States in the northern Midwest and Great Plain regions saw the worst rates of coronavirus infection nationwide in the weeks leading up to Thanksgiving Day, expanding hospitals beyond capacity and leading to states like North Dakota, South Dakota , Minnesota, Iowa and Wisconsin reported some of the largest per capita population deaths in November.
But in the last two weeks, those states have seen them the average of daily cases decreases, with declines ranging from 20% in Iowa to 66% in North Dakota, according to researchers Johns Hopkins. Since mid-November, the entire region has returned to levels similar to those seen in October.
“We are in a place where we have controlled the fire, but it would be very easy to light it again if the conditions were right,” said Ryan Demmer, an epidemiologist at the University of Minnesota School of Public Health.
For a region that was a harbinger of virus waves now affecting much of the country, the positive direction in the Midwest offers hope that people can come together to take the precautions against the virus seriously while waiting for vaccines during what experts believe will be the last months pandemic.
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Governors have used declining figures to justify their divergent approaches to fighting the pandemic, even at times. In Minnesota, Gov. Tim Walz, a Democrat, defended maintaining restrictions until early January, saying the limits for bars and restaurants work. In neighboring South Dakota, Republican Gov. Kristi Noem argued the opposite, using the recent decline in numbers in her state to argue that masked mandates make no difference.
But some epidemiologists believe that the most compelling factor for many who have redoubled their efforts to prevent infections may be that they have experienced the virus on a personal level. As the pandemic spread to communities in the Midwest, more people had loved ones, friends, or acquaintances get sick or die.
“It’s the religion of fox holes – everything becomes more real when the guy next to you is shot,” said Dr. Christine Petersen, director of the Center for Emerging Infectious Diseases at the University of Iowa. “Suddenly, your local hospital is full, and your sister, aunt, or grandmother are in the hospital.”
About one in every 278 people in the Nordic states stretching from Wisconsin to Montana needed hospital care for COVID-19, according to data from the COVID Follow-up Project. In closely related communities, those experiences have gained attention.
The virus outbreak was so widespread by early November that almost everyone knew someone severely affected by COVID-19, said Dr. James Lawler of the Global Center for Health Security at the University of Nebraska Medical Center.
“That seems to bring things home in a way that just by talking about it earlier doesn’t,” he said, noting that he noticed more people wearing face masks, as well as avoiding gatherings, parties and meals indoors.
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Until the fall, the Upper Middle West did not see the widespread outbreaks and high death rates experienced by other parts of the country in the first months of the pandemic. Many have adopted lax approaches to virus mitigation measures. Republican governors in the region have avoided government mandates to wear masks or other infection prevention efforts.
Many health experts have warned that the region is ripe for widespread infections, especially as the weather has cooled and people have gathered inside, facilitating the spread of the coronavirus.
“Once the snowdrop started, it took them all down,” Petersen said. “I knew this was happening. Those who took precautions and doubled it did something better, but I knew it was going to be hard, no matter what.”
Petersen attributed renewed efforts to slow infections to a combination of factors: warnings from health officials and health care workers that hospitals were filling; some Republican governors who issue orders to wear masks; and the lived experience of the pandemic. Other experts say that some people’s pockets, such as those working in meat-packing plants where infections have been spread, have experienced such high rates of infection that the virus has slowed.
But across the region, many feared that success in avoiding a Thanksgiving peak could be offset by the Christmas and New Year holidays. Petersen feared that people would decide to give up Thanksgiving meetings just to have family Christmas holidays. As a Midwesterner, she acknowledged that resisting the gathering with family on holidays was difficult.
“I hope many of us don’t feel guilty in a few weeks,” she said.
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