COVID-19 and a Lack of Emergency and Intensive Care Access: This is Not Just an Urban Problem

Published: April 3, 2020

Updated: April 8, 2020

Daily headlines are dominated by reports of total cases and deaths in the United States. While stories about the sheer volume of cases are compelling and critical for identifying hotspots, understanding the per capita and per healthcare provider case rate highlights dire issues of access to critical and emergency care in places in the country that aren't (yet) making headlines due to number alone.

Using population, hospital- and provider-level data, in this post I look at the intersection of COVID-19 patients and access to emergency rooms (ERs, often the first step for COVID patients getting care) and intensive care units (ICUs, where COVID patients with extremely dire symptoms are transferred and cared for, including being connected to a ventilator). Whenever I mention per capita analysis, I am referring to the number of people with confirmed, reported cases of COVID-19 for every 1,000 residents in their county or state.

At its most basic, per capita analysis shows where cases are concentrated and health systems are more likely strained. For example, the crisis in New York City is not just a factor of its large population – New York has the highest case volume in the country in total cases and among the top cases per-capita as of the publish date of this post.

Per capita analysis also shows that some towns and rural areas are being hit hard, especially in the South and Midwest. The COVID crisis is not merely an urban or coastal problem -- not by a long shot. Some of the counties that have high per-capita infection rates are also relatively high in total case count as well. For example, at the time of this post, counties in Idaho, Colorado, Georgia, and Louisiana that have populations among the smallest 30% in the country are nevertheless in top 80% in total case count and cases per capita.

Queens County, NY First in the Country for Total COVID Cases, and Blaine County, ID Leads Country in Cases Per Capita

National Rank County: Total Cases County: Per Capita Cases
1 Queens County, NY Blaine County, ID
2 Brooklyn, NY Rockland County, NY
3 Nassau County, NY Westchester County, NY
4 Suffolk County, NY Orleans County, LA
5 Bronx County, NY Nassau County, NY
6 Westchester County, NY Randolph County, GA
7 New York County, NY Dougherty County, GA
8 Cook County, IL Terrell County, GA
9 Wayne County, MI Queens County, NY
10 Bergen County, NJ Suffolk County, NY

Confirmed COVID Cases Per Capita

Confirmed COVID cases per 1,000 county residents

Blank areas on the map represent counties with no reported COVID cases