By Neil McGovern, April 16th, 2020
Wednesday April 15th, 2020 saw a pushback organized by the Michigan Conservative Coalition against Governor Gretchen Whitmer’s orders to keep people at home and businesses locked during the current Coronavirus outbreak. The very fact that the protesters could congregate without fear of retribution belied the “Gov. Whitmer We Are Not Prisoners” theme of course. But instead of telling everybody what they didn’t want, the protesters might have pointed to South Dakota as their model. South Dakota has persisted in keeping business-as-usual. South Dakota Governor Kristi Noem said it was up to individuals — not government — to decide whether “to exercise their right to work, to worship and to play. Or to even stay at home.”
I’m concerned for the people of South Dakota, because my ongoing analysis of the infection and death rates does not bode well for the state. There are three trends, which if they continue, put South Dakota in the bullseye for the next Coronavirus wave.
Trend 1: Highest Growth in Infections in South Dakota
Currently South Dakota is an outlier in growth. For the three-day period from April 13th to April 15th South Dakota was growing at 16.0% per day. This is almost twice Rhode Island (8.9%), and actually twice Iowa, in third place, with 8.0% daily growth. This is not a blip. South Dakota has recorded 17.6% growth since March 22nd so the curve is definitely not flattening. To put this in other terms, South Dakota is doubling every 5 days (next closest, Rhode Island, is 8 days). Also, if the current rate continues, 10% of the population will have tested positive by May 14th, 10 full days before any other state at current growth rates, and most other states have been flattening their growth and hope to continue to do so. And since positive tests do not reflect the total infection rate, the actual numbers in South Dakota could be multiples higher.
Trend 2: Growth in Rural America
The more urbanized states have been bearing the brunt of the Coronavirus impact so far, however in the last few days there has been a stunning reversal. The link between how urbanized a state is and the growth in new cases has flipped. For the period March 23rd to April 12th there was a 19.6% correlation between states that were more urbanized compared to those that are more rural. Basically if you lived in a state with more cities where more people were packed closer together, you had higher growth in new cases.
In a stunning reversal, this has changed. The correlation for the three days form April 13th to 15th shows 3.6% more growth in more rural states than in more urbanized ones. The disease isn’t a coastal problem any longer. It is making its way into rural America and despite the huge challenges faced in densely packed cities, growth rates are now higher in less densely populated areas.
Trend 3: Surviving an Infection is More Likely in Urban America
The number of infections is one aspect, but the real tragedy is the number of deaths. If you do get the disease, are you going to survive? There are many factors that come into play, but when we look at outcomes, the numbers are not telling a comforting story for the more rural states.
Since March 23rd, there has been an overall correlation between cases per million and urbanization of 38.4% – for most of the last three or four weeks, if you live in a city, you were more likely to get Coronavirus. However, the correlation between urbanization and death rates per million in the same period was only 22.5% – despite higher infection rates, the difference in deaths is relatively lower in urban America. Compounding this is that most of the impact has been in the North Eastern states where the medical systems have been severely stressed. The fact that even over-stressed urbanized medical systems are outperforming rural medical systems hints that the real discrepancy between your chance of surviving is significantly less in rural America. South Dakota is very definitely in rural America.
The Issue for South Dakota
South Dakota is not alone in being rural. It isn’t even the most rural state by a large margin, that honor is tied by Maine and Vermont, whose census defined urbanization is only 39%, against South Dakota, Arkansas, Montana which are 56-7% urbanized. Also, South Dakota isn’t unique in having rural-scale healthcare systems, often with fewer doctors and larger distances to hospitals. However South Dakota is unique in having all three factors, and the growth factor seems to be closely linked to their reluctance to take active measures at the gubernatorial level.
America as a nation has bent the curve on Coronavirus due to the measures we have undertaken to date. California, a very urbanized state (95% vs 57% for South Dakota) has growth a three-day growth rate of 5.4% per day from April 12th to April 15th – not great, but a lot better than the growth rate of 22.4% it was recording on March 27th. The right actions work.
Nobody is happy with the restrictions we are accepting in America to help keep our medical system, first responders, and other essential workers safe, but I’d plead with the better informed politicians and pundits who know and understand the actual numbers and trends to put their “Don’t Tread on Me” attitude aside for the sake of their own supporters and viewers.
|4/14/2020||Population||Urbanized||Growth (last 3 Days)||Growth (from 3/22)||Total Cases||% Population||1% Tested Positive by||10% Tested Positive by|
|District of Columbia||705,749||100%||104.8%||113.4%||2,058||0.292%||10-May||28-Jun|
|Growth to Cases/M||2.0%||20.1%|
|Urbanization to Cases/M||38.6%||38.6%|
|Urbanization to Growth||-10.8%||19.3%|
|Urbanization to Death||24.8%||24.8%|