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?:abstract
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INTRODUCTION: As the response to the COVID-19 pandemic has become increasingly politicized in the United States (US), political party affiliation of state leaders may contribute to policies affecting the spread of the disease. We examined differences in COVID-19 infection and death rates stratified by governor party affiliation across the 50 US states and the District of Columbia (DC). METHODS: We conducted a longitudinal analysis examining daily COVID-19 incidence and death rates from March 1 through September 30, 2020, for each US state and DC. We fit a Bayesian negative binomial model to estimate adjusted daily risk ratios (RRs) and posterior intervals (PIs) comparing infection and death rates by gubernatorial (mayoral for DC) party affiliation. We adjusted for several state-level variables, including population density, age, race, poverty, and health. RESULTS: From March to early June 2020, Republican-led states had, on average, lower COVID-19 incidence rates compared to Democratic-led states. However, on June 8, the association reversed, and Republican-led states had higher per capita COVID-19 incidence rates (RR=1.15, 95% PI: 1.02, 1.25). This trend persisted until September 30 (RR=1.26, 95% PI: 0.96, 1.51). For death rates, Republican-led states had lower average rates early in the pandemic, but higher rates from July 13 (RR=1.22, 95% PI: 1.03,1.37) through September 30 (RR=1.74, 95% PI: 1.20, 2.24). CONCLUSION: Gubernatorial party affiliation may drive policy decisions that impact COVID-19 infections and deaths across the US. As attitudes toward the pandemic become increasingly polarized, policy decisions should be guided by public health considerations rather than political ideology.
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