The paper explores the tale of two 'epicentres’ – metropolitan New York and Lombardy – and seeks to depict the socio-demographic patterns that characterise the worst cases of infection, hospitalisation, and death during the first six months of the Covid-19 pandemic in 2020. By drawing upon secondary data concerning sub-territorial units within the two regions – ZIP-code level and counties in New York and municipalities in Italy – the paper compares the characteristics of the two areas in an effort to understand both how they became the original major epicentres and how their experiences of the pandemic differed. We suspected initially that the pandemic in Lombardy was a function of a complex constellation of variables, such as the age of the population, the unexpected emergence of the virus, and features of the local health system. In New York, the pattern seemed to fit a more familiar dynamic, the kind one would expect from the course that most pandemics take: the poor suffer the worst. The paper tries to extend the understanding of the complex and not univocal mix of social variables that can facilitate the spread of a pandemic and make its effects extreme.