Hospitals in Michigan and Minnesota are reporting a wave of COVID-19 patients not seen in months. Beds are filling with unvaccinated people, and health care providers are warning that staff are being worn down by yet another surge. Michigan had slightly more than 3,000 COVID-19 patients in hospitals this week for the first time since spring. Nearly all hospital beds were occupied in Minnesota. Meanwhile, some states are ignoring federal guidance and expanding boosters. Arkansas this week joined California, Colorado and New Mexico in offering them to anyone 18 or older. Michigan has the country’s highest seven-day COVID-19 case rate at 503 per 100,000 people.