How a third wave of COVID-19 engulfed the US – USA TODAY

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America faces outbreaks of coronavirus in most communities as waves of disease strike places blasted by earlier surges and those previously spared.

The spring surge was centered on New Orleans and urban areas in the Northeast. The summer surge primarily rocked Sun Belt states such as Texas, Arizona and Florida. Now, nearly every corner of America is getting hit with extraordinary case counts.

Forty-five states reported more cases during one week in November than in any other week since the start of the pandemic, a USA TODAY analysis of Johns Hopkins University coronavirus data shows. Only Florida, Hawaii, Mississippi, New York and South Carolina had worse peaks in prior months.

How the COVID-19 pandemic progressed

In November, about one in 76 Americans tested positive for coronavirus. The country reported 36,918 coronavirus deaths for the month, a death toll greater than American losses in the Korean War.

Last month, the virus reached into communities big and small, rural and urban, white and minority, north and south, east and west. More than two-thirds of American counties reported more cases in a week of November than they’ve ever had, USA TODAY’s analysis shows. 

The virus worked its way into small places such as Crowley County, Colorado, where nearly 1 of every 5 residents tested positive in November. It rose up in modest-sized areas such as Grand Forks County, South Dakota, where at least 8,100 people have been infected – nearly all recently – among a population of less than 70,000.

“It was inevitable it was going to get to the mountain states,” said Matthew Fox, professor of epidemiology and global health at Boston University School of Public Health. “And when it got there, there were so many susceptible people, it was ready to take off.”

Texas, which got hit hard in the summer surge, is again experiencing staggering growth. El Paso County reported 37,287 new cases and 445 deaths in November. National Guard members help with the bodies, and the county uses more than a dozen refrigerated trucks as morgues. The hometown newspaper published a jarring photo of one mobile morgue to reveal the awful reality. 

Fox said more people will get sicker as the virus works through their bodies and government failures to respond aggressively will drive the cost higher.

“We have learned this time and time again: It’s early action that pays off,” Fox said. “If you wait until the spread is already substantial, at that point, your measures to contain the virus are really shutting things down completely.”

New confirmed COVID-19 cases and deaths by day

After the summer surge peaked in July, most of the Midwest and Great Plains states remained relatively unscathed by the coronavirus. Hard-hit Sun Belt states began cooling off. 

It didn’t last long.

North Dakota had growing embers of the pandemic in late July, even before the big Sturgis motorcycle rally in early August. In Iowa, outbreaks flared up around meatpacking plants and college towns. By late August, communities from southern Illinois to North Dakota were experiencing a rapid spread of the virus.

By early October, much of America was under siege, including a swath from Georgia to eastern Washington state. Most of the Northeast and Michigan were spared for the moment. 

By early November, Pennsylvania, Michigan, Connecticut and New Jersey – hit in the spring surge – were getting pummeled again. Some of the places hit hardest by the summer surge, including South Florida, Texas and Arizona, suffered from rapid case growth. 

By the end of November, coronavirus was spreading at extraordinary rates almost everywhere. Only a few isolated pockets of people avoided some of the worst, including northern New England, counties around San Francisco and parts of rural Georgia.

Watch how coronavirus outbreaks  spread across America

Fox said it would be foolish to try to pin widespread outbreaks on single events such as the Sturgis motorcycle rally. Rather, he said, small get-togethers may make the spread inevitable.

“If you’re not limiting the number of people you’re having contact with indoors that are unmasked, we can say this is unlikely to change,” Fox said.

Scientists have learned more about how the virus spreads and what can prevent infections. Limited data suggests there may be less transmission in schools than scientists initially feared.

People are tired of restrictions and want to celebrate holidays. Colder weather has driven social gatherings indoors.

“We can predict that a couple weeks after Thanksgiving and again after Christmas, we’re going to see these rises,” Fox said.

Fox sees positive signs, including surprisingly effective trial vaccines being developed and manufactured at an unprecedented pace. Even America’s less-than-comprehensive adoption of social distancing and masks could have the side benefit of reducing the incidence of influenza this year. 

Hospitals have learned how to treat COVID-19 patients more effectively since the pandemic began. But, Fox said, the latest surges mean hospital workers face greater risks even as they’re needed more.

“We shouldn’t be here,” Fox said. “We had opportunities. We had time.”

Ramon Padilla contributed to this report.

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