Thomas Bollyky, CFR: The roots of the US Covid catastrophe—“a syndemic of politics and race.”

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“Not all U.S. states struggled equally.” Thomas Bollyky, CFR, led an ambitious, nuanced effort to break down Covid outcomes across 50 states and Washington DC, published in the Lancet in April. There is a striking four-fold difference between the best and worst performing U.S. states. Some of the best states, led by Republican and Democrat governors alike, rivalled the best performers in Europe. High-performing states provide a formula for success which may be helpful in the future. Pre-pandemic differences were decisive—poverty, education, and race. Partisanship and politics skewed results. “Trust plays an outsized role.” The current hardening of opinion today in America remains a cause for worry.