It was predictable and predicted. While large metropolitan areas like New York City bore the brunt of the early COVID-19 pandemic, disease eventually dispersed to more remote areas with fewer healthcare options, changing the trajectory of sickness and death.
An NPR analysis finds that the share of COVID-19 deaths outside places considered large metro areas by the Centers for Disease Control and Prevention has grown dramatically since the country passed its first 100,000 deaths. Then, about a fifth of deaths came from places outside large metro areas. In the second 100,000 deaths, that share jumped to nearly half.The largest growth occurred in small towns and rural areas, where the share of deaths nearly tripled.
NPR points to Hidalgo, Texas, a county of 868,707. Initially, it was untouched by COVID-19. Today, deaths stand at over 1,500. Val Verde, Texas — population 49,025 — has also been ravaged by the virus. California witnessed a similar trend after the virus hit the Central Valley.
The HIV epidemic once followed a similar path, epidemiologist Ali Mokdad told NPR. Viruses tend to take hold first in densely populated areas and then move out into suburbs and rural areas.
“None of us live in a bubble,” he said. “We're going to interact with each other — rural, urban, whatever. People live far apart, are less likely to see each other, but we have events that bring us together. And the cases follow that."