A reader pinged me on Twitter last night to say that it’s time to start paying attention to this. They’re right, but I’m not sure if what’s happening now qualifies as a third wave or a second wave or even the tail end of the first wave. The U.S. hasn’t yet had a true national wave of COVID; what it’s had are regional waves staggered in time. The northeast got crushed in the spring, the south and California were hit hard over the summer, and right now it’s the midwest that’s being pummeled, especially Wisconsin.

What that region is experiencing is a true wave. What most of the rest of the country is experiencing is more of a worrisome trend. Cases aren’t exploding, but they’re headed in the wrong direction just as the weather’s starting to cool down.

The state of the play as of Wednesday:

U.S. coronavirus cases surpassed 7.5 million on Wednesday with most states seeing a rise in cases – nine months into the pandemic – and a startling nine states setting ominous, seven-day records for infections.

A USA TODAY analysis of Johns Hopkins data through late Tuesday shows Alaska, Indiana, Kansas, Kentucky, Minnesota, Montana, North Dakota, Utah and Wyoming all set state records in the seven-day period. In all, 39 states reported more coronavirus cases in the last week than they had in the week before.

Yesterday the COVID Tracking Project reported 58,000 positive tests nationwide, the highest number in more than two months. (Some 55,000 of those came from the White House. No, no, just kidding. Black humor.) On Tuesday, South Dakota recorded the highest number of cases per capita that any state has seen since the start of the pandemic. The trend in hospitalizations is ominous too: “In 41 states, the number of people requiring hospitalization increased this week—only nine states saw declines in this crucial figure… Hospitalizations grew not only across the Midwest, but in states in every region of the country.” Mercifully, deaths continue to trend downward, but it usually takes a few weeks before daily deaths begin to track a rise in cases and hospitalizations. We’ll see where things stand on November 1.

Here’s what I mean about America suffering a series of regional waves rather than one, two, or three national ones:

You can read that graph as encouraging or discouraging as you see fit. The optimistic view is that, as bad as the midwest looks right now, things are basically stable everywhere else. The pessimistic view is that, if you look closely, all four regions have seen an increase in cases since September 1 or so. The west and south have plateaued at their slightly higher “new normal” and the northeast is tracking upward less aggressively than the midwest is currently, but everyone looks worse than they did a few weeks ago. Maybe that was inevitable as schools reopened, but early data suggests that schools don’t spread the virus much. It may be mom and dad rather than the kids who are getting infected now that they’re back on the job. Or it may be college kids returning to campus who are spreading it around.

Either way, the forecast is stormy. It’s been awhile since we looked at Kinsa’s “Health Weather Map,” which aggregates temperature data from people around the country who use Kinsa’s smart thermometers. They recently updated their map to indicate which states they believe will experience a further increase in cases over the next four weeks based on the data the company is collecting right now. There’s a lot of math that goes into that prediction, but Kinsa’s confident in its ability to foresee spikes. Here, for instance, is their data on Wisconsin dating back to March:

Assuming they’re being honest about when they predicted an uptick, they were correct in all three of their predictions. There was a slight increase in cases in May, a steeper one in July, and then an ugly one in September. With all of that as introduction, here’s what the national map looks like right now. Each little “bullseye” represents a state where cases are expected to rise this month:

That’s 23 states in all, including most of the northeast and midwest. New England, New York, and New Jersey look like they’re set to become the first region to experience a true second wave, which is what we’d expect given that the first wave arrived there sooner than anywhere else.

And yet, and yet, in spite of all the bad signs, here’s what the national positivity rate looks like right now:

It’s trended ever so slightly upward over the last two weeks but it’s still a hair below five percent and it’s lower now than it was during much of September. Maybe the answer to that is “Who cares? It doesn’t help the midwest any, does it?” If America’s pandemic is really just a sequence of regional pandemics then the “national picture” doesn’t tell us much. But looking at this graph, you could be excused for thinking that the “wave” we’re supposedly experiencing right now isn’t much of one yet. Part of the reason why we’re seeing more cases lately may simply be that we’re testing more people now than we used to. And the true surge in the midwest may be offset by declines in cases elsewhere.

Besides, it could be worse. We could be Europe:

Daily deaths in western Europe are still lower than they are in the U.S., although I’d guess that has more to do with the baseline state of health in America (e.g., more obese people) than anything specific to COVID or treatment.

I’ll leave you with this new ad from the Trump campaign, which celebrates the president for his handling of the pandemic and features an endorsement from populist hate object Anthony Fauci(!!). The Fauci cameo is outdated, though, as it comes from an interview he did back in March. Given that he was telling reporters yesterday that the White House is responsible for a superspreader event, and in light of how the administration has reportedly tried to stifle useful CDC guidance on masks, I’m guessing Fauci’s opinion of how Trump has handled COVID is more … nuanced than the ad suggests. But oh well. That’s politics.