Relationship between political partisanship and COVID-19 deaths: future implications for public health

BACKGROUND: COVID-19 has impacted more than 200 countries. However in the USA, the response to the COVID-19 pandemic has been politically polarized. The objective of this study is to investigate the association between political partisanship and COVID-19 deaths rates in the USA. METHODS: This study used longitudinal county-level panel data, segmented into 10 30-day time periods, consisting of all counties in the USA, from 22 January 2020 to 5 December 2020. The outcome measure is the total number of COVID-19 deaths per 30-day period. The key explanatory variable is county political partisanship, dichotomized as Democratic or Republican. The analysis used a ZINB regression. RESULTS: When compared with Republican counties, COVID-19 death rates in Democratic counties were significantly higher (IRRs ranged from 2.0 to 18.3, P < 0.001) in Time 1-Time 5, but in Time 9-Time10, were significantly lower (IRRs ranged from 0.43 to 0.69, P < 0.001). CONCLUSION: The reversed trend in COVID-19 death rates between Democratic and Republican counties was influenced by the political polarized response to the pandemic. The findings support the necessity of evidence-based public health leadership and management in maneuvering the USA out of the current COVID-19 pandemic and prepare for future public health crises.