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Red States are less prepared for a COVID resurgence

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The defining feature of COVID-19 in America, beyond its sheer size, is the way it has been politicized.

Republican states, perhaps inspired by President Donald Trump's willingness to downplay the threat to life and health, even in the wake of his own infection and hospitalization, tend to take a minimally cautious approach. Democratic states, some of which were hit hard in the early days of the pandemic, have generally tried more aggressively to contain the virus, mandating mask-wearing and social distancing, limiting indoor dining and embracing contact tracing. The data are clear that the blue-state strategy has been more successful in limiting the coronavirus's spread.

Red-leaning states — those that either voted for Trump in 2016 or are led by Republican governors — have tested fewer people per capita than blue states and more readily opened public venues, from football stadiums to restaurants. Red states score substantially lower than blue states do on an Oxford University index that measures the strictness of containment measures.

An analysis of COVID-19 testing data collected by Johns Hopkins University researchers shows that, in September, states that tested in the middle of the range for Republican states screened fewer people than median blue states — about 25% less per 1,000 residents. It's hard to say what impact the president's infection and recovery might ultimately have on state actions, but in the week after his illness there was no visible increase in testing in Republican-led states.

The partisan testing gap has existed since last spring, but in recent months it has widened. The gap is especially large between the reddest-red states, those that both voted for Trump and have Republican governors, and those that consistently vote for Democrats.

A look at the rate of COVID-19 infections — measured by the percentage of tests that come back positive — reveals an even starker divide between red and blue states. Some red states are clearly struggling to keep up with expanding outbreaks.

It's possible that the red states' higher infection rates result from their political response to the pandemic — their leaders' reluctance to impose requirements for mask-wearing and social distancing and some residents' unwillingness to comply with recommendations to protect themselves.

Consider Florida, a state that has recently lifted capacity constraints on restaurants and other businesses and where the governor, Ron DeSantis, has made it hard for local leaders to institute stricter measures of their own. The state is now reporting more daily cases than it had at the start of its summer surge, which prompted its last round of restrictions.

Nisen is a Bloomberg Opinion columnist covering biotech, pharma and health care. Fazeli is senior pharmaceuticals analyst for Bloomberg Intelligence and director of research for EMEA.

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