missouri have warned hospitals not to require employees to get vaccinated. And Gov. Mike Parson has sent mixed messages.

“You’re gonna have to take responsibility, to take the vaccine, if you so choose to,” Parson said last week. “But you know, I think it’s important to understand that there’s risk involved.”

A few Republican governors have taken a different approach. “We’re in a race against this Delta variant,” Gov. Asa Hutchinson of Arkansas said on Sunday. “The solution is the vaccinations.” Gov. Jim Justice of West Virginia was blunter: Anybody who is not vaccinated, he said, has entered “the death lottery.”

For more:

To reach unvaccinated Americans, President Biden said the government would set up clinics at workplaces and urge employers to offer paid time off.