CITIES WERE A MISTAKE:

The city's early success may be one reason things are so bad right now. "What happened in New York is that people got very scared and they behaved," said Karin Michels, who chairs the department of epidemiology at the UCLA Fielding School of Public Health. "We did so well, people started to relax, and they stopped following the rules."

Many also hoped spread in LA would be buffered by year-round warm weather that allows activities to continue more safely outdoors. But winter has come to Los Angeles too, and while it may not be freezing here, the early darkness forces many indoors. [...]

Early on, many experts thought LA's notorious sprawl might be protective. They were wrong. LA doesn't have a majority of residents living in and sharing elevators in dense high-rises like New York. But what the county has may be worse: a large population, a high rate of poverty, and, in some neighborhoods, the nation's highest rate of severe overcrowding. [...]

The virus has laid bare many of the city's vulnerabilities, and also its shocking inequalities. While the stereotype of LA is celebrity mansions on hillsides, its reality is overcrowded neighborhoods where entire families may squeeze into one-bedroom apartments or converted garages, settings where essential workers often live with older relatives, and social distancing is impossible. [...]

Bibbins-Domingo's city, San Francisco, has seen far lower case and death rates, something many attribute to the city's better adherence to masking, strong public health infrastructure, and extensive network of social supports. While San Francisco has developed innovative programs to place those infected with the virus into hotel rooms to help stop spread within households, LA's Project Roomkey, an attempt to use hotels to shelter the unhoused and prevent the spread of Covid-19, has seen less than 2,000 of its promised 15,000 rooms occupied.

But epidemiologists note that San Francisco County is also wealthier than LA County, and much smaller. While LA's high case and death rate -- 281 deaths were reported Wednesday -- can seem shocking, it's important to measure that against the county's large population, Beletsky said. "Just the sheer number of people here makes our numbers look dire," he said. "That said," he added, "things are really bad." Though there are counties in Texas, Wyoming, Montana, Oklahoma, and North Carolina with higher daily case rates, LA's is about twice the U.S. average.

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