The US is a large country, with regions that have their own subcultures, climates, demographics, economies and politics. COVID-19 affected US regions at different times and in different ways. Those varying experiences have shaped Americans’ views of the pandemic.

So far, the US has experienced five major “waves” of the virus. The first wave hit cities the hardest, as the virus was most likely to show up initially in cities and then spread among their dense populations. In the spring of 2020, US cities saw surges in infections, hospitalizations and deaths. New York City was the epicenter of that wave, but other cities such as New Orleans and Seattle also struggled.

According to recent data analysis from the Pew Research Center, drawing on data from The New York Times, the first wave struck densely populated areas much harder than less populated areas. Given the political alignments with urban and rural areas in the country, this also meant that populations that tend to vote for Democrats had far more infections and deaths than places that tend to vote Republican.

The reality that Democratic-leaning populations suffered far more than Republican-leaning Americans early in the pandemic played a major role in shaping partisan views of COVID-19. The different experiences mapped onto other cultural and political divides, encouraged by then-President Donald Trump. The early experience with the pandemic melded with other partisan characteristics to forge Democrats’ tendency to take the virus more seriously than Republicans and to support more mitigation measures.

The virus spread beyond densely populated areas to more rural Americans, however. While the lower levels of population density might have offered some protection, less populated areas were more vulnerable in other ways. They tend to have older populations more susceptible to the virus. And rural Americans are less likely to have access to nearby healthcare facilities.

Political identity and partisan views also played a major role. Rural and less densely populated areas strongly tend to vote Republican, while urban and densely populated areas tend to vote Democratic, with suburbs often in between. As multiple polls have shown over the last two years, Democrats were much more likely to wear masks, practice social distancing and avoid crowds. Republicans were much more likely to continue normal socialization, with few or no mitigation measures.

Experience with the first wave also shaped partisan differences, leading many outside of populous areas to feel that the pandemic was mostly a coastal city problem. The third — and most deadly — wave hit during the winter of 2020/2021 and was much harder on the rest of the country. While the cities that initially suffered fared better, the middle and south of the country struggled. As Pew notes, in the first wave, the “death rate in the 10 percent of the country that lives in the most densely populated counties was more than nine times that of the death rate among the 10 percent of the population living in the least densely populated counties.” However, in the other waves, “the nation’s least dense counties have registered higher death rates than the most densely populated places.” Furthermore, after the first wave, deaths have been higher in deeply Republican areas than in strongly Democratic areas.

The US began vaccinations during the third wave, in early 2021. When the fourth wave, involving the more severe delta variant, arrived in fall 2021, vaccinations played a major role in shaping how the pandemic played out across the country. The denser, more Democratic areas that suffered badly in the first wave tended to have significantly higher vaccination rates and managed relatively well during the delta wave. This fourth wave again hit less dense areas of the country harder, reflecting their lower vaccination rates. Unfortunately, vaccination had also become politicized; for example, a Gallup survey from September found that, among adults, 92 percent of Democrats had received at least one vaccine dose, compared to 56 percent of Republicans. The omicron variant was more evenly spread across the country but still led to more deaths in Republican-leaning areas.

The long-term consequences of regional differences during the pandemic are difficult to predict, but will be significant. For example, schools were more likely to remain open in areas governed by Republicans, which might leave Democratic areas with more learning loss. The economic consequences will take years to play out. Socially, the pandemic further polarized Americans, as partisan views played a major role in attitudes toward the virus, and the stakes were high. Many relationships were broken as people tried to determine whether to socialize, how and with whom. The partisan gap regarding trusted sources deepened; for example, trust in the Centers for Disease Control and Prevention has fallen significantly among Americans who primarily consume conservative media outlets, according to a recent Ipsos/Axios poll.

While 70 percent of Americans say that it is time to move on with regular life, according to a recent Monmouth University poll, there is still a deep partisan divide shaping the extent to which Americans are ready to move on. The poll found that 89 percent of Republicans, 71 percent of independents and only 47 percent of Democrats agreed. These partisan differences will continue to shape attitudes and politics in different regions of the country. If no new and severe variants emerge, then Americans are likely to soon reach a consensus that it is time for life to return to normal, but the scars of the last two years will last and continue to shape regional differences.

• Kerry Boyd Anderson is a writer and political risk consultant with more than 18 years of experience as a professional analyst of international security issues and Middle East political and business risk. Her previous positions include deputy director for advisory with Oxford Analytica.

Twitter: @KBAresearch

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