Seattle may have lowest rate of COVID-19 cases among major U.S. cities

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The City of Seattle operates free, drive-thru coronavirus testing sites, including this one in Sodo. (Ellen M. Banner / The Seattle Times)

When the novel coronavirus hit the Seattle area at the beginning of the year, there was no playbook on what to do. In late February, with a major outbreak at the Life Care Center nursing home in Kirkland, we became the nation’s first epicenter. Things could have easily spiraled out of control, as they did in New York City, the nation’s second epicenter.

But by the end of March, it was clear the virus was not spreading as quickly here as it was in the New York area and some other parts of the country. Our hospitals, though stressed and stretched thin of personal protective equipment, were not overwhelmed to the same degree. And we’ve continued to keep the spread in check.

In total, through the end of September, Seattle has recorded just shy of 5,600 cases. With the city’s population of roughly 750,000, that pencils out to a rate of 7.4 cases per 1,000 Seattle residents.

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Compare that with New York, the nation’s second coronavirus epicenter, and where the virus’s impact was devastating. There, a total of about 239,000 cases have been recorded through September, for a rate of 28.7 per 1,000 city residents — nearly four times higher than Seattle.

And data shows we haven’t just contained the virus more effectively than New York. We may have the lowest rate of coronavirus infections of any major U.S. city.

This finding comes from the office of Seattle Mayor Jenny Durkan, where staff compiled coronavirus data from local health departments for the 30 largest U.S. cities. When they undertook this task, they didn’t anticipate that Seattle’s rate of cases would be the lowest.

“The mayor meets every week with a group of national experts that she’s convened, and one of the conversations that we had was focused on the trends across the country as we’re reopening,” said Stephanie Formas, chief of staff to Durkan, and one of the researchers who compiled the public health data. “So the mayor was interested to see how Seattle compares with all the other major cities.”

There’s a caveat with the data, though, and that’s the reason we can’t definitely say Seattle has the lowest rate of coronavirus infections. For 15 of the largest U.S. cities, the local health department doesn’t produce data at the city level. Instead, researchers had to use the numbers for the county in which the city is located. For example, the data for Portland is actually for Multnomah County.

So it’s not a perfect comparison. That said, there’s no reason to believe the numbers for any large city would be wildly different from the county in which it’s located.

The highest rate of cases is not in New York, which only ranks 11 among the 30. Nashville (Davidson County) has the unfortunate distinction of the highest rate, at 41.8 confirmed coronavirus infections per 1,000 residents. It had about 29,000 coronavirus infections through September, with a population of nearly 695,000.

It’s no wonder the Mayor’s Office wanted to share the findings with me. Seattle’s low rate of infections is a noteworthy achievement, particularly in light of the fact that we had to confront the virus before any other area of the country.

Formas is quick to point out that our success in containing the spread of the virus reflects the vigilance of all Seattle residents.

“It’s the people of Seattle who have kept the case count low, by being serious about social distancing, about hygiene and washing your hands, about wearing face covers, and about getting tested,” she said. “Seattle has made the commitment to protect our neighbors and to protect ourselves from the spread of COVID.”

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And of course, she also credits leadership. From the beginning of the crisis, she notes, local leaders spoke with a unified voice — from the governor to the King County executive to the mayor.

The state and city acted quickly, instituting some of the most aggressive containment policies in the nation. As early as the end of February, officials were urging social distancing and asking people to stay at home. By mid-March, a moratorium on events and gatherings was in place, and restaurants, bars and gyms were closed. The governor’s full stay-at-home order was issued March 23.

Seattle went further, closing or limiting access to parks, beginning in April. The city made other policy decisions to encourage safe behaviors, such as the “Stay Healthy Streets” initiative, to allow residents to walk and exercise at a safe distance from each other. The city has also instituted free temporary permits for sidewalk cafes, merchandise displays and food vending.

There was concern that the protests that began in June, in the wake of the killing of George Floyd by police in Minneapolis, could accelerate the spread of the coronavirus. The city handed out face coverings to those who needed them at some of the initial protests, Formas says. The city also signed an agreement with Public Health – Seattle & King County to allow anyone who attended a protest to get tested for COVID-19.

Protests don’t appear to be driving coronavirus surge in Seattle area or elsewhere, researchers say

The data also show that Seattle has one of the lowest death rates from coronavirus among large cities, at 0.2 deaths per 1,000 residents (the death total through September was 174). San Francisco has the lowest rate, at 0.1 deaths per 1,000.

The highest death rates are in New York and Detroit, both at 2.7 deaths per 1,000 residents. More than 19,000 New Yorkers died from the virus.

There could also be a demographic component to Seattle’s low rate of cases. Data from the Centers for Disease Control shows that white and Asian people have the lowest rate of coronavirus infection. Black, Hispanic and Native American people have rates more than two times higher.

Among the 30 cities, Seattle has the highest percentage of white and Asian residents, at 79% of the population. The percentage is just slightly lower in Portland (Multnomah County), which ranked second lowest for coronavirus infections, at 8.9 per 1,000 residents.

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Correction: An earlier verison of this column included an incorrect calculation of the coronavirus case rate for Las Vegas. The Seattle Mayor’s Office miscalculated the city’s rate, ranking Las Vegas first. In fact, Las Vegas has a case rate of 29.9 per 1,000, which ranks eighth.

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Gene Balk / FYI Guy: gbalk@seattletimes.com; .