The Worst Day of the Pandemic Since May

Read: Wisconsin is on the brink of a major outbreak

What we’re seeing in the Midwest could foreshadow what is in store for the rest of the nation. The current wave of COVID-19 infections stretches across the whole country, and hospitalizations are rising in every region. Per capita, hospitalizations in the Midwest have now outpaced the South’s peak over the summer.

Even the Midwest remains far short of the per-capita hospitalizations in the Northeast’s spring outbreaks, but some low-population Midwest states are posting alarming per-capita numbers. And as noted above, we may have a long way to go before we see these outbreaks peak.

In both North and South Dakota, more than 1 in 2,000 state residents are hospitalized with COVID-19 right now. Only New York and New Jersey have seen higher rates of hospitalizations per capita.

Treatments for COVID-19 have improved since the Northeast outbreak. The ratio of hospitalizations to deaths has fallen tremendously since the spring. But it is also true that wherever we see hospitalizations go up, deaths rise two to three weeks later. We’ve seen it happen in state after state, in region after region, and nationally as well.

Improved outcomes depend on maintaining the highest standard of care. With hospitalization numbers like these, it is not clear that health-care systems in all hard-hit areas will be able to maintain this standard. In North Dakota, so many health-care workers have contracted COVID-19 that the state is now putting asymptomatic—but still infectious—workers back into hospitals to care for patients. Another crucial difference from the spring: When the surge hit New York and New Jersey, thousands of medical workers flew in from all over the country to help treat patients. With so many states experiencing severe outbreaks at the same time, it could be harder to mobilize surges of frontline workers to areas where health-care systems are at risk of failure.

The COVID-19 fatality rate is not a constant that can be permanently improved by better knowledge of the disease and the availability of treatments alone. To recover, patients require attentive, informed, round-the-clock care. Although hospital systems have made emergency calls for federal staffing support, discharged seriously ill patients to die at home, and been forced to send patients to other regional hospitals, the United States has never experienced the kind of widespread health-care collapse and care rationing seen in other parts of the world in the spring.

Throughout the year, hospitals and health-care workers have issued warnings that if we do see hospitals overwhelmed, fatality rates will soar. As cases and hospitalizations continue to rise nationwide, we are poised to enter a new and possibly bleaker phase of the pandemic. We can only hope that if more state officials act quickly to establish effective mitigation measures, their effects will come in time to avoid the worst.

This post appears courtesy of The COVID Tracking Project.

Alexis C. Madrigal is a staff writer at The Atlantic, a co-founder of the COVID Tracking Project, and the author of Powering the Dream: The History and Promise of Green Technology.