"Off the charts": Virus hot spots grow in middle America

Cases also have been rising rapidly in Detroit, where poverty and poor health have been problems for years. The number of infections surged to 1,381, with 31 deaths, as of noon Saturday. The city’s homeless population is especially vulnerable, officials said.

“At this time, the trajectory of Detroit is unfortunately even more steep than that of New York,” said Dr. Teena Chopra, the medical director of infection prevention and hospital epidemiology at the Detroit Medical Center.

“This is off the charts,” she said.

Chopra said many patients have ailments like asthma, heart disease, diabetes and hypertension. She also acknowledged that in Detroit, one of the nation’s largest African American cities, there is a distrust among some in the community of the medical system and government due to systemic racism.