Tennessee and Massachusetts have similar populations. Massachusetts has 6.9 million residents and Tennessee has 6.8 million. They are ranked 15th and 16th, respectively, in population among the 50 states. They have also had a similar number of COVID-19 cases. As of August 19th, 2020, Massachusetts has 124,000 total confirmed cases and Tennessee has 138,000. The Volunteer state ranks 11th in total COVID-19 cases and the Bay state ranks 13th. However, COVID-19 has been much deadlier in Massachusetts, with 8,876 deaths due to the novel coronavirus, while Tennessee has had 1,452. Why the dramatic difference?
There is a possibility of an under count in the Tennessee data. Looking at excess death data from the CDC, a likely upper bound for the number of COVID-19 deaths in the Volunteer state is no more than 2,400 still more than 70% lower than they Bay state. One clue is provided by COVID-19 demographics in both states. See the table below.
Cases in Tennessee have occurred more frequently in younger people. The largest group of cases is people in their 20s. In Massachusetts, older people have been harder hit, with the biggest group being those in their 50s. Massachusetts has had many more cases in those over 80 compared to Tennessee. This may be due to the fact that the outbreak in Massachusetts occurred before there was much information available. Older people in Tennessee have likely been much more careful, while young people in the Volunteer state have not been as respectful of the risks.
A key reason for the difference is nursing homes. According the The New York Times, those residing in elder care account for 41% of all deaths due to COVID-19. It has accounted for almost two-thirds of the deaths in Massachusetts, but only a quarter of the deaths in Tennessee. The difference between the two states just due to nursing home deaths is more than 5,000. This alone accounts for most of the disparity.
Very interesting, Christian. Certainly, younger people being less careful than others has been a problem of late. Another developing issue is that the disease has become less deadly over time, perhaps encouraging recklessness. Viruses becoming less deadly over time is apparently common – who wants to kill their host? At the same time, the medical community observes other lasting effects of COVID-19, such as brain inflammation, and possible lung damage.
Do you imagine that the dropping death rate will encourage less careful behavior?
Thanks for the comments Doug. Those are good insights. Could there also be a seasonal influence on mortality rates?
Yes, I think a lower death rate will encourage riskier behavior.
Christian – there is one factor you may not know when it comes to those infected in MA. Even before COVID-19 was even realized, BIOGEN had a world conference in Boston. After the conference, it was discovered that people were infected with COVID-19 and spread it (around the world). It turned out that as many as 20,000 people were infected as a result. Obviously not all were from MA, but it can also account for the larger increase in MA. Elderly people was a major issue for a while, particularly in retirement homes. This is more under control for the most part, but still they are all at risk. I do salute the MA Governor – Charlie Baker – he has done a great job trying to keep this under control.
Thanks for that insight Neil. That is good information.
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