February 26, 2021

UNEXPECTEDLY: Many heartland states have outperformed more prominent counterparts in the fight against Covid-19.

Gretchen Garofoli, a local pharmacist in Morgantown, West Virginia, administered one of her state’s first Covid-19 vaccinations—a jab in the arm of a nursing-home patient— on December 15, weeks before any other state could do the same. “It was a beacon of hope,” Garofoli later told NPR. West Virginia is the only state in the country to use independent pharmacies to deliver shots; pharmacists in these communities often know their patients by name. “The more the state collaborates with those at the local, community level, the greater the vaccine uptake,” concluded Christopher Martin, a professor at the West Virginia University School of Public Health. As of mid-February, West Virginians have received more than 400,000 doses of the coronavirus vaccine, and some 8 percent of the population has received at least two jabs (a rate second only to Alaska’s 9 percent).

Smaller, redder states have been more successful than media coverage would suggest. Look at the rankings for Covid-19 vaccine doses given and you’ll see West Virginia, Alaska, North and South Dakota, and Utah ranking high. These states benefit from having fewer people to vaccinate—and only a few large health systems operate in North and South Dakota, allowing for easier logistics and nimbler vaccination plans— but they aren’t without geographical difficulties. Yet many of their governors have been pilloried in the press. South Dakota governor Kristi Noem, a common target, began planning her state’s vaccine rollout in mid-summer, well before the federal government gave its own guidance. Noem’s team held daily coordination meetings with local partners, who, in turn, led the distribution and shared lessons learned along the way.

The success of heartland states compares favorably with the performance of New York and California.

To be fair, it’s difficult to even imagine worse performances than Andrew Cuomo’s or Gavin Newsom’s.

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