Just when America looked like it had turned a corner, COVID has seemingly returned with a vengeance. Most of the recent media attention has focused on rising infection rates in Florida, Texas, Arizona, and California. Three of those four (FL, TX, and CA) top the list of most populous states, so their raw case numbers should be no surprise. The fourth most populous state is New York, which (second only to New Jersey) leads not just the US but the entire world in accumulated per capita infections and mortality. Understanding the COVID “comeback” helps us offer an informed, compassionate response.