Top prepared states for COVID-19: Did your state make the cut?

As of this writing, there are 97,226 confirmed cases and 1,478 deaths from COVID-19 in the United States alone. Citing these numbers, lay people and experts alike have criticized the federal government for being unprepared for this pandemic. However, many states quickly took matters of preparation into their own hands. 

For instance, governors in all 50 states—as well as in Washington DC, Puerto Rico, Guam, and the US Virgin Islands—have called in the National Guard to assist with everything from managing mobile testing sites in parking lots to equipping pop-up hospitals in city convention centers. 

In order to determine the states that have been the most and least aggressive in their efforts to prevent coronavirus, the personal finance website WalletHub ranked all 50 states and the District of Columbia across 46 unique metrics such as “Tested Cases of COVID-19 per Capita” and “Public Hospital System Quality.”

“One of the most aggressive actions that states have taken thus far is to institute mandatory stay-home and shelter-in-place orders for all residents, along with nightly curfews,” said WalletHub analyst Jill Gonzalez. “Another drastic measure has been to ban all public gatherings.”

Here are the top 10 states that WalletHub found to be the most prepared for the COVID-19 outbreak. (Rankings are based on data available as of March 23.)

10. Louisiana

Louisiana is ranked the 10th most prepared state, although it comes in 7th in WalletHub’s overall “Prevention & Containment” ranking. This ranking includes factors such as “Emergency Centers and Services per Capita,” “Total Public Health Emergency Preparedness Funding Per Capita,” “Tested Cases of COVID-19 per Capita,” and nearly 20 other factors. Louisiana came in 6th for “Hospital Beds per Capita,” but is ranked at the bottom (50th) for “Epidemiology Workforce per Capita.”

How is Louisiana faring? Governor John Bel Edwards issued a statewide “stay at home” order that began March 23. “In Louisiana, we have taken aggressive measures to mitigate the spread of COVID-19 and flatten the curve; however, this is not enough. As our number of cases continue to grow, I am directing all Louisianans to stay at home unless it is absolutely necessary for you to leave,” Gov. Edwards said. “This order is not something I take lightly, but it is necessary to protect the health, safety, and well-being of our people, our communities, and our way of life.”

As of this writing, Louisiana has 2,744 confirmed cases of COVID-19 and 119 deaths.

9. Colorado

Colorado ranks 3rd in the overall “Risk Factors & Infrastructure” ranking, which includes factors such as “Public Hospital System Quality,” “Public Healthcare Spending per Capita,” “Share of Uninsured Population” and about a dozen others. Among these, Colorado ranks in 2nd place for its low “Share of Elderly Population” and 9th for “Intensive Care Unit Beds per Capita.”

How is Colorado faring? Following a state of emergency order from the governor of Colorado, the City and County of Denver issued a “stay at home” order that went into effect on March 24.

Currently, Colorado has 1,430 confirmed cases of COVID-19 and 24 deaths.

8. Maine

Maine ranks in 3rd place for its low “Population Density,” which certainly helps with social distancing, and comes in 7th place for both “Tested Cases of COVID-19 per Capita” and “Public Hospital System Quality.” On the other hand, Maine is ranked in last place (51st) for its high “Share of Elderly Population.”

How is Maine faring? Maine was the last state in New England to see cases of coronavirus (the first didn’t occur until March 12), so the state had more time to take proactive steps for prevention.

“The Maine CDC has been preparing for this eventuality since the end of last year,” said Governor Janet Mills at the time. “With one presumptive positive case, Maine has a unique window of opportunity to delay an outbreak like those we see in other states, and to minimize our exposure.” Since then, the state has done just that. 

Maine now has 168 confirmed cases of COVID-19 and 1 deaths. 

7. New York

The State of New York has been hit the hardest—by an order of magnitude—compared with other states, with more than 120,000 residents tested. Accordingly, it ranks in the top spot for “Tested Cases of COVID-19 per Capita.” 

On the downside, it ranks among the bottom for measures of healthcare infrastructure, coming in 44th for “State and Local Public Health Laboratories per Capita,” 45th for “Emergency Centers and Services per Capita,” and dead last (51st) for “Total Public Health Emergency Preparedness Funding Per Capita.” It’s also the state with the third-highest “Population Density,” which doesn’t help with social distancing. 

On the upside, New York has had relatively few deaths (so far) compared to its tens of thousands of COVID-19 cases. Accordingly, it ranks 48th among states for its low “Deaths Due to COVID-19 per Capita.” New York also ranks well, at 9th place, for “Epidemiology Workforce per Capita,” and 6th in “Prevention & Containment.”

How is New York faring? Not too well, but it could be worse. In mid-March, the New York City suburb of Westchester County became the nation’s largest COVID-19 hotspot, marking a surge in cases and sparking a 1-mile containment zone that didn’t end until March 25. But the plan worked, keeping the number of new cases to a manageable level. 

Meanwhile, Governor Mario Cuomo has been metaphorically shouting from the rooftops for help in the beleaguered Empire State. “We're not slowing [the rate of infection], and it is accelerating on its own," Gov. Cuomo said. “We were looking at a freight train coming across the country—we're now looking at a bullet train.”

Gov. Cuomo has been a vocal critic of the White House, demanding that President Trump invoke the Defense Production Act to produce more ventilators, masks, and personal protective equipment. Gov. Cuomo said that the state needs 30,000 ventilators, but the Federal Emergency Management Agency would only be sending 400. “What am I going to do with 400 ventilators when I need 30,000? You pick the 26,000 people who are going to die because you only sent 400 ventilators.”

Currently, New York has 44,745 confirmed cases of COVID-19 and 519 deaths. 

6. Connecticut

Connecticut ranks well, at 7th place, in the overall “Risk Factors & Infrastructure” ranking. For instance, it ranks 6th for its high “State Rainy Day Fund Balance,” which is good because it also ranks near the bottom, at 44th place, for “Preparedness for Unemployment Insurance Claims.” On a brighter note, Connecticut also ranks low, again at 44th place, for “Deaths Due to COVID-19 per Capita.”

How is Connecticut faring? “We have been preparing for weeks for COVID-19 to come to Connecticut, and we should expect more cases in the coming days as this virus reaches every corner of the globe,” said Governor Ned Lamont on March 9, when the first case in the state was identified. 

State epidemiologist Matthew Cartter, MD, MPH, said, “At least in living generations, most of us do not remember the kind of control measures that are going to be needed to keep hospitals open, to keep taking care of the most seriously ill.”

Currently, Connecticut has 1,012 confirmed cases of COVID-19 and 21 deaths. 

5. New Jersey

New Jersey is 5th in the overall “Prevention & Containment” ranking. But the Garden State came in 48th for “State and Local Public Health Laboratories per Capita,” 49th for “Public Hospital System Quality,” and in nearly last place (50th) for its high “Population Density.”

How is New Jersey faring? New Jersey appears to be following in New York’s footsteps with drastic increases in cases on a daily basis. On March 23, New Jersey Governor Phil Murphy announced 935 new cases, largely due to increased testing. Just three days later, March 26, the governor announced 2,492 new cases—the state’s largest single-day increase since the outbreak.

“[W]e have been fully expecting the number of positive cases to increase dramatically as our specimen collection capabilities increase and, in particular, as the private sector lab companies have increased their scale and ability to process these tests,” he said. “We know that it takes up to 2 weeks for people to show signs of the illness, so new cases today could still mean new cases 2 weeks from now and so on and so on.”

“It’s gonna get worse before it gets better,” Gov. Murphy told ESPN Radio. “And I’ll be shocked if that doesn’t continue meaningfully into May.”

New Jersey now has 8,825 confirmed cases of COVID-19 and 108 deaths.

4. New Hampshire

New Hampshire is in 4th place for both “Prevention & Containment” and “Risk Factors & Infrastructure” rankings, with high marks in “Emergency Centers and Services per Capita” (2nd place), low “Infectious Disease Incidence Rate” (2nd place), low “Population Density” (5th place), and “Total Public Health Emergency Preparedness Funding Per Capita” (10th place). However, the state has poor marks in “ICU Beds per Capita” (41st place), and “Share of Elderly Population” (44th place). 

How is New Hampshire faring? The state didn’t have a mandatory shelter-in-place order until Thursday, but many residents had already been limiting their travel, noted Governor Chris Sununu. He added that the number of COVID-19 cases in New Hampshire is expected to increase significantly, but the peak may still be months away. “We don't know when it’s really going to hit its peak so until then we will have to be very, very vigilant about our personal responsibility, with our businesses and who we interact with, and take the concept of social isolation very seriously,” said Gov. Sununu. 

New Hampshire currently has 158 confirmed cases of COVID-19 and 1 death. 

3. Maryland

With so many hospitals and doctors in the state, it’s no surprise that Maryland ranks in first place in “Epidemiology Workforce per Capita” and 9th place for its low “Infectious Disease Incidence Rate.” Early on, Maryland took the precautions that many other states eventually did, like restricting travel, banning large gatherings, closing schools and non-essential businesses, and enacting budget legislation in response to COVID-19. 

Surprisingly, Maryland ranks poorly for a number of healthcare infrastructure and prevention factors, coming in 41st for “State and Local Public Health Laboratories per Capita,” 46th for “Hospital Beds per Capita,” 48th for “Public Hospital System Quality,” and 50th for “Tested Cases of COVID-19 per Capita.”

How is Maryland faring? When the first cases of COVID-19 appeared in Maryland in early March, Governor Larry Hogan assured the public that the state was well prepared for the impending outbreak. “We have been actively preparing for this situation over the last several weeks across all levels of government," he stated during a press briefing.

Since then, Maryland has been more proactive than many other states in its preparation measures, including teaming with Johns Hopkins, the University of Maryland Medical System, and others. “It’s absolutely critical that everyone be a part of breaking the back of this virus,” Gov. Hogan said recently. “This is not over by any stretch of the imagination, and we need everybody at the federal, state, and local level of government, the private sector, and every individual to help fight this battle.”

Maryland currently has 775 confirmed cases of COVID-19 and 5 deaths. 

2. Rhode Island

Rhode Island is tied for first place for fewest “Deaths Due to COVID-19 per Capita”—ie, zero. (Other states with zero deaths include Hawaii, Nebraska, North Dakota, and Wyoming.) Rhode Island also ranks 4th in “Emergency Centers and Services per Capita,” 8th for both “Total Public Health Emergency Preparedness Funding Per Capita” and “Public Healthcare Spending per Capita,” and 9th for “State and Local Public Health Laboratories per Capita.” However, it ranks 43rd for “Epidemiology Workforce per Capita” and 48th for its high “Population Density.”

How is Rhode Island faring? Rhode Island is one of the states that has administered the most COVID-19 tests per capita, among other actions, noted WalletHub’s Gonzalez. 

“Aggressiveness in combating the coronavirus is not all about recent actions, though. A lot of it is years in the making,” she added. “For example, Rhode Island has the infrastructure to handle this type of pandemic in large part because of its relatively high funding for public health programs and its high number of healthcare facilities.”

Rhode Island currently has 203 confirmed cases of COVID-19 and, as noted above, 0 deaths.

1. California

California is the most prepared and most aggressive state in the fight against COVID-19, according to WalletHub’s rankings. It’s the top state for the highest “Share of Workers with Access to Paid Sick Leave,” and ranks 5th highest for “Epidemiology Workforce per Capita.” It also ranks 6th for a low “Share of Elderly Population” and 7th for “Share of Chronically Ill Population.” It has the number 10 spot for its high “State Rainy Day Fund Balance.” 

On the downside, it comes in 45th for its few “Hospital Beds per Capita,” 47th for its high “Population Density,” and 50th for a lack of “Total Public Health Emergency Preparedness Funding Per Capita.”

How is California faring? “Some of the key reasons why California is the most aggressive state against the coronavirus include the [early] closure of schools, bars, and restaurants in the state, as well as the statewide shelter-in-place order currently in effect. California is also one of the states now requiring early prescription refills,” said Gonzalez.

But even with those precautions in place, the outlook for California isn’t exactly rosy. Governor Gavin Newsom cited numbers from one model that estimated that the coronavirus could infect 56% of Californians (more than 25 million people) in 8 weeks. In a worst-case scenario, the state would be short about 17,000 hospital beds, hundreds of millions of masks, and 1 billion protective gloves, the governor said. 

California now has 4,205 confirmed cases of COVID-19 and 85 deaths.

Ill-Prepared for Illness

Meanwhile, here are the states that have been the least aggressive in preparing for the virus, according to WalletHub: 

42. Missouri –  520 cases and 9 deaths

43. South Dakota – 58 cases and 1 death

44. Nebraska – 82 cases and 0 deaths

45. Montana – 109 cases and 1 death

46. Oklahoma – 322 cases and 8 deaths

47. Arkansas – 381 cases and 3 deaths

48. Idaho – 205 cases and 3 deaths

49. Tennessee – 1,145 cases and 3 deaths

50. Nevada – 536 cases and 10 deaths

51. Mississippi – 579 cases and 8 deaths