IT TOOK A CONCERTED EFFORT FOR THE DAKOTAS TO CATCH UP:

These spatial patterns in the spread of COVID-19 had important implications for US politics. We showed this by analyzing whether counties with varying political leanings experienced different COVID-19 severity. The patterns we found were interesting and told a consistent story. Early on, Trump-leaning counties were less severely affected by the disease. As time progressed, however, there was a reversal: starting in the spring of 2020, Republican counties experienced a higher number of deaths compared to 'blue' and 'purple' counties. [....]

How can we make sense of this reversal? In America's polarized political context, the response to COVID-19 has been highly politicized. Early in the pandemic, locations that were less severely affected developed habits, attitudes and preferences that made people less keen on wearing masks, social distancing, and lockdowns. When the pandemic eventually spread to these locations, politicians and the general population may have been relatively unwilling to deal with the pandemic by adopting policies and behaviors that could slow its spread. In sum, our interpretation of the reversal is that Republican-voting counties acquired lax attitudes toward mask-wearing and lockdown measures when COVID-19 was less severe in their areas, leaving them unwilling to respond more decisively when the pandemic caught up with them over the late spring and summer of 2020.

Circling back to our initial question, are all locations in the US converging to similar degrees of COVID-19 severity? No. Our research has highlighted strong and persistent factors associated with counties' vulnerability to the disease. First, density matters - as long as it is properly measured. Second, vulnerabilities such as a high share of minorities and poor people, persistently predict a more severe impact of the disease. Finally, COVID-19 severity is politically patterned: in the second half of 2020, Republican-leaning counties started to experience significantly higher COVID-19 deaths. These results help make sense of the pronounced and persistent geographic differences in disease prevalence that are observed across the United States. 

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