Make America Sick Again

The south’s gonna fall again. The deep south. The rural deep south.

I’ve mentioned that when the caseload rate for COVID-19 (the number of new cases per day per million population) gets above 100, I call it the “critical zone.” That’s when the strain on the health system degrades the quality of care — and when suicide rates go up because health care workers sometimes have to choose who lives and who dies. They don’t want to.

New York was hit so hard, so early, they couldn’t prevent a long stay in the danger zone. They paid a heavy price, in lives lost, but with perseverence they’ve got the caseload rate below 100. They’re just now dipping below 50 — even leaving what I call the “danger zone” (50 to 100 per day per million population).

Other states reaped a great benefit from the advance warning we got from New York, managing to stay out of the critical zone entirely. Some even avoided the danger zone, mostly or entirely. But the deep south states of Mississippi, Alabama, and Georgia are losing their grip on restraint, and their caseload rates are on the rise again. Mississippi has even entered the critical zone, with Alabama not far behind:

Until mid-April, Georgia had the highest caseload of the three. Perhaps this is because it has the region’s only “urban” area (by my crude definition, counties with at least one million population): Fulton county, Georgia is home to the Atlanta Braves, the Atlanta Falcons, and Hartsfield–Jackson Atlanta International Airport, America’s busiest. Here’s how things are going for Fulton county, which I’ve labelled “Urban Georgia”

Until mid-May, they were doing excellently. The lockdown and social distancing measures didn’t just keep the caseload from rising, it was dropping, out of the danger zone. They haven’t yet gone critical, or even come that close.

But since mid-May, things don’t look so good. Yes they’re still only in the danger zone, but the trend is up toward the critical zone. They’ve already lost some of the gains they earned, and are likely to lose more. And just being in the danger zone costs lives; the more cases per day, the more deaths per day. Getting out of the danger zone saves lives.

Perhaps the recent losses are because Georgia governor Brian Kemp has been pushing so hard to re-open the economy. This, despite warnings from the genuine experts that it’s too early and the troubling fact that his administration is implicated in misdeeds regarding the data on Georgia’s cases and their presentation.

Most reasonably developed areas have counties with at least 100,000 population but less than a million, which I call “suburban.” We can compare the progress for those counties in all three states:

All three have done reasonably well in their suburban regions. They’ve managed to avoid the critical zone, and “keep the lid on” by avoiding upward gains or losses; Georgia showed some gains in early May but lost them pack in late May. In the danger zone it’s a lot of work to keep people alive, but things don’t seem to be getting much worse yet except in Alabama.

Rural areas (counties with less than 100,000 population) tell a different story:

It’s not so different in rural Georgia, which like the rest of the state showed gains but has lost them recently. But things in rural Alabama have been getting worse since late April, with no sign of relenting, and as for rural Mississippi, they seem to have missed the memo entirely.

They didn’t do nothing, of course. If rural Mississippi had done nothing, the caseload would have continued to grow exponentially. But they only did enough to slow the growth — they didn’t even “flatten” the curve, they only managed to bend it.

When the curves lower, lives are saved. When the curves rise, lives are lost.

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