Pennsylvania today (April 3) has over 8,400 known cases of COVID-19. Some of the county-level variation reflects lags in testing, but it's also about differences in mobility, connection, density, labor, & vulnerability. TL;DR: We should really, really worry about Luzerne. 
Here's what the data looked like a few days ago. I traced on the regions @4st8 & I spent lots of tweets defining, back a lifetime ago in November. The differences btwn NEPA & the region we decided to call Upper Susquehanna, & btwn Upper Susq & North Ctrl further west, is clear
Here are the same regions traced onto the @AmCommPro map that categorizes counties by demography+economics
We were focused on politics then but some of the same characteristics, tragically, shape vulnerability to disease spread—& also, capacity for effective response to it
Here's today's map, which is distressing enough even before you realize that countywide case counts from 110 to 2000+ are the same color orange. Our @PAHealthDept color scheme is like the opposite of logarithmic scale
What we really want to know tho is how hard-hit regions are (so far) taking population into account. The answer is even though SEPA registered cases ~2 wks before other regions, their total case count per capita has already been surpassed by Lehigh Valley & NEPA as well as Philly
Like other Americans Pennsylvanians are living radically divergent experiences of this emergency. For frontline healthcare workers & essential (service) workers—concentrated in the middle & lower middle income quintiles—the safety of zoom isn't an option brookings.edu/blog/up-front/…
Pennsylvania's regions are not equally vulnerable. Households in SEPA are disproportionately able to self-isolate & work from home. Philly's at the opposite end of that spectrum.
Philly's population is beset by the medical vulnerabilities poverty & structural racism bring. It has, though, by far, the smallest elderly population in the state. Both Lehigh Valley & NEPA, in contrast—where case growth is high & rising—have many more elderly residents.
.@4st8 has brilliant pointed out how maps show the political legacy of Pennsylvania’s laboring past. Coalfields built industry; Labor organizing built electoral clout
What's the human legacy of coal & steel past? Aging & ailing populations that make "personal care aide" the largest single occupation in whole regions. Working-age pop disproportionately frontline "essential workers" today
.@nettiequette points to this site. I especially appreciate the choice to report "loved ones lost" rather than use dehumanizing language. Meshing accurate info w/ maintaining humanity isn't just an ethical imperative: it's essential for good policy choices nepa-alliance.maps.arcgis.com/apps/opsdashbo…
Update: Known COVID-19, April 4. Luzerne goes from 484 total cases yesterday to 648 today. Tragedy looms in NEPA with Rust Belt-COVID ‘perfect storm’ of aging population, legacy chronic illness, racialized poverty, & disproportionate frontline healthcare emplymnt w/o adequate PPE
(underlying image ^ is from pennstate.maps.arcgis.com/apps/opsdashbo… h/t @heatherfro, & much-classier-than-usual regional overlay is from @PhillyResistNow who reached out to offer. Mutual Aid for visual communication of the PA labor history/politics of care/pandemic vulnerability nexus ftw!)
Tragedy isn't inevitable. The problem is the same trends of inequality & underinvestment that leave regions especially vulnerable to pandemic have worn down communities' ability to hold employers & political leaders accountable for the actions urgently needed to stop it.
There is a deeply ironic here to the fact that the same workers least protected by labor laws—& most likely to women, immigrants, people of color—are "essential workers" @ the frontlines now. It's the care labor most routinely devalued on which, turns out, we depend.
Labor protections for those workers would have amplified their voices & obliged employers to build systems of care with far greater resilience & backup. For the past 40 ys, that's not the choice our courts or public institutions (or upper-middle-class consumers) have been making.
This 👇is a critical point and I'm not sure folks in those regions are getting the accurate message they need. The sole advantage they have is lower density & less out-of-region mobility, which will slow (but not prevent) the arrival of coronavirus. BUT
...once community spread reaches the most marginalized rural/rustbelt (=long-ago-coal + no substitute since) regions of PA, they are the *most* vulnerable to most severe case outcomes. Action _now_ to prepare is extra urgent there. See vulnerability index covid19.jvion.com
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