This analysis was excerpted from the April 22 edition of CNN’s Meanwhile in America, the daily email about US politics for global readers. Click here to read past editions and subscribe.

(CNN)Living in America’s heartland during a pandemic can be both a blessing and a curse. Infection maps show hot spots on the East Coast, through the Midwest, down in Florida, to the West in Texas and with more misery afflicting the Pacific coast region. But the vast interior seems largely untouched — one reason why local leaders want to fire up normal life.

Rural Americans have some advantages when it comes to avoiding the coronavirus. Cars and pick-up trucks are the transport of choice, rather than crowded pathogen-spreading subways. Scattered single homes are already a form of social distancing compared with densely packed apartment buildings. And there are simply fewer people around to infect one another. On Tuesday, the Midwestern state of Nebraska had registered 1,685 cases of Covid-19 and only 33 deaths. Its curve might be accelerating, but it’s still far safer to be a Nebraskan than a New Yorker. The Cornhusker State had 87 cases of Covid-19 per 100,000 people. The Empire State had 1,328.Read MoreHow long can we live under lockdown?How long can we live under lockdown?How long can we live under lockdown? But life away from the urban crush brings its own problems. In rural areas, hospitals are often sparse, poorly equipped, have only a few ICU beds and suffer from a shortage of doctors. It’s harder to get quick test results. And rudimentary health care in some areas means patients have preexisting conditions that carry a higher risk of Covid complications. “We have not dodged this in any way,” says Dr. Angela Hewlett, associate professor at the division of infectious diseases at the University of Nebraska. “I’m afraid what we are going to see is a peak, a downslope and, if we go back to business as usual in any way, we are going to see another peak and possibly a lot more cases.” Another interior state, Utah, has seen hot spots around ski resorts and cities. Infection curves in the country will be slower than in populous metropolitan areas — but will be sustained for longer in a series of mini-epidemics. “We are going to be fighting this for weeks and months to come,” says Dr. Andrew Pavia, who heads the pediatric infectious diseases division at the University of Utah School of Medicine. “It is going to make reopening that much more challenging.”

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