After pounding big United States cities in the spring, Covid-19 now has engulfed rural and small-town America, seeming to seep into the country’s every nook and cranny.

According to Reuters’ interviews with more than a dozen medical care providers and public health officials in the nation’s heartland, many hospitals are severely lacking in beds, equipment and — most critically — clinical staff, including specialists and nurses.

Covid-19 cases and hospitalisations are spiking nationally. But the Midwest — encompassing a dozen states between Ohio and the Dakotas — has been especially brutalised. Reported case rates are more than double that of any other region in the US, according to the Covid Tracking Project, a volunteer-run data provider. From mid-June to mid-November, reported cases in the Midwest rose more than twentyfold.

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