The coronavirus has spread to all 50 states, hitting the northeast especially hard. Regional patterns reveal the challenges faced by different states as they work to combat the virus.

The northeast

This region has been the hardest hit in the entire country. New York state has become the epicentre of the outbreak, with 36 per cent of all deaths in the United States. Even after adjusting for population size, the state still has the highest fatality rate for coronavirus in the nation.

The states in the northeast account for nearly two-thirds of fatalities in the United States. Researchers suggest that the virus began spreading in this region in mid-February, weeks before the first confirmed case, and that a majority of cases have links to Europe, not Asia.

The west

Some of the earliest cases in the country were diagnosed in this region, which has also been the most successful in mitigating the virus. California, Oregon and Washington, in fact, have shipped ventilators to hot spots on the east coast.

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California, the most populous state in the country, had nearly 600 direct flights to China in January — more than twice as many as New York state — making it especially vulnerable to the spread of the virus.

Still, the state was the first to implement broad stay-at-home measures and has managed to keep its death toll comparatively low, ranking 29th among all 50 states and Washington DC, in deaths per capita.

Late Tuesday, officials in Santa Clara County, California, announced that two residents there had died of the coronavirus in early February, shifting the timeline of the virus’s spread across the country much earlier than previously believed.

The midwest

Several governors in the Midwest, which is home to multiple hot spots, have announced that they will coordinate plans to reopen their economies. Protesters in some of these states have taken to the streets to demand that governors loosen restrictions, even though public health experts warn that relaxing stay-at-home rules too soon could lead to new waves of outbreaks.

In Illinois, the Chicago area has emerged as a hot spot. The Cook County Jail — one of the nation’s largest — is among the largest single sources of infection in the country. Michigan has some of the highest rates of infection and fatality in the country, ranking third in coronavirus deaths and seventh in total cases among the 50 states and Washington, DC Racial disparities are also stark in Michigan, where black residents make up just 14 per cent of the population but 40 per cent of virus deaths.

The south

Most states in the south lagged behind the rest of the country in implementing stay-at-home orders, with many waiting until the end of March or early April to do so. These same states are now poised to be among the earliest to loosen those very restrictions, even though their populations have disproportionate rates of underlying conditions that put people at a higher risk of dying of the coronavirus.

In Florida, a beach festival held in early March was the source of dozens of infections. Nearly a month later — and after the official case count in Florida reached 7,000 — governor Ron DeSantis issued a stay-at-home order. One-quarter of Florida’s population is older than 60, the age group for whom the coronavirus is most deadly.

In Georgia, a funeral in the small city of Albany became a super-spreader event. Three counties near this city have some of the highest per-capita rates of infection outside the New York area.

Many point to the failure of New Orleans to cancel the Mardi Gras festival as a precipitating factor in Louisiana’s outbreak. The state ranks fifth in the country in deaths and is home to numerous hot spot counties.