I have previously posted a table that listed the incidence of death in countries. I think it is also useful to do this same exercise for US States and Territories. As before, the number of deaths per 100,000 people is provided. Here are the top 10:
- Puerto Rico – 0.8
- Utah – 0.6
- Guam – 0.6
- Hawaii – 0.5
- California – 0.4
- Florida – 0.4
- New York – 0.3
- Nevada 0.3
- Arizona – 0.3
- Rhode Island – 0.3
There are several striking results from this analysis. First, Puerto Rico has a very high incidence of death. If it was a country, it would rank number 8. Yet, we hear little about what is going on in Puerto Rico. Why so many deaths? One possibility is that people in Puerto Rico are receiving poor quality medical care. There are anecdotal reports that late treatment is likely to lead to a higher case fatality rate. However, it is worth noting that islands in a tropical environment are disproportionately represented among the top 10 countries with the most deaths per 100,000 people. It may be that environmental factors play a role the spread of the virus or in its ability to kill. Supporting this hypothesis, Guam and Hawaii are in positions 3 and 4, respectively, on the US states and Territories list.
Utah’s number 2 position on this list is not easily explained. Colorado, which is similar to Utah in many ways, has one of the lowest incidences of death of any State. Could Utah have harbored a more severe strain of H1N1 than other States? It might be worth testing viral isolates from Utah to see if they cause more severe disease than viral isolates from Colorado.
New York’s position at number 7 is likely an underestimate of its true level of deaths. New York City stopped reporting its deaths weeks ago. The high population density in New York City and other megacities is likely to result in a higher incidence of death in the coming months.
The relatively small number of cold weather states near the top of this list is interesting. One possible interpretation is that higher latitude states have more extreme flu seasons, just as their weather is more extreme. If so, those states will move up the list as temperatures drop.
The CDC no longer provides information on the number of deaths per State, although they presumably have this information. This is unfortunate as it makes it more difficult for other scientists and the general public to form their own hypotheses about what this new flu is doing.
Many thanks to the newshounds at PFI_Forum for their diligent work in tracking deaths within the United States and the world.