5 U.S. Cities Hit Hardest By COVID-19 And What They Learned

by Kroger Health Staff

Last Updated: May 26, 2020

COVID-19 has spread around the globe like wildfire, reaching all fifty states and the District of Columbia. Here’s a look at the five U.S. cities hit the hardest, and the factors that could have played a role in their unique challenges in managing the spread of the virus.
  1. New York City
    The nation’s largest city is the epicenter for COVID-19 in the United States, with the worst outbreak so far. The Brookings Institute compared the COVID-19 responses of New York City and San Francisco and found significant differences. Acting on the advice of experts, San Francisco implemented economic lockdowns, physical distancing, and hygienic safeguards early in the crisis. New York City didn’t act as swiftly to enact lockdowns and close schools. New York waited to implement its stay-at-home order four weeks after the first estimated introduction of the virus to the city. This slow response resulted in a much higher per capita death rate in the Big Apple. The former head of the Centers for Disease Control and Prevention (CDC), Dr. Thomas R. Frieden told The New York Times that had New York adopted social distancing measures a week or two earlier, the death toll could have been 50% - 80% lower.
  2. New Orleans
    The CDC issued a report finding Mardi Gras likely accelerated the spread of COVID-19 in New Orleans. The celebration with thousands of people in close proximity, combined with New Orleans’ high poverty rate of 25%, caused a high rate of COVID-19 transmission in the Crescent City.
  3. Washington D.C.
    The nation’s capital has the sixth-highest per person rate of COVID-19 cases according to data compiled by The New York Times. Based on research ranking cities on their vulnerabilities to COVID-19 based on health, financial, social, and economic factors, the District ranked among the most vulnerable economically. D.C. Mayor Muriel Bowser recently opted to extend the local stay-at-home order to stop the spread of the virus.
  4. Detroit
    Wayne County—the home of Detroit—is the county with the fifth most confirmed cases of COVID-19 outside New York state. Before the outbreak, Detroit ranked high among America’s unhealthiest cities. In 2017, a study by WalletHub found Detroit to be the unhealthiest city in America. Also, one of America’s poorest big cities, the Motor City has a large homeless population, which is at high risk. These underlying public health challenges could have been a factor in Detroit’s COVID-19 spike.
  5. Chicago
    In addition to Chicago’s sizable African-American population and concentrated poverty, Cook County Jail is one of the nation’s largest-known sources of coronavirus infections according to data collected by The New York Times. More confirmed cases were traced back to Cook County Jail than any other hot spot, including the U.S.S. Theodore Roosevelt, the Life Care Center nursing home in Kirkland, WA, or the cluster in New Rochelle, NY.

Overall, it appears cities where people stayed home earlier and practiced social distancing have a lower mortality rate. According to a recent study by Columbia University disease modelers, if social distancing measures would have been implemented one week earlier, an estimated 36,000 fewer people would have died in the pandemic. There is also evidence that poor underlying health in communities and populations could also play a role in the outcomes of individuals who become infected, as the CDC has reported that poorly managed chronic conditions such as diabetes, kidney disease, and obesity can make COVID-19 more deadly. Managing both the policy piece, as well as the community health piece, is important to keep our cities and country safe, now and into the future.

Disclaimer: The information in this story is accurate as of its publication. However, the situation surrounding COVID-19 is ever-evolving. We are working to keep our stories up-to-date as changes occur, but we also encourage everyone to check news and recommendations from the CDC, WHO, and their local authorities.