The numbers began ticking up in September. After a quiet summer, doctors at Rhode Island Hospital began seeing one or two patients with Covid-19 on each shift — and soon three. Then four.
Cases climbed steadily until early December, when Rhode Island earned the dubious distinction of having more cases and deaths per 100,000 people than any other state in the country. The case rate still puts it among the top five states.

Where did this tightly knit state go wrong? Former Gov. Gina Raimondo’s “pauses” on economic activity were short-lived and partial, leaving open indoor dining, shopping malls ufabet and bowling alleys. But the shutdowns were no patchier than those in many other states.
Until late summer, she was lauded for reining in the virus. Even now, few residents blame her for the bleak numbers. (Ms. Raimondo was sworn in as the secretary of commerce on Wednesday night.)
Experts point instead to myriad other factors, all of which have played out elsewhere in the country but converged into a bigger crisis here.
Central Falls, the epicenter of Rhode Island’s epidemic, has a density of 16,000 people per square mile, almost twice that of Providence. “Just imagine, 16,000 people per square mile — I mean, that’s amazing,” said Dr. Pablo Rodriguez, a member of the government committee that guides Covid vaccine distribution in Rhode Island. “It doesn’t take much for the spark to create an outbreak.”
For months, the hospitals in Rhode Island were understaffed and overwhelmed. Doctors and nurses were trying to cope with rising caseloads, often without the protective equipment they needed, with constantly shifting guidelines and with their own resilience stretched to the limit.