After two years in a pandemic that has killed nearly a million people in the United States, analysts are examining how the crisis has evolved.

An essay released this month by Pew senior researcher Bradley Jones used death data compiled by The New York Times to explore how location and politics influenced responses to COVID-19.

“The pandemic rolled across the U.S. unevenly and in waves. Today, the death toll of the pandemic looks very different from how it looked in the early part of 2020,” Jones wrote in “The Changing Political Geography of COVID-19 Over the Last Two Years.”

In a perhaps-unexpected seesaw, data shows community characteristics associated with higher death rates at the beginning of the pandemic are now associated with lower death rates, the report says. Areas with early low death rates have seen them climb.

“Obviously, the pandemic has been front and center in so many of our lives over the last two years,” said Jocelyn Kiley, who is associate director of research for Pew Research Center and was involved in shaping the report. “I think it’s clear that the pandemic has impacted different populations differently and at different stages.”

America’s first COVID-19 wave, between March and June 2020, was concentrated in the Northeast, around New York City. That summer, most of the deaths were in the South. But the deadliest period took place from fall 2020 into winter 2021 and those 370,000 deaths occurred amid far less pronounced geographic distinctions, Jones writes. 

“Early on, the fact that it impacted urban centers in the Northeast more than other parts of the country I think really did shape some of that early coverage,” said Kiley. “If we look at public opinion data, we also saw that people in urban areas were more likely to say they saw COVID-19 as a public health threat in those early stages.” She said Pew also looked at geography and politics in the pandemic in December 2020. 

When vaccines became widely available to adults in spring and summer 2021, national death rates slowed, though they picked up again with the arrival of first the delta variant at summer’s end, then omicron. In those two waves, more than 300,000 people in the United States died.

COVID-19 and political ideology

Pew’s analysis also considers how political leanings might have changed the response to COVID-19 and thus the toll of the pandemic over time. Jones wrote that in spring 2020, areas that had the most deaths were those that were more likely to vote Democrat than Republican. The pattern reversed by fall of 2020.

Other geographic reversals have also occurred over the course of the pandemic. The report highlights:

  • During COVID-19’s first wave, the death rate in the top 10% most densely populated counties was nine times higher than in the 10% of counties with the lowest population density. Since then, though, the least-dense counties have experienced higher death rates.
  • Counties representing the fifth of the population where Donald Trump had his highest voter margin in 2020 have seen close to 70,000 more deaths from COVID-19, compared to the counties representing the fifth of the population where Joe Biden had his greatest support.

That change probably comes from differences in mitigation efforts and how many people were vaccinated, as well as “other differences that are correlated with partisanship at the county level,” according to Pew’s report.

  • Around the time of the delta variant wave, 1 in 10 Americans lived in counties with adult vaccination rates lower than 40%, as of July 2021. Death rates in low-vaccination counties were about six times as high as death rates in countries where at least 70% of adults were vaccinated.

The report notes that “among the large majority of counties for which reliable vaccination data exists, counties that supported Trump at higher margins have substantially lower vaccination rates than those that supported Biden at higher margins.”

Jones found that counties with lower vaccination rates have had substantially greater death rates in each wave of the pandemic during which vaccines were widely available.

Kiley emphasized that Pew is far from the only survey organization to document a partisan divide on COVID-19 attitudes and behaviors, which she described as “established fairly early on. We saw it in the very earliest surveys, with the exception of those conducted in that first week or so when we all first heard about the pandemic.”

Between the third and delta waves of the pandemic, case counts dropped and people were more apt to say they were comfortable going places they’d avoided earlier. But that changed again as case counts and deaths rose with the delta variant, Kiley said. 

In late 2020, she said, about 80% of Democrats and Democratic leaners said the outbreak was a major threat to the health of the U.S. population. “By comparison, just under 50% of Republicans and Republican leaners said that, and really that pattern persisted over the course of the entire pandemic,” said Kiley.

Attitude adjustment

The patterns of infection aren’t the only thing that changed in the pandemic. In February, Pew issued a report called “Increasing Public Criticism, Confusion Over COVID-19 Response in the U.S” which found that the public was increasingly dissatisfied with how elected officials and public health experts have handled the pandemic.

“Amid debates over how to address the surge in cases driven by the omicron variant, confusion is now the most common reaction to shifts in public health guidance,” Pew research fellows Alec Tyson and Cary Funk wrote in that report. They found 60% of U.S. adults have been confused by changes to public health recommendations on how to slow the spread of the coronavirus. That’s up 7 percentage points since last summer.

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The report shows a near-even split on whether the response to COVID-19 by public health experts has been “fair or poor” or “excellent or good.” Public health scored about 10 points higher in August, which was also a drop from early 2020.

Approval of elected officials has also dropped, with 6 in 10 calling Biden’s response to the coronavirus only fair or poor. The 40% who say Biden is doing a good or excellent job is barely above the 36% who said that of Trump during his presidency.

Kiley sees great diversity in the reaction to the pandemic throughout the country — “not even in terms of state or local policies, but in terms of almost culture.” She said people wore masks in restaurants and stores even when it wasn’t explicit state or local policy in some parts of the country, while in other areas that behavior was far less common. It’s likely that an area’s culture and even what neighbors do influence such decisions, she said.

Who got vaccinated?

The February report found more than three-fourths of U.S. adults said they’d gotten at least one vaccine dose, including 73% who claimed to be fully vaccinated. Of those fully vaccinated, 66% said they’d received a COVID-19 booster shot, too. 

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Vaccination is another area with significant differences along political lines. The survey showed 90% of Democrats or those who lean to the Democratic Party have received at least one dose, compared to 64% of Republicans or those leaning to that party.

And 73% of vaccinated Democrats say they’ve gotten a COVID-19 booster in the past six months, compared to 55% of fully vaccinated Republicans.

The report said age and education “strongly shape the vaccine decision among Republicans.” The share who’ve gotten the vaccine seems to go up with age, from a low of 52% for those ages 18 to 29 to 80% among those 65 and older who received at least one coronavirus vaccine dose.

Well-educated Republicans are more likely than those with less education to be vaccinated (81% of Republicans with a postgraduate degree compared to 57% of those with a high school diploma or less). “Among Democrats, the differences were modest, the report said.

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