has skyrocketed in the last two months. in one county the only hospital is stretched to its limit. cnn's miguel marquez is live in iowa with us for more. what are you seeing? >> reporter: look, this is the case across the entire state. think of places like this as a river feeding this massive river of cases and hospitalizations. if it keeps going at the way it's going we will be at a situation where a broad swath of the country the health care system will be filled to the brim. butch hanson, 84 years old, diagnosed with covid-19 last week. >> we're going to get a cat scan of your chest. you've got some junk in your chest so you probably have a little pneumonia but i want to make sure you don't have a blood clot in your lung. >> reporter: today he is back in the emergency room. why did you come in today? >> that i had a rough time with that phlegm last night. that's all i did, cough up that