National

Data: Coronavirus Resource Center at Johns Hopkins and The COVID Tracking Project; Map: Michelle McGhee and Andrew Witherspoon/Axios

In the seven states hit hardest by the pandemic, more than 1 in every 500 residents have died from the coronavirus.

Why it matters: The staggering death toll speaks to America's failure to control the virus.

Details: In New Jersey, which has the highest death rate in the nation, 1 out of every 406 residents has died from the virus. In neighboring New York, 1 out of every 437 people has died.

In Mississippi, 1 out of every 477 people has died. And in South Dakota, which was slammed in the fall, 1 of every 489 people has died.

States in the middle of the pack have seen a death rate of around 1 in 800 dead.

California, which has generally suffered severe regional outbreaks that don't span the entire state, has a death rate of 1 in 899.

Vermont had the lowest death rate, at 1 of every 3,436 residents.

The bottom line: Americans will keep dying as vaccinations ramp up, and more transmissible variants of the coronavirus could cause the outbreak to get worse before it gets better. 

Experts also say it's time to start preparing for the next pandemic — which could be deadlier.

Where the pandemic has been deadliest

In New Jersey, 1 out of every 413 people has died from the virus

Health Care

Coronavirus

Health

Data: Southern Poverty Law Center; Note: There are some monuments with unknown dedication dates and they are not represented in the bar chart; Map: Michelle McGhee/Axios

Mapped: Confederate monuments over time

This map shows where they were established, and where some are now being removed.

Confederate States of America

President Biden has made the COVID-19 crisis and a post-Trump return to national unity and traditional democratic ideals his top priorities. From vaccinations to stimulus to schools, Biden is seeking bipartisan compromise while showing a willingness to use executive authority and bare Democratic majorities in the U.S. House and Senate to implement his policies. Republican leaders are navigating deep party divisions over if and how to move beyond former President Trump.

Politics & Policy

Tampa Bay

Axios Tampa Bay

Two of the seven Confederate statues near Tampa Bay still remain: the Stonewall Jackson Monument in Ft. Mead and a Confederate soldier statue outside a Brooksville courthouse. 

When the others came down: Most Confederate monuments in Hillsborough, Manatee and Pinellas counties were removed in 2017 after white supremacists rioted in Charlottesville.

An exception: The Cow Cavalry Monument in Plant City was removed along with nine others around the state in 2020.

Where Confederate monuments remain across Florida

Two of the seven near Tampa Bay still remain.

Black History Month

Two of the seven Confederate statues near Tampa Bay still remain: the Stonewall Jackson Monument in Ft. Mead and a Confederate soldier statue outside a Brooksville courthouse. When the others came down: Most Confederate monuments in Hillsborough, Manatee and Pinellas counties were removed in 2017 after white supremacists rioted in Charlottesville.<ul><li>An exception: The Cow Cavalry Monument in Plant City was removed along with nine others around the state in 2020.</li></ul>

Politics

Data: Department of Health & Human Services, University of Minnesota COVID-19 Hospitalization Tracking Project, and Zach Levin; Chart: Michelle McGhee/Axios

Children's hospitals across the country say they're still seeing a surge of kids suffering from a serious illness that typically follows coronavirus infections. 

The big picture: Severe coronavirus infections in children remain extremely rare, compared to the risk to adults. But persistent side effects from those infections mean that kids' hospitalization rates don't exactly mirror adults'.

Even as coronavirus hospitalizations decline overall, children's hospitals say they're still seeing large numbers of kids suffering from multisystem inflammatory syndrome, commonly known MIS-C, — a serious illness that generally occurs several weeks after a child is infected with the coronavirus. 

MIS-C can cause inflammation in various body parts, and symptoms include fever, abdominal pain, vomiting and diarrhea. Most cases occur in children between 1 and 14 years old, and the condition disproportionately effects children of color, per the CDC.

"As the population in general seems to have fewer active cases, we are seeing more children being admitted with COVID-related problems, but most of those — I'd say more than half over the last five weeks — are children who have MIS-C," said Rob McGregor, chief medical officer at Akron Children’s Hospital.

What they're saying: Hospitals say the disease seems to be more common now than it was earlier in the pandemic, and children are sicker now than they were in earlier surges.

"The MIS-C has really hit us this time, and the last month has been way higher numbers and higher acuity than we [had] before with MIS-C — and that's hard to explain," said Lara Shekerdemian, chief of critical care at Texas Children's Hospital.

Unlike other children's hospitals interviewed by Axios, Texas Children's has also seen more severe cases of acute COVID too. "It feels like ... we have seen in the last two three months patients who are sicker when they present with COVID than we did in the early experience," Shekerdemian added.

By the numbers: Pediatric COVID-related hospitalizations increased by 50% between Oct. 1 and Jan. 7, according to an analysis of Health and Human Services data by the University of Minnesota COVID-19 Hospitalization Tracking Project. 

Adult hospitalizations rose by almost 300% over the same period.

Adult hospitalizations have since fallen by 54%, while children's hospitalizations are down by 25%.

As cases began to rise in late November and December, "based on our experience, we said OK, MIS-C task force, mark your calendars," said Roberta DeBiasi, chief of the Division of Pediatric Diseases at Children's National Hospital in Washington, D.C. That surge began in January, and continues today.

The CDC only has complete information on the number of MIS-C cases specifically through mid-December, when they were on the rise.

What we're watching: The children's hospitals said that, based on previous trends, they expect the number of hospitalizations to fall in the coming weeks, a delayed result of the coronavirus's lower community prevalence.

"It seems like the peaks we had in the children's hospital lagged a little behind those we were seeing in the adult systems," said Ronald Ford, chief medical officer at Joe DiMaggio Children’s Hospital. "I would expect peds admissions to start to fall. Now, the big unknown here for everyone is how these new variants are going to affect things."

He said it's still unclear how the new virus variants impact children, and that it's a "distinct possibility" that they could be related to more severe cases of MIS-C. 

"We don't know, but that’s one of those things that will have to be studied and looked into, if different variants have a different rate of severity of MIS-C in children," he added.

For children, the COVID surge isn't over

Children's hospitals are still seeing a surge of patients with a COVID-related condition.

Children&#x27;s hospitals across the country say they&#x27;re still seeing a surge of kids suffering from a serious illness that typically follows coronavirus infections. The big picture: Severe coronavirus infections in children remain extremely rare, compared to the risk to adults. But persistent side effects from those infections mean that kids&#x27; hospitalization rates don&#x27;t exactly mirror adults&#x27;.

Special report: How America's top hospitals send patient costs soaring

A new analysis by Johns Hopkins University reveals the tactics hospitals use to pursue patients with unpaid bills.

Illustration of a hand coming out of a pile of bills.

Hospitals

 hand reaching out of a pile of overdue bills

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Michelle McGhee

Stories

Special report: How America's top hospitals send patient costs soaring

Mapped: Confederate monuments over time

Where Confederate monuments remain across Florida

For children, the COVID surge isn't over

Where the pandemic has been deadliest