As the spread of COVID-19 increases and begins to move like wildfire through some parts of the nation, two metrics are used to show how hard places are hit. One is the number of cases per 1,000 people, and the other is deaths per thousand people. These figures have been particularly high in sections of Arkansas, Florida, Georgia, Louisiana and Tennessee.

The hardest hit of all counties in America is Hancock County, Georgia, where deaths per 1,000 people reached 5.16 on October 14, an extraordinarily high number.

Hancock County sits east of Atlanta. Its average population over the past five years was 8,535. That population is made up mostly of Black Americans. In the county seat, Sparta, 84% of the population was Black, according to the 2010 Census, while 15% of the population was white.

A look at the state of Georgia shows that both cases and deaths have been higher over the past seven days.

Based on the deaths per 1,000 measurement, Hancock County is followed by two counties in Virginia. Deaths per 1,000 people in Emporia County were 4.83 on October 14. The county has a five-year average population of 5,381. It is in the southern part of the state, near the North Carolina border. Galax County, also near the border, ranks third in deaths per 1,000 at 4.52. Its population is 6,638.

Next on the list based on deaths per 1,000 is Randolph County, Georgia, near the Alabama border. Its count was 4.09 on the 14th. It has a five-year average population of 7,087. Just behind it, East Feliciana, Louisiana, has a count of 3.85 and a population of 19,499.

The second measure of how hard a county has been hit is cases per 1,000. On the 14th, this figure was highest in Trousdale, Tennessee, where the number was 179.36. It has a five-year average population of 9,573. Chattahoochee, Georgia, followed with a count of 158.54 and a population of 10,767.

Next on this list is Lafayette, Florida, at 143.3 (population 8,744); Lake, Tennessee, at 126.49 (population 7,526); and Dakota, Nebraska, at 118.32 (population 20,317).

Notably, every county but one by each measure is in the South.

According to The New York Times, there are COVID-19 hot spots east of Atlanta, on Georgia’s border with Alabama and in central Tennessee. These all contain the hardest-hit counties in American, based on deaths per thousand, or are close by.

Troubled Hancock County finds itself surrounded by hot spot counties as bad as any other in the country.

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