Health

How the Omicron Wave Has Hit American Communities Differently

by Dante Chinni March 08, 2022

The United States is in a very different, and better, place on Covid-19 today than it was at the start of 2022. The omicron variant came and went quickly — cases have fallen, but only after creating record peaks in cases across the country.

Through the lens of the American Communities Project, however, the story looked different depending on the community type and two important factors:

  • how densely populated the community type is, and
  • how much of the population was vaccinated.

Places that are densely populated and where people live in tight clusters had higher case rates from January 1 to February 17. Big Cities, Military Posts, College Towns, and Urban Suburbs, for instance, all had 30% or more of their total Covid-19 cases during that time period — the highest of all 15 community types.

More rural communities — Aging Farmlands, Rural Middle America, and Working Class Country — had 26% or fewer of their total Covid-19 cases in that time period. The three rural locales had the lowest figures of the 15 types. The numbers suggest that there was natural “social distancing” that offered protection against contracting omicron.

Covid Deaths

But looking at Covid deaths, the story looks to be much more about vaccinations. The community types with the highest death rates — Middle Suburbs, Rural Middle America, and Working Class Country — all had two-shot vaccination rates below 60%. Those three  communities experienced at least 13% of their total Covid-19 deaths from January to mid-February 2022.

The numbers suggest a complex equation of density and vaccination rates determined how badly omicron hit communities. Some densely populated places couldn’t escape omicron infections, but vaccinations warded off the worst impacts. Meanwhile, some rural places seem to have been sparsely populated enough to avoid high death rates, despite low vaccination numbers.

The places hit the hardest seem to be ones with some density coupled with low vaccination rates.

Communities with High Case Rates

Four of the top five communities for high case rates fit with omicron’s highly contagious nature. College Towns, Big Cities, Military Posts, and Urban Suburbs are all either densely populated or contain densely populated housing clusters —  dorms and barracks.

One of the trademarks of omicron was how it infected many who were trying to be vigilant around the virus, even those who masked and were careful with social interactions. That explains the high case numbers in places with tighter Covid restrictions, including big urban areas, college campuses, and military bases. With omicron, even the cautious got sick.

But it’s interesting to note that even with these higher infection rates, the death rates in these communities were more likely to be in the middle of the pack. They were not especially low, but low considering their higher infection rates.

One possible reason is high vaccination rates. As of February 17, Urban Suburbs and Big Cities had the highest vaccination rates among the ACP types. College Towns and Military Posts had lower vaccination rates, but are home to more young people, which might have prevented higher death rates there.

The African American South

African American South communities are an outlier in the group, with higher case rates and lower vaccination rates, but also lower death rates. This set of numbers requires more study, but one possibility is the higher case rates are driven by a few places with larger populations and higher rates. African American South communities tend to be rural, but also include some counties with larger cities, such as New Orleans and Greenville, N.C., both of which were far above the case rate for the type.

Those numbers could have pushed the case figure higher while the rural nature of other counties kept the overall death number lower. In the end, most people who got omicron did not die, so higher case rates in a few densely populated places could have pushed up the overall case rate for a community type that is full of many rural places.

Communities with High Death Rates

The community types with higher death rates may tell the more important story in the data. They are a collection of rural and urban places — some densely populated and some not — but mostly with lower vaccination rates.

Most interesting on the list may be the Middle Suburbs. They had the largest percentage of total Covid deaths between January 1 and February 17: 15% of all Covid deaths occurred in the six-week span. That was true even though their case numbers were among the lowest in the ACP, about 25% of all their Covid cases in that period.

Why? They have relatively low vaccination rates, under 60%, and they are fairly-densely populated. So as omicron spread, it found more unprotected people.

The same may be true, to a lesser extent, in the Exurbs. Those communities had about 13% of all the Covid deaths they’ve experienced in the period between January 1 and February 17, 2022. While they are not as densely populated as the Middle Suburbs, they often have town centers and places where people gather. They have higher vaccination rates, but still under the 65% mark.

Also with relatively high death figures during omicron were Rural Middle America and Working Class Country. Both had lower case rates between January 1 and February 17. In Rural Middle America, 25% of all their cases came at this time. In Working Class Country, the figure was 26%.

The Role of Politics

There is one other crucial point to consider for all those high death rate locales: They all voted for former President Donald Trump in the 2020 election by double digits.

Normally, drawing a line from politics to deaths from a virus would be a stretch, but that’s not true with the way this pandemic has been politicized. Mitigation efforts such as masking or even getting the Covid vaccine became directly tied to politics and whether people considered themselves supporters of Trump or not.

Some politically conservative communities, such as the very sparsely populated Aging Farmlands, were able to compensate for low vaccination rates by being so spread out that transmission of omicron was more difficult. But in communities like the Middle Suburbs and Rural Middle America, the combination of low vax rates, low mitigation actions, and just enough density appears to have created a toxic mix.

See our complete coverage of Covid-19 case rates, death rates, and vaccination rates:

 

Vol. 3 2020-2021

Deaths of Despair Across America

The American Communities Project is undertaking a 30-month study of Deaths of Despair in its 15 community types.

Learn More