Three weeks ago, the COVID-19 winter surge was well under way and terrifyingly broad. Every day, the Northeast, South, and Midwest were seeing more than 100 deaths per million people, and the West was just shy of that, at 94 per million, with deaths increasing. The winter surge was the first time conditions had worsened nationwide; previously, the spring saw cases concentrated largely in the Northeast, followed by a summer surge across the South and West. But by early October, all four regions, as defined by the census, saw climbing hospitalizations.

Now, the pandemic’s geography is fracturing again. Hospitalizations in the Midwest peaked on December 1, and have maintained a precipitous decline ever since. Hospitalizations continue to rise in the Northeast, but they are still at about 60 percent of the spring’s awful totals.

The hardest-hit areas right now, as indicated by hospitalizations per million residents, are in the South and Southwest. The hotspots are primarily in the Sun Belt, including California, Nevada, Mississippi, Alabama, Tennessee, and Georgia. New York is also a cause for concern again. In other words, we’re returning to a patchwork pandemic.