The Washington PostDemocracy Dies in Darkness

Vaccine politics only worsened the partisan divide in covid-19 deaths

A health-care worker prepares a dose of the Pfizer-BioNTech coronavirus vaccine at a vaccination site in Lake Worth, Fla., on Aug. 13. (Saul Martinez/Bloomberg News)

Since the coronavirus pandemic first emerged early last year, more Americans living in counties that voted for Joe Biden in 2020 have died of covid-19 than have Americans living in counties that voted for Donald Trump. That’s also true in 2021, albeit more narrowly.

But that comparison ignores a critical consideration: There are far more people in counties that voted for Biden because those counties are home to most of America’s largest cities. Adjusted for population, 245 out of every 100,000 residents of Trump-voting counties have died since the beginning of the pandemic, compared with 206 out of every 100,000 residents of Biden-voting counties. This year, the gap is wider: 146 out of 100,000 in Trump-voting counties, 101 in Biden-voting ones.

And if we look solely at the places where Trump or Biden won most heavily, the gap grows wider still. In 2021, counties that Trump won with at least 60 percent of the vote saw 164 deaths per 100,000 people. Counties that Biden won with at least that level of support saw only 91 deaths per 100,000.

In a new article in the New York Times, David Leonhardt considers that recent gap. His point is one that has been elevated before, as when I wrote in June about how “red and blue America are evolving into vulnerable and safe America”: The broad partisan divide on the coronavirus vaccines is leaving more-Republican places more vulnerable to outbreaks and deaths. While this seems pretty clearly to be true, it seems to understate the long-standing partisan gap in approaches to the pandemic. In other words, the vaccines seem to have widened the gap, not to have created it.

Again, there’s no question that the latest wave of coronavirus cases hit redder parts of the country harder. You can see that in Leonhardt’s graphs of the cumulative death toll by month. His graphs, though, show only 2021. If we extend it back to 2020, we see not only the surge in deaths in redder counties in recent months, but also a similar surge at the end last year. From November 2020 to February 2021, the most Trump-friendly counties went from seeing the fewest deaths per capita to the most. That shift predated the broad rollout of vaccines.

In fact, the number of deaths per month was higher in the most red counties during those months than it was this summer.

The death toll has been higher in the reddest counties ever since. That’s a function not only of vaccinations, but probably also of all of the other manifestations of skepticism about the pandemic, from being less supportive of mask-wearing to being less worried about contracting the virus to being more likely to believe a number of false claims about the virus and its spread.

That said, though, the gap between the reddest and the bluest counties was wider in recent months than it was during last winter’s peak. You can see it on the graph above; the dark-red line is much further from the dark-blue one recently than it was then. Or, if we simply subtract the per capita death rates between the two groups, we see how the gap between the two has grown.

This reinforces our thesis: The gap already existed, but now it has gotten worse.

Republicans have sought to undercut the idea that partisanship plays a role here, in part because they’re interested in defending Republican officials like Florida Gov. Ron DeSantis who have leaned in to the cultural fight over addressing the pandemic. In DeSantis’s defense in particular, Republicans have frequently tried to dismiss the recent surge in cases as being seasonal, arguing that it perhaps reflects warm weather pushing people indoors and not DeSantis’s policy choices.

If we pick out data from Sun Belt states, though, we see that the same partisan gap exists. We also see that the number of deaths in recent months has diverged much more widely along partisan lines than it did nationally.

In fact, the per capita death toll in the most pro-Trump counties in Sun Belt states was worse this summer than it was last winter, even with vaccines in wide deployment. That’s not true of the most pro-Biden counties.

If we again compare the two directly, we see that the recent surge has been far worse in more-Republican areas of the Sun Belt than in more-Democratic ones.

The surge in coronavirus cases and then deaths over the summer and into October not only reinforced the gap between the most-Trump and most-Biden counties. It also led to a surge in less strongly Trump counties. At the beginning of October, strongly pro-Biden counties, weakly pro-Biden counties and weakly pro-Trump counties all had about the same rates of covid-19 deaths. By the beginning of November, the death toll had largely sorted along partisan lines, with the cumulative rate of deaths reflecting the extent of support for Trump.

Another challenge to the idea that politics aren’t involved is that even outside Sun Belt counties, the number of covid deaths in recent months was worse. Consider the cumulative death toll from August through October in both 2020 and 2021. This year, even counties in the Pacific Northwest got hammered — if they were strongly pro-Trump.

It was only after October that the cumulative number of covid-19 deaths per capita was higher in the most heavily pro-Trump counties than the most heavily pro-Biden ones.

Important to notice on that graph? That during the winter, the number of population-adjusted deaths in both the most heavily pro-Biden and most heavily pro-Trump counties surged. In recent months, though, only the Trump counties did.

The pandemic is partisan, as it has been for more than a year. But that partisanship has only grown increasingly deadly.