Mississippi, now experiencing the country’s highest rate of positive tests, is emblematic of the pandemic’s new reality. The virus is no longer principally an urban problem: It is present throughout every state, and those infected often don’t know it, leading to what top public health officials call “inherent community spread.”…

State health officials in Alabama, for instance, say they are starting to see the impact of a mask mandate imposed two weeks ago. But some worry the dramatic spread might be attributable to people giving up on testing, as results can take days or weeks to come back.

“My fear is if we don’t see some decline in hospital caseloads, we’re going to be really, really challenged when we’re faced with increased caseloads due to schools reopening,” said Don Williamson, president of the Alabama Hospital Association. “I hope I’m wrong but I don’t know of any biological reason I’ll be wrong.”

School openings in Alabama are a local decision, but public health officials offer guidance in part based on the risk in that county. As of Thursday, 44 of the state’s 67 counties are considered “high risk” or “very high risk.”