To begin to recover from any disaster, an assessment of damages is a necessary first step. In the case of Covid, the damage is not related to a single event. Instead, pandemic-related damages will continue to unfold until an effective vaccine is developed and universally distributed. As such, tracking Covid-related damage will require monitoring more than one metric over multiple months.
This section tracks a select number of highly-vetted indicators to examine the extent of Covid-related damage to lives and livelihoods. It examines how peoples’ lives are faring, and how this impact differs across different sections of society. It also looks at damage to livelihoods state by state.
Much of the current discussion about the pandemic is limited to these types of indicators on the health and economic impacts. In later sections of this report, these indicators serve as a backdrop for a unique analysis of the complex interactions between the pandemic and our nation’s civic health.
As more data becomes available, additional metrics will be added to this section to assess better how states are protecting lives and livelihoods.
Indicators in this section
- New Covid cases in past week
- Age-adjusted Covid-19-associated hospitalization rates by race/ethnicity
- Total jobs lost
- Unemployment claims
The South and Midwest have the highest Covid case rates, with hotspots continuing to erupt across rural America.
Average daily cases per 100,000 people in past week, by county
Analysis of state and local health agencies and hospitals data as of Sep 20, 2020
Source: From The New York Times. © 2020 The New York Times Company. All rights reserved. Used under license.
Despite concerns about testing backlogs this month, the rate of new cases still represents the most valid and immediate indicator of Covid’s spread.1,2 Both hospitalization and death rates – while important measures of impact – lag weeks or months after initial diagnosis and fail to capture the full magnitude of the pandemic.3 However, epidemiologists warn that in the absence of widespread random sampling of the population, we will not know the pandemic’s true scale and will continue to struggle in managing the crisis. The hotspots of new cases in the last week are troubling, and only represent perhaps as little as 1 in 5 of the actual infection rate.4,5
The Northeast, which experienced the worst of the virus early, continues to hold levels down. The West and Gulf Coasts have reduced covid rates over the last month. However, medical professionals are concerned that wildfire smoke in the West may worsen Covid outcomes for those residents, and gulf coast states are wrestling with high case rates as they reel from Hurricane Sally and prepare for Tropical Storm Beta. The Dakotas, Wisconsin, Montana, Oklahoma, Iowa, Arkansas, Utah, and Tennessee are experiencing extraordinarily high rates of infection (above 150 new cases in the last week per 100k population). Local leaders attribute these flare-ups to the return of in-person classes at schools and universities, transmission in group quarters such as correctional facilities and Immigration Customs and Enforcement (ICE) facilities, and failure to wear masks in public.6,7,8,9
American Indian/Alaskan Native, African American, and Hispanic/Latinx individuals are ~4.5 times more likely to have severe Covid impacts than white individuals.
Age-adjusted Covid-19-associated hospitalization rates, March 1-September 5, 2020
By race and ethnicity
Despite ongoing debates about the quality and completeness of data on Covid cases reported by hospitals,1 available data on hospitalizations nonetheless illuminates stark disparities between racial groups. Hispanic/Latinx, Black, and Indigenous individuals are around 4.5 times more likely to be hospitalized or die due to Covid than white people.
Recent CDC analyses of hospitalization data reveal that the disparity applies to children as well, with cumulative hospitalization rates 8 and 5 times higher, respectively, for Hispanic and Black children than for white children.2
Racial disparities in health outcomes have existed long before Covid, but only partially explain the divide in this pandemic. Emerging research points to occupational exposure as a key driver of higher infection rates.3 Populations of color most impacted by Covid are over-represented in front-line work such as agriculture, food processing, transportation, janitorial work, and caregiving, and thus are not granted the privilege of working from home.4,5,6 Plus the cumulative health impacts of living in unsafe neighborhoods, breathing polluted air, having less access to healthy foods or quality medical care, and a lifetime of experiencing racial discrimination mean that these populations have higher rates of comorbidities such as diabetes, heart disease, and obesity that are associated with greater morbidity and mortality in Covid cases.7,8,9,10 For example, baseline rates of diabetes are nearly 15% among Native Americans, 13% for Hispanics, and 12% for Black Americans, compared to 8% for white Americans according to the CDC’s 2020 National Diabetes Statistics Report.11
The U.S. has 10 million fewer jobs than one year earlier. 2 states have lost more than 1 million jobs and 7 additional states have lost 400k+ jobs.
Total jobs by month, U.S.
Source: Bureau of Labor Statistics
Loss of jobs by state, August 2019 to August 2020
Employment by state, seasonally adjusted
Source: Bureau of Labor Statistics Note: Data for July 2020 and August 2020 are preliminary
The total number of U.S. jobs fell from a high of 152 million in February 2020 to a low of 130 million by April 2020. Despite recent rebounds, the total number of jobs in September at 140 million is still 11.5 million fewer than its February peak. The U.S. hasn’t experienced such a low jobs number since March 2014. Both California and New York have at least 1.2 million fewer jobs compared to last summer. Texas, Pennsylvania, Florida, Ohio, Michigan, Illinois, and Massachusetts each lost more than 400,000 jobs in August compared to a year ago.
As of August 15, the number of continuing unemployment claims, not including special pandemic unemployment assistance claims, is more than double the peak claims from the Great Recession.
Continuing unemployment claims, regular state and Pandemic Unemployment Assistance
Through August 15, 2020
Source: Department of Labor, Economic Policy Institute Note: Non-seasonally adjusted numbers, due to change in counting methods. PUA and Continued Claims should be non-overlapping, but in some instances may be due to counting errors.
There were 3.5 times more continued unemployment claims during the height of the Covid-19 pandemic (thus far) compared to the height of the Great Recession. As of August 15, there are more than double the claims than at the Great Recession’s peak. Pandemic Unemployment Assistance has also been made available to some of those not eligible for the regular assistance. This expanded support helps those in certain work situations or those who have exhausted normal assistance avenues. Due to the enormous job loss, Congress approved an additional $600 in weekly unemployment benefits in March. But this support ended in late July, and unemployed workers are now receiving only about 40% of their pre-pandemic wages per week.2 This will likely contribute to significant hardships for millions of American households including food and housing insecurity. In addition, recent research from Opportunity Insights suggests that the effects of stimulus payments and the PPP program on consumer spending has been minimal. In contrast, social safety net programs like unemployment benefits have the potential to spur demand and support jobs.3 In fact, one economic analysis estimated that the loss of the additional $600/month would reduce consumer spending and lead to the loss of roughly 2 million jobs over the next year.4
Average daily cases per 100,000 people in past week, by county
- “What Is Needed to Fix California’s Coronavirus Testing?” Ho. Governing.com. August 2020. https://www.governing.com/next/What-Is-Needed-to-Fix-Californias-Coronavirus-Testing.html
- “To speed up results, states limit COVID-19 testing.” Vestal. Herald Mail Media. August 2020. https://www.heraldmailmedia.com/news/nation/to-speed-up-results-states-limit-covid-19-testing/article_20891f06-d2aa-5889-bf5c-d416f62ad8ef.html
- Personal communication with infectious disease specialist Dr. William Pewen, June 2020
- “Defining the Epidemiology of Covid-19 — Studies Needed.” Lipstitch, Swerdlow, and Finelli. The New England Journal of Medicine. March, 2020. https://www.nejm.org/doi/pdf/10.1056/NEJMp2002125?articleTools=true
- “Covid-19: four fifths of cases are asymptomatic, China figures indicate.” Day. BMJ. April 2020. https://www.bmj.com/content/369/bmj.m1375
- “142 more COVID-19 cases in state, 11 in Phillips County.” Drake. Great Falls Tribune. August 2020. https://www.greatfallstribune.com/story/news/2020/08/13/montana-covid-19-update-142-more-cases-state-11-phillips-county-august-13-thursday/3365512001/
- “Wedding linked to COVID-19 cases – updated.” Hogg. Great Bend Tribune. August 2020. https://www.gbtribune.com/news/community-covid-19/wedding-linked-multiple-covid-19-cases-update/
- “Tribal leaders warn of COVID-19 spread on Spirit Lake reservation.” Shirley. Inforum. August 2020. https://www.inforum.com/newsmd/coronavirus/6604784-Tribal-leaders-warn-of-COVID-19-spread-on-Spirit-Lake-reservation
Age-adjusted Covid-19-associated hospitalization rates
- “Trump plots broad health data overhaul after troubled rollout of Covid-19 database.” Tahir, Roubein. Politico. August 2020. https://www.politico.com/news/2020/08/19/trump-plots-broad-health-data-overhaul-after-troubled-rollout-of-covid-19-database-398403
- “Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, March 1–July 25, 2020.” Center for Disease Control. August 2020. https://www.cdc.gov/mmwr/volumes/69/wr/mm6932e3.htm?s
- “To protect frontline workers during and after COVID-19, we must define who they are.” Tomer, Kane. Brookings Institution. June, 2020 https://www.brookings.edu/research/to-protect-frontline-workers-during-and-after-covid-19-we-must-define-who-they-are/
- “A Basic Demographic Profile of Workers in Frontline Industries.” Rho, Brown, and Fremstad. CEPR. April, 2020. https://cepr.net/wp-content/uploads/2020/04/2020-04-Frontline-Workers.pdf
- “Differential occupational risk for COVID‐19 and other infection exposure according to race and ethnicity.” Hawkins. American Journal of Industrial Medicine. June, 2020. https://onlinelibrary.wiley.com/doi/full/10.1002/ajim.23145
- “Report of the Secretary’s task force on black and minority health.” Heckler. U.S. Department of Health and Human Services. 1985.
- “Unequal treatment: Confronting racial and ethnic disparities in health care.” The National Academies Press. Institute of Medicine. 2003.
- “A decade of studying implicit racial/ethnic bias in health care providers using the implicit association test.” Maina, Belton, Ginzberg, Singh, and Johnson. Social Science & Medicine. 2018.
- “’Weathering’ and Age Patterns of Allostatic Load Scores Among Blacks and Whites in the United States.” Geronimus, Hicken, Keen, and Bound. American Journal of Public Health. December, 2005 https://pubmed.ncbi.nlm.nih.gov/16380565/
- “Structural racism and health inequities in the USA: evidence and interventions.” America: Equity and Equality in Health. Bailey, Krieger, Agenor, Graves, Linos, and Bassett. April, 2017. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30569-X/fulltext
- “National Diabetes Statistics Report 2020.” Center for Disease Control. 2020. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf