The United States does not have one coronavirus pandemic, it has 50.
Over the last three months, states have begun to display distinct local and regional outbreak patterns. New England, for example, has had relatively low caseloads, with Maine and Vermont recording zero deaths for days on end. The Northeast — New Jersey, New York and Massachusetts — took the bulk of the nation’s COVID-19 cases in April, then recovered and are now showing a steady rise in cases.
So far, the most distinct regional pattern as the virus enters its third wave is happening in the Midwest. On Wednesday, hospitalizations reached the highest levels yet in North Dakota, South Dakota, Nebraska, Minnesota, Wisconsin, Iowa, Missouri and Ohio.
Adjusted for population, the Midwest’s cases surpassed the peak New York and New Jersey saw in April. Of the 15 cities with the highest rate of new infections over the last two weeks, 11 are in North Dakota or Wisconsin.
The most alarming thing about the Midwestern outbreak is not its severity, but its grim predictability.
“Virus transmission dynamics are pretty clear at this point,” said Anne Rimoin, an epidemiology professor at the UCLA Fielding School of Public Health. “We know that indoor gatherings with individuals from multiple households where people are unable to social distance and are not wearing masks are risky.”
And despite having months to prepare, Midwestern governors have taken steps that exacerbate the spread of the coronavirus, with no impetus from national leaders to do otherwise.
Why The Midwest?
It’s tempting to blame the Midwest outbreak on factors outside of states’ control. Over the last three months, the coronavirus pandemic has generally moved from cities to suburban and rural areas. Many Midwestern states are sparsely populated and dotted with the kind of remote, midsize communities now emerging as a vulnerability for the virus.
Plus, it’s getting colder, and residents are abandoning...