Population density has everything to do with it! I see that here in the islands. Oahu island with urban Honolulu has about a million people closely packed…. and we are on the second lockdown there now as cases exploded to the capacity of the medical facilities. Neighbor islands where there are fewer people and more spread out have less than 5% of the cases that Honolulu has. Crowds spread disease… it’s that simple.
I am extremely thankful that I live out in the jungle and don’t socialize. I spend a fair amount of time also staying with 89 year old Papa and keeping him safe. But the Hawaii population is very ‘social’ and loves to party in large family groups. And that is their infectious downfall.