Experts say experience convinced Midwest of virus dangers

SIOUX FALLS, S.D. (AP) - With much of the country hit by soaring virus rates, postponement from a devastating spike in coronavirus in the upper Midwest has cautiously eased the burden on health officials amid fears that infections remain widespread and holiday gatherings re-set the worst outbreaks could the pandemic.
In the northern Midwestern states and the Great Plains, the rate of coronavirus infections was highest in the weeks leading up to Thanksgiving. The hospitals were congested, causing states like North Dakota, South Dakota, Minnesota, Iowa, and Wisconsin to report some of the cases among the nation's highest per capita deaths in November.
However, over the past two weeks, the average daily cases in these states have decreased. According to Johns Hopkins researchers, the decline went from 20% in Iowa to as much as 66% in North Dakota. Since mid-November, the entire region has returned to levels similar to October.
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"We're in a place where we've controlled the fire, but it would be very easy if it flared up again if the conditions are right," said Ryan Demmer, an epidemiologist with the University of Minnesota School of Public Health.
For a region that heralded the virus waves that hit much of the country today, the positive direction in the Midwest offers hope that people can rally to take serious virus precautions while in the the pandemic has been waiting for vaccinations for the last few months
Governors have used the falling numbers to justify their different approaches to fighting the pandemic, sometimes even tournaments. In Minnesota, Democratic Governor Tim Walz has defended keeping some restrictions in place through early January, stating that the restrictions on bars and restaurants are working. In neighboring South Dakota, Republican Governor Kristi Noem has argued the opposite, using her state's recent drop in numbers to argue that mask mandates make no difference.
However, some epidemiologists believe that the most compelling factor for many who have redoubled their efforts to prevent infection is that they experienced the virus on a personal level. As the pandemic crept into communities in the Midwest, more people had loved ones, friends or acquaintances fell ill or died.
"It's foxhole religion - it becomes a lot more real when the guy next to you gets shot," said Dr. Christine Petersen, the director of the Center for Emerging Infectious Diseases at the University of Iowa. "All of a sudden your local hospital is full and your sister, aunt or grandmother is in the hospital."
About one in 278 people in northern states from Wisconsin to Montana needed hospital care for COVID-19, according to the COVID Tracking Project. These experiences have found their way into close communities.
The virus outbreak was so widespread in early November that almost everyone has known someone severely affected by COVID-19, said Dr. James Lawler of the University of Nebraska Medical Center's Global Center for Health Security.
"That seems to bring things home in a way that it hasn't used to do before," he said, noting that he has observed more people wearing face masks and avoided gatherings, parties and meals indoors.
Until the fall, the upper Midwest hadn't seen the widespread outbreaks and high death rates that other parts of the country experienced in the early months of the pandemic. Many took lax approaches to virus mitigation. Republican governors in the region turned down government mandates for wearing masks or any other effort to prevent infection.
Many health experts warned the region was ripe for widespread infections, particularly as the weather cooled and people gathered inside, making the coronavirus easier to spread.
"As soon as the snowball started, it took it all down," said Petersen. “We knew this was coming. It was the ones who took the precautions and doubled up on them that did a little better, but we knew it was going to be difficult no matter what. "
Petersen attributed the renewed efforts to slow infection to a combination of factors: warnings from health officials and medical staff that were filling hospitals; some Republican governors who ordered masks to be worn; and the lived experience of the pandemic. Other experts say that some bags from people, like those who work in meat packing plants, where infections were widespread, had infection rates so high that the virus has slowed down.
However, across the region, many feared that the success of avoiding a Thanksgiving festival could be undone by Christmas and New Year celebrations. Petersen worried that people had chosen to skip Thanksgiving gatherings just to have family celebrations over Christmas. As a Midwestern national, she admitted that resisting the draw to see family over the holidays was difficult.
"I hope a lot of us don't feel guilty in a couple of weeks," she said.
Funk reported from Norfolk, Nebraska. Steve Karnowski of Minneapolis contributed to this report.

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