A Detroit resident will be tested for coronavirus disease (COVID-19) and antibodies for free at the Sheffield Center in Detroit, Michigan on April 28, 2020.
Rebecca Cook | Reuters
Coronavirus cases in the Midwest are rising after leading U.S. health officials warned the country's heartland could be prone to new outbreaks.
According to a CNBC analysis of the data collected by Johns Hopkins University, coronavirus cases in 21 states and Washington DC increased by 5% or more as of Saturday based on a weekly average to smooth daily reporting. That equates to an increase of 12 states Monday.
Several Midwestern states reported growing cases – Indiana, Iowa, Kansas, Michigan, Minnesota, Nebraska, North Dakota, Ohio, and South Dakota.
At the national level, however, cases continue to decline, albeit more slowly than in the past few days. The US reported an average of 41,638 new infections per day over the past week, a decrease of more than 5% from the previous week. This is evident from a CNBC analysis of Hopkins' data.
Sun belt states that have faced outbreaks in the summer months are showing signs of improvement. Texas, Florida, California and Arizona all reported declines of more than 15% compared to a week ago.
The Midwest "gets stuck"
The best health officials in the country, including White House Coronavirus Task Force member Dr. Anthony Fauci and Dr. Deborah Birx, have warned that hotspots could emerge in the Midwest that have not yet seen the country's worst outbreak.
In July, Fauci pointed to what is known as the positivity rate, or percentage of positive tests, that appeared to be increasing in these states – an early sign that the outbreak is worsening.
The director of the Center for Disease Control and Prevention, Dr. Robert Redfield said Dr. Howard Bauchner of the Journal of the American Medical Association last week that there are worrying signs in the middle of the country where cases appear to be plateauing but not falling. The area "remains stuck", which is worrying as seasonal influenza threatens to overwhelm hospitals and cause preventable deaths, he said.
"We don't need a third wave in the heartland now," said Redfield. "We have to prevent that especially when we come in autumn."
The virus is likely to spread to rural America, which has been "largely untouched" by the country's worst coronavirus outbreak, and "every community is at risk," said former Food and Drug Administration commissioner Dr. Scott Gottlieb, told CNBC last week.
"Really, an outbreak can happen anywhere," he said.
State officials have taken some measures to prevent further spread. Ohio governor Mike DeWine ordered K-12 students to wear face covers upon return to school and restricted events at the state county fair. Iowa Governor Kim Reynolds ordered bars to close in some of the state's most populous counties on Thursday and continued to urge residents to wear face covers even though it is not enforced.
The schools are returning
The worrying trouble spots in the Midwest emerge as universities attempt to bring students back to campus in the fall, though some didn't report hundreds of cases and quarantined students until a few weeks into the semester.
"People need to understand that there will be cases of Covid when 50,000 people are together," said Dr. Preeti Malani, Chief Health Officer and Professor of Medicine and Infectious Diseases at the University of Michigan.
"It's about whether you have the infrastructure to identify cases – testing, surveillance, random testing of asymptomatic people, quarantine, contact tracing, isolation – and you've done everything you can to step up public health efforts." , she said .
Notre Dame University in South Bend, Indiana, has reported more than 500 cases since the beginning of this month. The university almost sent students home before deciding on Friday to allow students to return to class once their positivity rate dropped from over 10% to nearly 6%.
The University of Iowa reported 130 cases with a positivity rate of 13.6% after the first week of class, even though the university said it still "had adequate isolation and quarantine housing."
Kansas State University reported an outbreak in four sister houses on Friday that resulted in more than 20 cases, according to the Riley County Health Department. The university has canceled all sisterhood and brotherhood events until September 10th. At the University of Kansas, the Sisterhood and Fraternity Fellowship reported 270 cases with a manageable positivity rate of 10.01%.
Correction: 21 states and Washington D.C. report rising coronavirus cases. In an earlier version of this story, the number of states was incorrectly stated.