BOSTON — Last week, as Dr. Emily Wroe left her home in Boston and drove west to see her parents in Idaho, she watched the signs of the pandemic grow farther and farther away.
After he left Ohio, gas station customers no longer wore masks. In Nebraska, when her truck needed repairs, the mechanic seemed to look at her strangely because she was wearing one. In Montana, there were no masks and motorcyclists gathered in groups of 20.
The farther he was from the East Coast, the more he found Americans treating the threat of the virus as “remote and not important.”
“I wasn't surprised, but it's impressive,” said Dr. Wroe, who spent the spring preparing contact tracers for Massachusetts. “We are in the middle of a global pandemic and there are many cities and businesses along the way where nothing has changed.”
Six months since the coronavirus crisis was first detected in the United States, the Northeast is in stark contrast to the rest of the nation.
Along the East Coast, from Delaware to Maine, reports of new cases remain low, a fraction of their peak in April. Six of the nation's 11 states with stable or declining case rates are in this northeast corridor.
New York State announced Wednesday that just over 700 people were hospitalized for the virus, the fewest since mid-March and a huge drop from a peak of 18,000. Deaths have also slowed significantly, hovering around 20 over the past six days, compared with nearly 800 deaths a day at their peak.
“It works like Europe,” said Dr. Ashish Jha, director of the Harvard Global Health Institute, for the Northeast United States.
Like Europe, the northeastern country suffered a devastating wave of illness and death in March and April, and state leaders responded, after some hesitation, with aggressive lockdowns and heavy investments in testing and tracing efforts. Residents largely followed the rules and supported unexpectedly harsh measures, even at the cost of financial pain.
Dr Jha said the difference in regional trajectories was so stark that, when flu season starts in late autumn, “I wouldn't be surprised if what we have are two countries, one neck-deep in coronavirus, hospitals another part of the country that is struggling a bit, but largely doing well with their economy, is also being overwhelmed.”
It's also true that the Northeast remains the corner of America that has suffered the most from the virus. New Jersey, New York, Connecticut, Massachusetts and Rhode Island have reported the most deaths per capita in the country during the pandemic, with more than 61,000 combined. And the economic wounds from extended shutdowns run deep: Massachusetts' unemployment rate in June rose to 17.4%.the worst in the country, according to federal figures released Friday.
However, polls so far show that voters in the northeast are prepared to tolerate prolonged economic pain in order to stop the spread of the virus. Governors from states hit early by the pandemic were retained the highest acceptance rates in the country.
And in May, when a poll by Suffolk University's Center for Policy Research asked Massachusetts residents how long they could endure the hardships of a shutdown, 38 percent of respondents said “indefinitely.”
“This is not economic policy, it is life or death,” said David Paleologos, director of the center. “That's the core of why people say, 'I'll do whatever it takes.'
The crisis has highlighted key regional differences in how Americans view the role of government in their lives, said Wendy J. Schiller, chair of the political science department at Brown University in Providence, R.I. The Northeast, with its 400 years, said. The tradition of local, participatory governance has been less affected by decades of anti-government rhetoric.
“In New England and the Northeast, it's easier to say, 'Let's put on a mask and lock up, we're all in this together, we know each other,'” he said. “It's this reservoir of belief that government exists to be good.”
Four months ago, all New England governors were scrambling to contain the spread of the virus. They had hesitated to impose shutdowns in early March, when many in the public health community were calling for immediate action, Dr. Tza said.
“It took longer than it should have,” he said.
But the responses that followed were aggressive. Charlie Baker, the Republican governor of Massachusetts, decided after a late-night phone call with Jim Yong Kim, co-founder of the nonprofit Partners in Health, to fund $55 million for contact-tracing programs that would recruit and train a corps 1,900 people. new public health workers. The program was up and running within a few weeks.
“I certainly felt under the gun – and I know many of my colleagues did – to make decisions with less than perfect information,” Mr Baker said.
Until this month, trackers were able to reach 90 percent of contacts within 24 hours. New cases had fallen so sharply that the body was down to 500.
There was a similar scramble to acquire personal protective equipment, which included chartering six flights from China to carry shipments of masks. In early April, Robert K. Kraft, the owner of the New England Patriots, transported one million N95 masks from China to Boston Logan International Airport on a group plane.
“There are all kinds of things that happened during that period of time that were unusual decisions and risky, but for most of us, we felt like we did what we had to do,” said Mr. Baker, whose approval ratings of work rose to 81 percent at the end of June, according to a Suffolk University Poll.
In Rhode Island, Gov. Gina Raimondo, a Democrat, has taken a tough approach since late March, at one point ordering State Police to stop cars entering the state from New York to enforce quarantine requirements. He regularly warns that the expansion of freedoms will be curtailed if residents do not adhere to social distancing rules.
It was a transformative political moment for Ms. Raimondo, raising her approval ratings to 81 percent at the end of Aprilat the height of the pandemic, from 35 percent in January. Her signature warning—”knock it off”—became so popular that a gift shop in Providence printed it on t-shirts.
Mr Baker said the high level of compliance with quarantine measures was natural given how badly the region was hit in the spring.
“Like everyone else, I know people who have been directly affected by this thing,” he said. “I've had very close friends almost die. I've had good friends lose family members because of it. I went 100 days without seeing my father because he's 92 and in an assisted living facility.”
It is uncertain what the coming months will bring for the Northeast. A new surge in cases in the South and West spread to other states, and as of this week, cases were rising in 41 states. The number of people hospitalized for the coronavirus across the country was nearing its highest point in the spring, according to the Covid monitoring project. Among the states where cases rose slightly in recent days were Rhode Island and Massachusetts.
In New York, the drop in cases has held even as the state has gone through a gradual reopening process, one that began with officials warning they would not hesitate to restore restrictions if the virus showed signs of a comeback. Nearly two months after the state began reopening, New York has seen about 1 percent of its Covid-19 tests come back positive.
Dr. Tza said he was optimistic that northeastern states could keep the virus under control over the summer by reopening gradually while closely monitoring changes in data.
“I think they're watching what's happening in the South and they're horrified,” he said.
Gov. Janet Mills of Maine, a Democrat, sounded cautious. She said officials in her state were “exhaling, but safely, with masks.”
“The last few weeks, in particular, we've felt good, but we're not out of the woods,” he said.
The coming months will also bring new waves of hardship as the economic impact of the spring break ripples outward, unemployment benefits run out and an expected wave of evictions begins.
Of all the difficult decisions she faced this year, Ms Mills said, none was more “devastating” than her first stay-at-home order.
“Nobody wants to be the skipper who puts the kibosh on graduations, weddings, beach parties, bars,” he said. “No one wants to be the governor against whom the tourism industry turns. Nobody wants to be that governor.”
Mitch Smith contributed reporting from Chicago and Michael Gold from New York.