The Changing Geography of the Pandemic

During the pandemic's first phase in March and April, the Northeast was devastated by COVID-19. After Memorial Day, the surge was in the South and West. As cases decrease nationwide, they are now spiking in the Midwest, particularly North Dakota.

August 27, 2020, 5:00 AM PDT

By Irvin Dawid

Coronavirus COVID-19

Pranay Chandra Singh / Shutterstock

"Novel coronavirus infections are trending upward across the Midwest, raising concerns that those states are struggling to contain their outbreaks even as the nation’s total daily caseload continues to decline," reported Derek Hawkins and Marisa Iati for The Washington Post on Aug. 22.

Seven-day averages for new cases rose over the past week in the Dakotas, Illinois, Iowa, Kansas, Minnesota, Oklahoma and Wyoming, according to tracking by The Washington Post. South Dakota and Wyoming experienced the biggest jumps, with average daily caseloads up 58 percent and 50 percent, respectively.

The tracker (click on "trends") on Aug. 25 shows that North Dakota, after Guam, had the nation's highest increase in daily reported cases per capita over the last week, 46 percent, based on on a seven-day rolling average of daily new reported cases per 100,000 residents, followed by South Dakota with a 42 percent increase. (See below emboldened header for more specific information on the outbreak in the International Peace Garden State.)

Several cases in South Dakota have been linked to a motorcycle rally that drew hundreds of thousands of people to Sturgis this month. Health officials there said Thursday that they were aware of fewer than 25 infections among attendees, but acknowledged that they could not identify every case that exists because of the event.

Update: Twin Cities Pioneer Press reports on Aug. 25 that 112 coronavirus cases in eight states are linked to the motorcyle rally. "But it’s still far too early to gauge the full extent of the spread of COVID-19 from the annual event, where organizers counted more than 460,000 vehicles in attendance from across the nation."

CDC Director Robert Redfield warned of a "third wave in the heartland" if Midwestern states don’t follow guidance from health officials to slow the virus spread.

Alek Korab reported for ETNT Health on Aug. 25 on the five states that Redfield warned were particularly at risk of outbreaks, with links to local articles: Kansas, Kentucky, Nebraska, Oklahoma, and Minnesota. Two days earlier, he reported that cases are soaring in Iowa, Kansas, Illinois, and North and South Dakota.

North Dakota number three in coronavirus case incidence

"A dramatic increase in North Dakota's coronavirus cases showed signs of stabilizing on Monday, Aug. 24, capping the worst week for new cases since the start of the pandemic," reported Adam Willis for the Grand Forks Herald, though that turned out not to be the case as the aforementioned Washington Post tracker indicated on Tuesday. Like his counterparts at The Washington Post, Willis noted the downward trend of new infections nationwide, and more importantly, what caused it.

Nationally, new case reports are in decline, a trend that health experts have attributed to local mask mandates and business closures in some of the most affected areas.

Harvard's COVID Risk Levels Dashboard indicated on Aug. 25 that North Dakota trailed only Mississippi in having the highest coronavirus case incidence, with 24.2 cases per 100,000 people (seven-day moving average), but that is based on Aug. 23 data. The dashboard does not include U.S. territories. Guam shows 36 new daily reported cases per 100,000 people, a 176 percent increase in the last week based on Aug. 25 data, according to The Washington Post trackerNorth Dakota had the third-highest daily reported cases per capita, 28 per 100,000, after Guam and Mississippi with 29 per 100,000.

Return of college students increases community spread 

"Increased case counts in Grand Forks and Cass County have come as students at the University of North Dakota, in Grand Forks, and the North Dakota State University, in Fargo, return to campus for the fall semester," added Willis. A Grand Forks public health official "said upwards of about 75% of the recent spate of new cases are the result of UND students returning to campus," reported the Herald on Aug. 25. "Students were not required to get tested prior to arriving on campus, nor once they arrived on campus."

Hat tips to Angela Fritz and Avi Selk, authors of The Washington Post Coronavirus Updates newsletter.

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