8 of the 10 places with the most cases per capita are all in the upper midwest and the remaining two are in Nebraska and kansas. A bunch of people from all around the country coming in without masks. This was going to be the outcome. Luckily it's not very populated so it's not tens of thousands of people catching it.
https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html#hotspots