The rates of new confirmed COVID-19 cases in America have risen in the past few days, which has taken daily case counts to record levels. For several days in the past two weeks, the number jumped above 80,000. The winter will be worse. Fatal case rates have not been as bad as when the nation was hardest hit by this measure from early April to mid-May, when the counts rose above 2,000 nationwide on some days. However, the number of coronavirus fatalities has begun to reach 1,000 a day recently.

Rates of both confirmed and fatal cases are highly uneven across the nation. The county with the worst rate of fatal cases per 1,000 people is Jerauld County, South Dakota. It has a five-year average population of 2,029. Deaths per 1,000 stand at 6.41, many multiples of the national average.

Jerauld County is in the center of the state. It has been steadily losing population since 1930, according to information from the U.S. Census. Over 98% of the population is white. Almost 20% of the population lives below the poverty line, which is well above the national average.

According to The New York Times, South Dakota currently is one of the hardest-hit states in America and one where the rates of “new deaths are increasing.”

The next hardest-hit county is Hancock County, Georgia, which has a death rate of 5.27 per 1,000 people. This county sits east of Atlanta, and its average population over the past five years was 8,535. Next is Emporia, Virginia, with 5.20 deaths per 1,000 people on November 2. 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, Virginia, also near the North Carolina border, ranks fourth by the same measure 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 rate was 4.23 on November 2, and it has a five-year average population of 7,087.

Another measure of how hard a county has been hit is confirmed cases per 1,000. On November 2, this figure was highest in Trousdale, Tennessee, where the number was 188.24. The county has a five-year average population of 9,573. Lincoln County, Arkansas, was next at 170.72. Its five-year average population is 13,695.

Chattahoochee, Georgia, ranked third for confirmed cases per 1,000 at 167.55. Its population is 10,767. Bon Homme, South Dakota, followed with a confirmed case rate of 146.65 and a population of 6,969. Next on this list is Lafayette, Florida, at 146.27 and with a population of 8,744.

Except for Jerauld and Bon Homme, each hard-hit county, based on both confirmed death rates and confirmed case rates, is in the South and in relatively rural areas. Based on its population and size, Jerauld County is also nearly as rural as a county gets.

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