The new coronavirus is striking the Upper Midwest with a vengeance, as Wisconsin and the Dakotas became COVID-19 hotspots and health officials scrambled for hospital beds on Thursday.

After months where residents of those states downplayed the virus and rejected mask requirements, all three now lead all other states in new cases per capita, the Associated Press reported.

“It’s an emotional roller coaster,” said Melissa Resch, a nurse at Wisconsin’s Aspirus Wausau Hospital, which is working to add beds and reassign staff to keep up with a rising caseload of seriously ill COVID-19 patients.

“Just yesterday I had a patient say, ‘It’s OK, you guys took good care of me, but it’s OK to let me go,'” Resch told the AP. “I’ve cried with the respiratory unit, I’ve cried with managers. I cry at home. I’ve seen nurses crying openly in the hallway.”

What is unfolding in the Upper Midwest mirrors what has happened in other parts of the country since the pandemic began. In the spring, New York City hastily built field hospitals as emergency rooms were flooded with COVID-19 patients. Then, the coronavirus spread to states like Arizona, Texas, Florida and California over the summer. It then moved into the Midwest.

“What worries me is we haven’t learned our lessons,” Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle, told the AP. He cited data showing mask usage at 39% in Wisconsin and 45% in the Dakotas, both below the U.S. average of 50%.

“People let down their guard. They said, ‘It’s not us. It’s big cities,'” Mokdad said. “But eventually, like any other virus, it’s going to spread. Nobody lives in a bubble in this country.”

In North Dakota, which does not require residents to wear masks and whose 770 new cases per 100,000 residents are the highest in the country, 24 more deaths were reported Wednesday, triple the state’s previous single-day record.

In Wisconsin, health officials plan to open a field hospital next week at the state fairgrounds to prevent health care centers from being overwhelmed by virus cases, the AP reported.

The state surpassed 3,000 new virus cases for the first time on Thursday. And South Dakota set records Thursday for active cases, hospitalizations and new deaths.

Meanwhile, the Northeast is now seeing the first signs of what might become a second wave of coronavirus, The New York Times reported. The rise in case numbers has prompted state and local officials to reverse course, tightening restrictions on businesses, schools and outdoor spaces.

Michael Osterholm, an infectious diseases expert at the University of Minnesota, told the Times that no state should let down its guard. “The point is, once you let up on the brake, then eventually, slowly, it comes back,” he said.

Two companies seek emergency approval for antibody cocktails

Regeneron Pharmaceuticals Inc. said Wednesday that it is seeking emergency approval from the U.S. Food and Drug Administration for an experimental antibody cocktail given to President Donald Trump shortly after he was diagnosed with COVID-19.

Hours before the company made the announcement, Trump proclaimed in a video released by the White House that the drug had an “unbelievable” effect on his recovery from coronavirus infection, the Washington Post reported.

“I think this was the key,” Trump said, after acknowledging that the antibody cocktail was one of several drugs he was prescribed by his medical team. While there is no hard evidence yet proving the drug’s effectiveness in humans, it has shown promise in treating mild cases of the new coronavirus, the Post reported.

In his video, Trump said, “I have emergency-use authorization all set, and we’ve got to get it signed now.” However, an FDA spokeswoman told the Times that the agency does not confirm or deny product applications.

Regeneron said in its statement that it could initially produce doses of the antibody cocktail for 50,000 patients, and then ramp production up to doses for 300,000 patients in the next few months if granted emergency authorization.

The antibody cocktail is now in late-stage testing. The company has granted fewer than 10 “compassionate use” requests allowing people not enrolled in its trials to use the drug, the AP reported.

The U.S. government first inked a contract with Regeneron back in July, and has promised to distribute initial doses of the treatment at no cost if it is approved, the Post reported.

Regeneron isn’t the only company developing an antibody cocktail to battle COVID-19 infection: Eli Lilly and Co. announced earlier on Wednesday that it was seeking emergency-use authorization from the FDA for a similar cocktail. Both treatments use lab-made antibodies to give patients’ immune systems a boost. In both cases, scaling up production to meet demand is expected to be a major challenge, the Post reported.

White House approves tougher vaccine development rules

Following weeks of delay, the White House this week approved tough new rules for coronavirus vaccine developers that will make it unlikely that a vaccine will be approved before Election Day.

The approval came only after the U.S. Food and Drug Administration published the updated guidelines on its website as part of briefing materials for outside vaccine advisers, the Post reported.

The standards, which would be applied to an emergency-use authorization for a vaccine, are similar to the standards for a traditional approval. But the White House has worried that the criteria would delay authorization of a vaccine beyond Nov. 3 and sat on the guidance, the Post reported.

On Tuesday, the FDA circumvented the White House and published the criteria online as part of a briefing package for a meeting with its vaccine advisory committee that is scheduled for Oct. 22. Shortly after the standards were published, the White House approved the new vaccine guidance, the Post reported.

The guidelines recommend that participants in late-stage vaccine clinical trials be followed for a median of at least two months, starting after they receive a second shot. It is that provision that will almost certainly make it impossible for a vaccine to be authorized before the presidential election.

On Tuesday night, Trump tweeted and proclaimed that, “New FDA Rules make it more difficult for them to speed up vaccines for approval before Election Day. Just another political hit job!”

Despite the pressure from Trump, the head of the FDA section that oversees vaccines has repeatedly said he would stick to the criteria, the Post reported. He has also said that he has already told vaccine companies what he was looking for to grant an emergency-use authorization.

“The companies know what we’re expecting,” Peter Marks, director of the FDA’s Center for Biologics Evaluation and Research, said last week, the Post reported.

COVID continues to spread around the globe

By Friday, the U.S. coronavirus case count passed 7.6 million while the death toll passed 212,700, according to a Times tally.

According to the same tally, the top five states in coronavirus cases as of Friday were: California with over 847,000; Texas with more than 820,600; Florida with over 726,000; New York with over 474,800; and Illinois with more than 314,700.

Curbing the spread of the coronavirus in the rest of the world remains challenging.

By Friday, India’s coronavirus case count passed 6.9 million, just over one month after hitting the 3 million mark, the Hopkins tally showed.

More than 106,000 coronavirus patients have died in India, according to a Johns Hopkins tally, but when measured as a proportion of the population, the country has had far fewer deaths than many others. Doctors say this reflects India’s younger and leaner population.

Still, the country’s public health system is severely strained, and some sick patients cannot find hospital beds, the Times said. Only the United States has more coronavirus cases.

Meanwhile, Brazil passed 5 million cases and had nearly 149,000 deaths as of Friday, the Hopkins tally showed.

Cases are also spiking in Russia: The country’s coronavirus case count has passed 1.2 million. As of Friday, the reported death toll in Russia was over 22,000, the Hopkins tally showed.

Worldwide, the number of reported infections passed 36.5 million on Friday, with over 1 million deaths, according to the Hopkins tally.

More information

The U.S. Centers for Disease Control and Prevention has more on the new coronavirus.

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