We have all heard about the struggles of Washington, California, and New York, but who’s next? A simple test of the public health response in every state suggests an answer. If you live in New Jersey, Alabama, or Maryland, brace yourself. Where does your state rank?  

On the Diamond Princess cruise ship, where all of the passengers were tested, fewer than half had symptoms. And we now know that even cases with mild symptoms, or even none at allcan transmit the virus. So, only the most aggressive testing programs will catch a substantial portion of the infections. Imagine mice have invaded all of the houses on your block. You put out twenty traps and catch five mice. Your neighbor puts out five traps and gets four mice. Who has the bigger problem? To look only at the number of cases in two states is a bit like comparing how many mice you and your neighbor have caught. Which is more meaningful, the fact that you caught one more mouse or the fact that he gets mice 80% of the time and there are mice in only 20% of your traps? I would take your problems over his.

Every state has a problem but, in each case, we need to ask: Is the public health response proportionate to the threat? Specifically: are they measuring their problem with adequate testing? The glaring lack of capacity to test for the disease has played a key role in the explosive growth of the epidemic, making it almost impossible to control. You can’t stop what you can’t see. Some states are more blind than others.

Whose traps are most full? As of yesterday, based on data from the Covid Tracking Project, the percent of positive tests ranges from less than 1% in West Virginia to 67% in New Jersey. Alabama is at 48%. With six and five deaths respectively, it might already be clear that those two states have a problem. But other states in the top ten have only one death (Maryland, Connecticut, and Michigan). And four of the ten states have no deaths at all. If you live in Delaware, Utah, Iowa, or Tennessee, brace yourselves. It’s coming.

The full list. (Many thanks to Eryn Rogers for finding and assembling these data!)

RankStateTotal TestsPositive Tests% Positive TestsDeaths
1NJ63842767%5
2Ala.964648%6
3Md.1798547%1
4La57524042%4
5Conn.1936835%1
6Del762533%0
7Utah1946332%0
8Iowa1282923%0
9Mich.3558023%1
10Tenn.4479822%0
11Ind.1933920%2
12DC1703118%0
13NY14597238216%20
14Ohio5518816%0
15Nev.3535516%1
16Ill205228914%1
17Ga150819713%3
18Fla249331413%7
19Hawaii1191412%16
20Mass227125611%0
21Neb.2302410%0
22Ark.3193310%0
23Colo180018310%2
24Pa132013310%1
25Ariz.2782810%0
26SC643609%1
27Wyo.193158%0
28Wash1412910127%66
29Calif85926117%13
30Ky.380267%1
31Miss.513347%0
32Wis16831066%0
33Va.1278776%2
34Okla.517296%0
35Mo.266135%1
36Ore.1554755%1
37Texas1907834%2
38Kan.433164%1
39RI907334%0
40NH747263%0
41NC1850633%0
42Vt.611193%0
43Minn.2762773%0
44Maine1713433%0
45ND27462%0
46Mont.509102%0
47Idaho46892%0
48Alaska41261%0
49SD913111%1
50NM2354281%0
51WVa13711%0
2+