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The U.S. has reached 200,000 deaths from the coronavirus. Now experts are looking ahead, and the forecast for the fall and winter isn’t good.

USA TODAY

When state health officials modeled how they thought coronavirus would strike South Dakota in the early, grim, days of the pandemic, they assumed the virus would wallop the entire state at once.

The assumptions for how the pandemic would play out, including the need for thousands of additional hospital beds, didn’t go as planned. Instead, the virus flared up here and there in what state epidemiologist Joshua Clayton described as an eb and flow. Meanwhile, large parts of rural South Dakota remained lightly touched.

But the month of September looked more like that original model. Nearly two-thirds of the state’s counties saw a doubling of their positive cases. Hospitalizations hit a record, though well below the thousands estimated in April.

The start of