10 States on the Brink of Becoming COVID Hotspots, According to Experts

Even if your state currently has control of coronavirus, there's still opportunity for an outbreak.

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As the number of infections and deaths from coronavirus continues to soar in the United States, many people are thinking about whether their state is going to be the next one to see an outbreak. Even states that have already experienced upticks may still face more cases this fall—as temperatures change, reopening moves forward, and in some parts of the country, children return to school. With the White House forecasting an astonishing 230,000 American deaths by Nov. 1, according to reporting from Reuters, there is no clear end in sight to our nation's struggle to stop the virus. Here are 10 places the experts are watching closely due to their potential to become the next COVID hotspots. And for other regions causing concern in the U.S., check out These 7 States Need to Lock Down Right Now, Harvard Researchers Say.

1
Maryland

Maryland
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Maryland—specifically Baltimore City and Baltimore County—could potentially experience a boom in COVID-19 cases, according to a report by PolicyLab, a think tank at the Children's Hospital of Philadelphia (CHOP) whose projections are often used by the White House Coronavirus Task Force. Although their positivity rate has decreased recently, there are many factors that could contribute to a fast spread, including the high population density, the high rate of poverty, the volume of multigenerational households, and the proximity to other states that have had outbreaks. The city has a social distancing rate of about 44 percent, according to their analysis.

"Think about the factors that affect the rate of growth of this virus—it's about gathering and crowding," David Rubin, MD, MSCE, the director of PolicyLab, told the Daily Beast on Aug. 12. "And it's exposure times time: the number of exposures and the amount of time spent there." And for more on what drove recent outbreaks on the West Coast, check out This Is What Fueled California's Deadly COVID Outbreak, New Study Says.

2
Illinois

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The experts at PolicyLab note that Illinois is at risk because Chicago, the state's largest city of more than 5 million people, is not social distancing at a high enough rate. Chicago is a destination for many Midwesterners, which could be a big factor in the number of new cases Illinois will report over the next few months. Not only may new cases come along with those vacationers, but protests against police brutality are likely to continue, which could create additional interactions where the virus could spread. "Once you are growing and you have these large gatherings, whether it's a protest or whether it's a festival or whether it's a house party, there's going to be increased transmission," Rubin told the Daily Beast.

3
Massachusetts 

Sailboats on the Charles River with Boston's Back Bay skyline in the background.
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After struggling and overcoming an early boom in cases, Massachusetts may be overconfident that they are through the woods. Boston, Rubin says, "has looked better than much of the country, and they've escaped scrutiny." However, "they're growing as quickly as other parts of the country, just from a lower numerator," he explained With a possible influx of college students to the state's many universities preparing to begin the fall semester, there could be a significant uptick of new cases. And for more on the places that have shown cause for concern in recent weeks, check out These States That Contained COVID Are at Risk of Backsliding, Expert Warns.

4
Nebraska

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With more than 10 percent of COVID-19 tests coming back positive, the Cornhusker state has now been elevated to the highest warning for an outbreak, according to Deborah Birx, MD, who leads the country's Coronavirus Task Force, CNN reports. While Gov. Pete Ricketts said in a statement that the "the White House was using bad data," the state's positivity rate was an average of eight percent over the last seven days, according to tracking data from Johns Hopkins University School of Medicine. Still, Ricketts tweeted out a story about not cancelling the 2020 college football season on Aug. 12, adding the text "Nebraska is ready to play. #LetsPlayFootball". And for more on how athletics have been impacted by coronavirus, check out Dr. Fauci Says This One State Can Play Organized Sports in the Fall.

5
Georgia

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Schools opened in Cherokee County, Georgia, six days ago, and there are already 826 students and 42 teachers under mandatory 14-day quarantines after a possible exposure, according to reporting from The Atlanta Journal-Constitution. Staff at Cherokee schools must wear masks, but there are no mandates for the district's more than 42,000 students to cover their faces. Across the state of Georgia in general, the last seven days have seen an average positive test rate of 10.7 percent, according to data from Johns Hopkins. On Tuesday Aug. 11, the state recorded 125 deaths, which was its highest one-day total since the coronavirus pandemic began. And for more up-to-date information, sign up for our daily newsletter.

6
Tennessee

Nashville Tennessee Skyline
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Midwestern states, including Ohio, Indiana, and Kentucky "are starting to have that very early indication" of a surge, Anthony Fauci, MD, said in a recent interview. "That's a surefire sign that you've got to be really careful." Fauci then went on to single out Tennessee, which has seen 12,474 new cases over the last week, according to data from Johns Hopkins. In addition, Deborah Birx has suggested that Gov. Bill Lee close all of the state's indoor restaurants and bars to slow the spread of the virus, but he has refused, and said at a press conference: "Beyond the regions that currently have restrictions, that's not a plan for us now." He cited that he didn't want to shut down the state's economy, adding, "But I appreciate their recommendations, and we take them seriously."

7
New York

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Ever the tourist attraction, New York City is bracing for visitors from across the country, including two major current hot spots: Florida and Texas. The state is implementing quarantine requirements for incoming travelers, and have instituted fines up to $10,000 for those who break those rules. Yet even those strict guidelines may not be enough. "I think that these types of travel restrictions may be somewhat helpful, but we should assume that they're not going to be airtight," Isaac Weisfuse, a former deputy health commissioner of New York City, told The New York Times in July. Despited having served as a model for how to contain coronavirus, An uptick of 228 new cases in the Sunset Park neighborhood of Brooklyn has raised concerns, and the city's mayor, Bill de Blasio, said in a press briefing: "We now have a warning light. We have a sign there's something going on we want to know more about."

8
Mississippi

The downtown skyline of Jackson, Mississippi with the state house in the foreground
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With schools open across the state, Mississippi is starting to see new cases of COVID-19 across the school system. On Aug. 13, there were 42 cases reported—25 students and 17 employees. While the state is seeing improvement in the number of infections overall, experts are noting that now is not the time to stop social distancing practices and mask wearing. "We need to have the long view," Thomas Dobbs, MD, MPH, of the Mississippi State Department of Health, said in a recent public statement. "This isn't going anywhere anytime soon. In the summertime, people were ready to throw off the restrictions and go back to normal or even more than normal in some cases. And we paid the price for it."

9
Texas

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Texas is already a hotspot, but experts suggests that things are only likely to get worse. In fact, the state hit an astounding 500,000 cases of COVID-19 this week. To put that number in perspective, it is higher than the cases in some entire countries. The U.K., for example, has reported 312,789 cases as of today. While the state is already testing less and finding higher rates of positive results, they are also about to face whatever comes when schools reopen in the coming weeks.

10
Florida

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As of August 12, Florida accounts for six of the top 10 COVID-19 problems counties across the country. Franklin, Taylor, and Gulf counties are the top three in the U.S. in terms of new cases per resident over the last seven days, The New York Times reports. With about 542,792 total cases recorded in the state of Florida and 8,553 deaths, the state has seen one of the highest positive testing rates in the country, with 17.2 percent of tests coming back positive over the last seven days, according to data from Johns Hopkins. With limited steps being taken to control the spread, there doesn't seem to be any reason to take this current hot spot off the list of future hot spots.

Adam Shalvey
Adam Shalvey is a writer based in Rhode Island. Read more
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