That calculus assumes there are hospital systems to overwhelm. New analysis from Kaiser Health News published Friday suggests there are millions of Americans who live in counties where there may be no intensive-care unit beds at all. Many live in counties where there are not even hospitals.
The presence of a hospital and of intensive-care units correlates to how rural the county is, as you might expect. But that also means there is a remarkable bit of overlap with politics, given how central the rural vote was to President Trump’s election in 2016.
Comparing the county-level data from Kaiser Health News to 2016 presidential election data, we discovered a remarkable bit of data: About 8.3 million people who voted for Trump in 2016 live in counties where there are no ICU beds or no hospitals. That amounts to about 13 percent of the total votes Trump earned in that election, or one out of every eight votes.
Those counties are also home to about 3.8 million people who voted for Hillary Clinton, a figure which makes up only about 5 percent of her total. Most of the counties voted for Trump by wide margins; he won them by an average of 41 points. He won 10 times as many counties with no ICU beds as did Clinton.
More importantly, those counties which voted for Trump are home to about 6.5 million people over the age of 60, people in a particularly high-risk group for contracting covid-19.
For every person 60 or older in a county which voted for Clinton and has no ICU beds, there are 10 times as many people in that age group in counties that backed Trump and have no ICU beds.
Given the correlation between population density and the number of confirmed coronavirus infections, it is likely the virus will spread in more rural counties at slower rates. But there are already well over 100 counties in which there are no ICU beds and in which coronavirus cases have been confirmed, according to data compiled by the Conference of State Bank Supervisors.
In most cases, the number of confirmed infections in those counties is only one or two — at this point. The most cases out of those counties are in ones which backed Clinton in 2016. That matches the national trend; since cities tend to be the epicenters of the virus and since cities backed Clinton more heavily in 2016, there are about six times as many confirmed cases in counties that voted for Clinton as in counties that voted for Trump.
Of course, it’s not just counties without ICU beds that are at risk. The data from Kaiser makes clear that even those counties with ICU beds may quickly see strain in the event of a broad coronavirus outbreak. On average, counties with ICU beds have one for every 5,700 residents and one for every 1,300 residents aged 60 or older.
As of writing, the counties with the most confirmed cases are in the New York City area. The number of ICU beds in the city’s five boroughs varies from 114 on Staten Island (Richmond County) to 761 in Manhattan (New York County). Los Angeles and Chicago have relatively few cases for their size — and far more beds.
Not all counties which backed Trump are rural ones without many ICU beds, of course. Maricopa County, Ariz., has the most ICU beds of any Trump county, according to the Kaiser Health News data.
The issue here isn’t politics. It is that many Americans have limited access to the sort of medical care the virus might necessitate. It’s that many others live in places where that access will quickly be strained by the volume of covid-19 cases that are expected to emerge.
For a president so heavily focused on his base, though, it is worth noting how heavily that former group overlaps with his most fervent support.