For most of the COVID-19 pandemic's duration, Kansas and Missouri have been spared from the overwhelming crush of cases that overwhelmed hospitals and communities on the coasts and in the South.
But the current surge, which has been breaking records for case numbers in both states, is occurring in ways previously unseen in the U.S. and showing red flags for disease experts.
And it's happening as more and more members of the general public have grown increasingly impatient with governments taking steps to control it.
“Every time we issue a new rule, we get a huge political pushback. Masks are controversial, testing is controversial. ... That undercuts our ability as local leaders in Middle America to try to push back the virus’ spread,” Kansas City Mayor Quinton Lucas said Sunday on CBS’ "Face the Nation."
Kansas reported a record seven-day average of 819 new cases last week, according to data from the New York Times. And Missouri reported a record 1,428 hospitalizations in the seven-day period. The test positivity rates in both states also exceeded recommended levels.
The worrisome data follows in the wake of virus transmission trends unlike those seen in other parts of the country.
While states on the coasts and in the South managed to dramatically reduce cases following spikes in the spring and summer, both Kansas and Missouri have seen slow, continuous growth in new case numbers since summer.
That has positioned them for a fast acceleration of cases, according to Justin Lessler, an epidemiologist at Johns Hopkins Bloomberg School of Public Health.
“It’s sort of the nature of epidemics that things often look like they are relatively under control and then very quickly ramp up to seem like they are out of hand,” Lessler says.
The Midwest wave is also coming at a time when seasonal illnesses are typically on the rise.
Experts are uncertain whether the coronavirus thrives in cold weather, but many believe that transmission will become more likely as people spend more time in confined indoor spaces.
Regardless of why they're occurring, the timing of the case increases concerns health care experts.
“That worries me that we’re going to see a powerful seasonal effect that could really lead to a bad winter wave,” Lessler says.
Flu activity in the U.S. is still minimal, but doctors worry that flu and COVID-19 transmission at the same time could tax health care resources.
The case surges that took place in the spring and summer were confined to relatively small parts of the country, such as in and around New York City, where some hospitals were overwhelmed.
The recent wave of cases, however, is far more spread out, involving at least a dozen states covering a large geographic swath of the country and potentially affecting a far greater number of communities.
Lessler worries how those places could be affected if the Midwest surge reaches levels seen in New York and other cities.
“If we see a surge on a similar scale, but everywhere in the country at once, that would be a tragedy indeed,” he says.