Polarized Pandemic Response and Covid-19 Connectedness Across US States

Yves here. This study is useful because it tests and confirms some widespread intuitions: that more aggressive Covid containment measures reduce contagion levels, and that the degree of connection between high infection areas (which skew Republican) increases infection among them and also generates net spread to lower infection states.

By Umut Akovali, Post-doc Researcher, Department of Economics, Koç University and Kamil Yilmaz, Professor of Economics, Koç University. Originally published at VoxEU

Balancing the trade-off between strict public health measures and economic activity has been the key concern for governments since the Covid-19 outbreak. This column studies Covid-19 infections and their connectedness across US states. It finds that states with lax government policy and community mobility response had higher case growth trajectories and generated connectedness of Covid-19 cases to other states. Further, states with Republican governors tend to have higher connectedness of Covid-19 cases among themselves and generate net connectedness to states with Democratic governors.

Balancing the trade-off between strict public health measures and economic activity has been the key concern for governments since the Covid-19 outbreak.  While strict measures impose high economic costs, they may play an important role in containing the spread of the virus, and consequently in preventing a more prolonged and costly reduction in economic activity (Furman 2020, Odendahl and Springford 2020). In the case of the US, the federal government showed a lax response to the pandemic, focusing on the economic impact rather than the rapidly increasing cases of Covid-19 and the death toll.  The resulting public debate politicised the federal and state-level public health policies and led to the formation of demarcation lines across the party lines in a year of presidential elections.

In a new paper (Akovali and Yilmaz 2020), we study the substantial differences in state-level responses leading to a wide variation in the new Covid-19 case trajectories across the country. Our work adds to the recent literature by demonstrating the close association between government policy and community mobility responses to the pandemic and the trajectories of new Covid-19 cases as well as their connectedness/spillovers across the US.

Politicised State-Level Response and Pandemic Momentum

We first focus on the relative performance of the states in terms of new Covid-19 cases. Figure 1 shows the average per-capita number of daily new cases of Covid-19 in states with Democratic and Republican governors. Many coastal states that have Democratic governors were harshly hit at the earlier stages of the outbreak, but they managed to limit the pandemic’s early growth with strict measures.  The states with Republican governors outstripped their Democratic counterparts as of the first week of June. Since then, the number of new cases per capita has been 30-40% higher in states with Republican governors compared to states with Democratic governors.

Figure 1 Average per-capita new cases in Democratic and Republican states

In a next step, we use panel regression analysis and find that the strict public health policy implementation by state governments was critical for containing the virus. Panel regression results also reveal that the changes in community mobility patterns played a crucial role in the containment of Covid-19 cases. States with Democratic governors (blue bars) overwhelmingly followed more stringent (above the national average) policies to contain the virus. In contrast, the majority of the states with Republican governors (red bars) followed less stringent (below the average) policies (Figure 2).

Figure 2 Average state-level government stringency index

Figure 3 shows the time-series of the unweighted average government policy response in the states with Democratic and Republican governors.  While panel a shows that, on average, states with Democratic governors followed more stringent policies than those with Republican governors, panel b displays a clear positive trend of the policy stringency difference between the two groups over time. Both panels of Figure 3 provide further evidence for the government policy difference between the states with Democrat and Republican governors.

Figure 3 Stringency index in Democratic and Republican states

Even though the community’s use of public spaces can be influenced by strict public policy measures, this also depends on the local community’s awareness of the risks involved. Therefore, it is worth focusing on the changes in the state-level community mobility patterns in response to the pandemic.  The average mobility indices for the two groups of states in Figure 4 (panel a) depicts a picture similar to the one for the policy stringency index in Figure 2.   Communities in states with Democratic governors decreased their use of public spaces more than communities in states with Republican governors. This difference persisted until the end of the sample on 23 October.

Figure 4 Community mobility and travel intensity: Democratic vs Republican states

In line with the lax government policies, states with Republican governors also did not impose air travel restrictions across states. Consequently, travel intensity between states with Republican governors has been higher than the travel intensity between states with Democratic governors. Furthermore, travel intensity from Republican to Democratic states has been higher than travel intensity from Democratic to Republican states (see Figure 4, panel b).

Within and Between Connectedness Dynamics across Democratic and Republican States

The absence of leadership from the federal government resulted in relatively high rates of Covid-19 cases in many states. Moreover, the substantial variation in public health policy measures across states fostered the transmission of Covid-19. In a time-series context, a connectedness analysis (Diebold and Yilmaz 2014) is a useful tool to estimate the transmissions when structural models are not readily available. The connectedness of case growth provides further empirical evidence on the dissociation between the pandemic’s course in states along the party lines.

In our paper, we show the dynamic behaviour of system-wide connectedness over time. Connectedness was much more volatile in the early phases of the Covid-19 pandemic, but it became relatively more stable over time. Interesting results are obtained when the state-level connectedness measures are aggregated along the political party lines. As expected, the Covid-19 connectedness between Democratic states (Figure 5a) and from Democratic to Republican states (Figure 5b) is higher in the early phases of the pandemic.  Starting in May, however, there was a reversal in the direction of Covid-19 connectedness. The directional connectedness from Republican to Democratic states and between Republican states peaked when the number of new Covid-19 cases in Republican states increased from the middle of May up to the first week of July. As Americans started travelling for the summer holidays, Covid-19 cases increased in both Democratic and Republican states from the 4th of July up to the Labor Day weekend.  Consequently, over this period, the directional connectedness within and between Democratic and Republican states fluctuated around the same level. After the summer vacation, the directional connectedness from Republican to Democratic states and within Republican states increased again.

Figure 5 Within and between group connectedness across republican and democratic states

Finally, using secondary regression analysis, we focus on the impact of government and community responses and the travel intensities on the directional connectedness between pairs of states.  The states with lax government and community responses to the pandemic generated connectedness of Covid-19 cases to those states that followed stricter policy and community response.  We also found that Covid-19 connectedness between pairs of states was quite strongly related to the travel intensity across states, as measured by the mobile phone location exposure index (LEX).  Finally, the Republican party affiliation of the governors turned out to be a significant determinant of the pairwise Covid-19 connectedness across states.

Conclusion

We show that politicised responses to the coronavirus pandemic contributed to the spread of the virus across US states. We further find that strong government and community responses were effective in reducing the number of Covid-19 infections and lower the connectedness of Covid-19 cases across states. Finally, we conclude that unless the federal government starts implementing stringent public health policies at the national level and coordinating state-level policies, controlling both Covid-19 cases and their connectedness across states will remain challenging.

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42 comments

  1. Louis Fyne

    what are the per capita fatalities by red v. blue states? ideally normalized by age as some states (plains) skew older.

    honest question that I don’t have an answer to.

    the info is at the CDC website, I’d do the math….but no time.

    1. juno mas

      Well, that’s a fair question. It is likely one that the authors didn’t have the time to delve into. also. Many studies like this end with this sentence: Further study is needed to confirm these findings.

      1. flora

        I really hate the way both parties’ estabs and the MSM politicized the pandemic information and best practice responses right off the bat. The continuing red state vs blue state framing continues that politicization, imo.

        At the start of the pandemic the “red” states, being inland, were spared the worst of what was happening in NY and CA because the wave hadn’t reached them yet. As the wave reached the “red” states the “blue” states started to see the worst recede. Instead of talking about a wave movement, too many MSM outlets engaged in a moralizing schadenfreude. Don’t forget all the meat packing plants in rural areas where workers are denied PPE by the owners. There are lots of variables, including the closures of hundreds of rural hospitals and the loss of doctors and nurses in rural counties over the past 10 years. Now the wave seems to have rebounded into CA and NY and other “blue” states. This isn’t a football game to root for one color or the other in an effort to show one “side” is best.

    2. semiconscious

      this’s the correct question. & this’s the only question that’s ever mattered during previous pandemics. as long as it is that ‘positive pcr tests’ continue to define the covid pandemic conversation, is as long as it is that we continue to misunderstand & remain confused about what is truly going on…

      1. furies

        No fooling about the deaths tho, huh?

        This sidetracking of the ‘cycles of PCR’ tests is getting boring…

        and the ‘red’ states and rural ‘red’ areas are just now picking up momentum…

        1. inhibi

          Exactly.
          Above info is useless, you may as well talk about “frequency and adherence to COVID tests”.
          Once again, TESTS MEAN NOTHING. Do I also have to mention the 50%+ false positive rate?

    3. voislav

      Per capita fatalities are misleading, because early wave in March had a much higher fatality rate than later waves. This is the wave that hit the blue states, so blue states would show higher overall fatality rate. Later waves, ones hitting the red states harder, benefited from prevention and treatment lessons learned during the first wave, so mortality rate was lower.

      Getting proper data in the US is really hard, because even at the state level there is a big difference in response between the larger cities, which tend to be blue and rural areas, which tend to be red even in blue states. Enforcement also plays a role, different counties may enforce the rules to a different degree.

      1. Spoofs desu

        Also, I do not see any ,emotion of number of tests per capita. ( more tests create more cases).

        Or whether the same tests were used and whether they are measuring the same thing with respect to the degree to which false positives; related to the pcr mentioned.

        1. furies

          More tests and more deaths, disability and financial distress.

          Hey–are you suggesting that we just shouldn’t ‘test’?

          “It’s just the flu, brah…”

          stop it.

        2. drumlin woodchuckles

          My understanding is that more tests don’t creATE more cases, they merely FIND more cases IF there are more cases to BE found.

          Or am I wrong?

      2. Carolinian

        benefited from prevention and treatment lessons learned during the first wave

        Quite true. Contra the premise of the above post people out in the boonies are wearing masks and have been for months, It could be that mask orders really aren’t helping very much although I’m sure they help a lot more in cities where public transportation and crowded stores and sidewalks are the norm. Without a doubt urban environments are more conducive to covid which is why a one size fits all scolding of the flyovers is inappropriate.

        In my state a third to a half of the deceased have been in nursing homes as is true everywhere else. Maybe what we really have is a nursing home problem. That goes for the blue states as well and especially NY.

        1. Yves Smith Post author

          “In the boonies people are wearing masks”? Really? That’s serious Making Shit Up.

          I can tell you here in AL that is absolutely false, even in affluent rural areas. IM Doc reports little mask wearing in his rural area. My contacts in CA say mask wearing is poor in the Inland Empire.

          The only place I have heard where your statement is consistently true is upstate NY. It may be good in Maine too (I saw this but only in the affluent tourist areas on the coast, which are not really rural) but Maine is odd due to very little night life (as in comparatively low levels of bars even in the well off parts).

          1. Carolinian

            As I mentioned in a previous comment the Upstate SC area where I live currently has the highest Covid rate in the state while the two main cities have had mask ordinances since the beginning of the summer. And in my of–course–limited experience people are wearing masks in stores with, always, a few exceptions.

            I’d say the notion that Red Staters are somehow less concerned about their health or that of their families and prioritize political defiance is a stretch. Surely you see just as much defiance up North including the religious as Cuomo takes on those Brooklyn orthodox Jewish communities. If places like NYC are now seeing a much lower rate of disease it’s probably because the huge early toll reduced the available victims. At any rate political explanations don’t convince–not this reader at least.

    4. Glen

      Certainly interesting data on Red State Vs Blue State, but that’s the division they want us to embrace. Keep the poors arguing over $1200 while the billionaires get trillions.

      It’s much more a rich vs. poor, has healthcare vs. no healthcare. Essential (expendable) vs. Stay Home.

      Face it, we have been abandoned by the Federal government, the states are all doing the best they can given the people that voted them in and may be running the state. But states don’t print money like the Feds, and they are going to start having to roll back services in a major way.

      We are going to get no help until either Wall St crashes or the gun toting people wise up and start shooting rich people. Until then it’s poor on poor warfare – may the best rats get the scraps.

      1. Walter

        You make some good points. The study ‘framed’ an outcome that could well have be equally framed in other ways.

    5. M. La

      I was told by a nurse here in Ohio that WVA is sending up patients right before they die. She was upset because the numbers are going to show the deaths at her hospital. I trust this person, she is a longtime neighbor. I don’t think you can accurately judge by anything at this current stage.

      1. furies

        “They” did this to my brother…discharged him *with active Covid* and he died that night at home, infecting how many all along the way?

        My poor brother…

    6. Pym of Nantucket

      I know a great statistic for Canada where I live. The number of deaths of individuals under 40 with no comorbidity is zero. Zero. That is as of Dec 10, 2020.

      The mindless blanket response to this is like chemotherapy. Note the extremely low death rates in countries with warm weather where elderly don’t live in concentration camps. Coincidence? Poor vitamin D, ventilation air, lack of natural UV germicidal effects.

      Seems pretty obvious they should direct the massive response to this to geriatric care where people are dying so the rest of society can function and support the elderly.

      The whole thing has been a science-free zone. It’s airborne in the crowded old folks homes where we ignore and neglect the people who raised us. Why this concerted effort to not allow statistics to come out? Fear of no fear?

      My two cents…

      1. eg

        A salient problem with your thesis — there are loads of people with comorbidities, and they are sprinkled throughout the population in such a way as to defy isolation.

  2. John Zelnicker

    I haven’t finished reading yet, but there needs to be a close code for the bold typeface after the first sub-head: “Politicized State-Level Response…”

    Also, Figure 4 is stretched out vertically to the point of being almost unreadable.

    It looks like Jules is on duty this morning, and I’d like to thank him for all the critical work he does to keep this web site running so well.

    Y’all stay safe.

  3. sharonsj

    I live in Pennsylvania; all the rural areas are Trump country along with certain portions of the larger cities (but our Governor is a Democrat). A customer came in last Sunday raving that he was forced to wear a mask in order to enter the building. He said that Covid was no worse than getting the flu–and then admitted he got all his news from watching Tucker Carlson on Fox. I told him I thought he was wrong but I would check the actual figures, which I did while visiting a reporter friend. I went to several medical web sites and then she went to the CDC web site. We estimated that Covid was about ten times more lethal. He hasn’t come back yet, but I know that when I tell him he’s wrong, he will tell me the numbers are fake. You just can’t win with these folks.

        1. JBird4049

          The California Republican Party has been getting crazier after each election that they loses some seats. Right now the Democrats have a super-majority in the Assembly, which makes the Republicans super nuts as if going insane will make them attractive. Unfortunately, it helps to make the base crazy also. To them reality, along with the Libs, is an enemy.

          Joy.

    1. Big Tap

      You mean Pennsylvania where Governor Wolf has just been diagnosed with Covid-19. Guess he wasn’t wearing his mask as often as he should have been or not social distancing properly. Wolf just shut down (again) indoor dining in restaurants, casinos, and K thru12 school sports but for now not schools. That should put the stake in many restaurants for good as they were barely hanging on. It’s too cold now in the state to eat outdoors. Yet Costco, Amazon. BJ’s, Sam’s Club, Target and other large stores never get shut down. Makes me wonder why. Yes I am cynical. I’ve been in big stores and people are closer than six feet from each other often. I do wear a mask for my self protection. Same reason why I wear a seat belt. I see what Tucker Carlson says but I ignore it cause I do think masks help. Maybe not much but I’ll take anything available.

  4. Shiloh1

    There’s that “state thing” again.

    Just for fun go to Illinois and start at Illinois Route 1 (Halsted Street) in Wrigleyville-Chicago and drive south on it about 7 hours until you get to Cairo, IL. After the first hour of the drive the rest bears no resemblance and little connection to Chicago. Some great Amish-style restaurants in Tuscola and Arcola, by the way.

    1. DJG

      Depends.

      If you get on North Avenue (Route 64) and head west to Oregon and to the Mississippi River at Savanna, you’ll find cultural continuity across the northern tier of Illinois from Stockton and Antioch south to Galesburg, Dixon, and Kankakee. This part of the state was settled by New Yorkers and New Englanders–you have only to go into a graveyard to check that. There’s as strong Swedish influence and ethic extending from Chicago to the Quad Cities.

      Jane Addams, who had a major impact on Chicago, is buried in the graveyard in Cedarville, along with more Union dead than I expected. It was disturbing, but then Galena is still associated with Ulysses Grant.

      The northern third of the state is still very much the Land of Lincoln. As mentioned, there is cultural continuity, and it still matters.

      You may have noticed that.

  5. IdahoSpud

    Yeah, about that. One of our early outbreaks arrived from Seattle, when several 1% ers decided to make a lark of doing their lock-down thingie in Sun Valley. They also bought up all the meat and TP in that little town. The article didn’t say which political party those fine folks from the Seattle area aligned with, but people in Red States are bad, for sure.

    If it wasn’t for the Seattle Globetrotters, Sun Valley would probably still be covid-free.

    1. The Historian

      While it is true that the first cases of Covid in Blaine County – where Sun Valley is located – probably came from a wedding party from Seattle, Blaine County was going to get the disease anyway because people from all over the world and the country come to ski there. And if you look at the numbers from Blaine County, the lock down the governor ordered DID slow the initial spread of the disease. It was only after the lock down was lifted that Blaine Country’s disease rate went back up and now it is pretty bad there.

      But, sigh, we have a governor who lives up to his name with his response now to Covid. He is under the belief that he doesn’t have to even mandate mask wearing in Idaho – that just ‘talking’ to people will be enough. Yea. He’s been ‘talking’ since July. How is that working out? Especially since according to news reports today, our hospitals are just about at the point of collapse?

  6. Glen

    Boy, we have created a Neo-liberal paradise with this whole issue.

    Bottom line, this is exactly how our current system is SUPPOSED to work. Support the rich, kill the poors.

    Are you reading this? Then you are a poors.

  7. polecat

    Just wait until you can’t step out your front, or Hell, even your back door .. without showing your papers .. your certified ‘Boot-on-Face’ C-vaccine ‘papers’… now currently all the rage with Big Broke Airline …

  8. chris

    I’m currently locked down because co-worker who still swears “its just like the flu” came to work while sick. Due to that exposure, I have tested positive and im experiencing symptoms that make me think the result was not a false positive. The maddening thing here is it really doesn’t take much to prevent the spread of this virus. Our society is simply incapable of handling even the minimal support it would require to help people stay home. Hopefully I won’t get too sick. Hopefully my kids and wife won’t get sick. Hopefully this person will have learned from their mistake. Hopefully…

      1. chris

        Thank you. Doing what I can to limit my chances of exposing anyone else now. Largely due to the articles written and reviewed on this site, my family changed our diet and what supplements we take to mitigate any effects if we were exposed. I guess I’ll see if that helps or not. Right now I can tell you that my experience is a lot milder than other co-workers who were exposed and are similar ages and similarly healthy. So go long green tea, vitamin D3, zinc, C, and good food in your diet!

    1. The Historian

      I am hoping right along with you for you.

      My family in ND got the disease – thankfully it was only light for them and they’ve recovered – but like what happened to you, someone came to work sick thinking they just had the flu.

      No matter how careful you are, sometimes you just cannot avoid getting this disease. And that is the hardest thing to convince people of.

    2. Glen

      I am so sorry to hear this. Unfortunately, it is not fake, and can cause very bad things to happen. Please, please please do everything you can to get better and keep you and your family safe!

  9. Jack

    I can’t speak for the rest of the country. I only know what I read and the anecdotal stories I read like here on NC. But in SC I am pretty familiar with the current state of Covid, from deep diving on our DHEC site (South Carolina’s state environmental and health department) and from my familiarity with the people I meet daily and in the course of my business (I am a wedding officiant and marry 35-40 couples a month). There is no state wide mask mandate in SC. Most major cities have a mask ordinance but the enforcement is extremely lax and/or it is worded so that it is impossible to enforce. In SC most of the deaths occur in the +65 age range. Most positive test results occur in the 11-40 year old range. I have to say 11 yo because that is the way that DHEC breaks down the age groups, 11-20, 21-30, etc. I would venture to speculate that more of the positives are coming from the upper range of the 11-20 and the lower range of the 31-40. So essentially, what the data tells us is that young people are spreading the disease and the older folks are catching it and dying (the average age of a Covid death is 75). The medical people at DHEC keep telling the governor what he needs to do to reduce the number of deaths and stop the spread of the virus and the governor (a Republican) continues to refuse to listen and act. The hospitals here are not yet full but that time is getting closer. Schools had opened but are now starting to close again. In case you are wondering, SC is a deeply red state. Very racist, ethically challenged (particularly at the top), and relatively uneducated when compared to the other states in the US. I personally am a SC native but left young and traveled the world for 40 years before returning. The ignorance and stupidity of my fellow native Carolinians continues to amaze and anger me. Maybe I will have to move soon, when as Rush Limbaugh recently postulated, secession of the red states occur. I probably need to move northwards anyway due to climate change.

    1. Carolinian

      I too have been following the SC statistics–not just recently–and in terms of deaths they actually seemed to peak in the summer with the opening of the beaches. Before that SC lagged significantly behind NY, NJ etc. Guess their citizens are even more ignorant than us?

      Statistically SC seems similar to other states on the I-95 corridor including Georgia and Florida. At one point Florida was even threatening to post troopers on the interstates to block New Yorkers from entering but of course that didn’t happen.

      And as I said up thread big cities like NYC have unique problems in dealing with a pandemic so, rhetoric aside, I don’t think we should point the political finger of blame at them either.

      1. Jack

        Sorry, but the spike occurred long after the beaches were open. McMaster opened the beaches in April, the week of April 20th to be exact. Deaths in Horry County stayed low until well into July, peaking Aug 8. I would say we lagged behind because 1. SC is less densely populated than NYC, and 2. we just do not get the same level of transients here. And I say ignorant because the people we pay to be knowledgable about this subject, tell us to wear masks, not congregate in enclosed spaces, and avoid crowded venues, and the state leadership ignores them as does the populace. That is ignorance and stupidity to me.

  10. Patrick

    “Balancing the tradeoff between strict public health measures and economic activities has been the key concern for governments since the Covid 19 outbreak”. The first sentence sums up the entire problem, the rest of the article is a description of the results.

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