The reason there are this many college towns is because this is a per capita ranking. You add tens of thousands of young people into mid-sized or small towns, and you get spiraling outbreaks. With less public health infrastructure, the more cases, the harder it is to contain. https://twitter.com/OcneanuStephana/status/1302357466005504001

Case investigation and contact tracing is delayed — we've seen anywhere from five days to a week or more — which means those people aren't necessarily quarantining, and their close contacts aren't either (except on their own recognizance).

That leaves you with more spread and a more limited picture of where it's spreading. Hospitalization rates have been raised in conversations about shutting down/shifting modalities, but hospitalizations are a lagging indicator, and young people aren't the only ones getting sick.

I spoke with the city/county health department director Stephanie Browning yesterday, and she said they've seen an increase in community transmission (people contracting the virus in public spaces) and anticipates that trend will continue.

So that means, if the infection rate continues unchecked, you're getting into the fall and winter with increasing hospitalizations and community spread, and that's when your hospital capacity gets tested or overwhelmed, not now.

Having record numbers of cases every couple of days is pretty scary, but it's worth considering we're just at the start of this.