ANALYSIS: 'Third wave' COVID cases are falling in the Upper Midwest. Will the rest of America follow?

'Third wave' COVID cases are falling in the Upper Midwest. Will the rest of America follow? Throughout the hard-hit states of the upper Midwest and northern Plains, coronavirus case counts have been falling for weeks. YahooNews

Throughout the hard-hit states of the upper Midwest and northern Plains — in Illinois, Wisconsin, Iowa, Minnesota, Montana, Wyoming and the Dakotas — coronavirus case counts have been falling for weeks.

Could this be a sign that America’s worst surge to date has peaked in the places it struck hardest — and is an encouraging preview in the places where COVID-19 cases are still increasing?

It’s a critical question whose answer will help determine the trajectory of the U.S. pandemic. And we can only answer it if we know why infections have been falling there. And that’s far from obvious.

When case counts were skyrocketing across the Upper Midwest earlier this fall, the national media was all over the story. But the near simultaneous regional turnaround that began in mid-November has attracted a lot less attention.

Part of that may have been a reluctance to find silver linings in states where infection rates still rank among the highest in the nation (even if they’re slowing down) and where hospitalizations and deaths, which lag cases by weeks, still haven’t peaked. If South Dakota were a country, for instance, it would have the world’s highest per capita death rate right now (2.5 per 100,000 residents); the next closest countries would be Slovenia (2.4), Bulgaria (1.9) and Hungary (1.7).

Another reason the press hasn’t been publicizing the Upper Midwest’s progress may be prudence. As one New York Times blog post asked, “Will it last?” The concern is that falling positivity rates are not only temporary but illusory: the result of residents without symptoms rushing to get tested so they could celebrate Thanksgiving and momentarily reducing the percentage of tests coming back positive before risky holiday gatherings inevitably raised them again.

But now, two weeks later — long enough for holiday transmission to start to register in official tallies — there has been no regional post-Thanksgiving spike to speak of. ...

Behavior is almost certainly the biggest factor in the Upper Midwest’s continued gains. Recent studies have found that 80 percent of people obey mask mandates once they’re instituted, regardless of whether they’re enforced; as a result, such mandates can reduce the spread of COVID-19 by more than 40 percent in three weeks.

After resisting statewide mandates for months, the governors of Iowa, North Dakota and Montana all reversed course in mid-November, and their new orders are undoubtedly helping. ...