The acceleration in the spread of COVID-19 in the United States in the past month is nothing short of astonishing. Confirmed cases now routinely rise by over 200,000 a day, on the way to what experts think will be 300,000. Fatal cases per day have risen to over 3,000, and experts fear that could surge over the course of January. Currently, total confirmed cases in the United States stand at 23,489,378 and fatalities at 390,738.

Some parts of the country are much worse off than others are. At this point, the surge of disease runs from coast to coast, from Rhode Island to California to Kentucky, where cases and deaths per 100,000 have surged. This has put the national intensive care unit bed capacity at 100% in some cities. Case counts in states where the growth has slowed also have picked up. This includes, in particular, New York, which was hit worse than any other state in terms of deaths during a horrible period from late March through April. The state still has more fatal cases than any other does at 39,997.

The effects of the disease on any area are measured in several ways. Among the most widely followed are confirmed cases per 100,000 people. This shows how deeply COVID-19 has spread in any given county. It also can be a sign of likely future spread because such a large portion of the population already has been affected.

Until vaccines can slow and start to eliminate COVID-19, people have to be on guard for the spread of the disease in their own communities. 24/7 Wall St. has looked at each state to determine the counties where the confirmed cases per 100,000 are the highest. We also have shown a more grim figure, which is deaths per 100,000.

The ways that people can protect themselves regardless of the intensity of the spread of the disease have changed very little since the start of the pandemic. Wear masks, social distance, wash hands and, when talking, stay outside as much as possible. Just as important, do not gather inside in groups of more than a few people.

This list shows the five counties in each state where the cases per 100,000 are the highest. It provides a picture of which areas in a state are most dangerous in terms of the spread of the disease.

Alabama
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Lowndes	10,236	1,076	36	10,512	352
Clay	13,378	1,237	43	9,247	321
Butler	20,025	1,651	57	8,245	285
Hale	14,887	1,721	42	11,560	282
Walker	64,493	5,803	177	8,998	274
Alaska
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Yukon-Koyukuk	5,415	172	4	3,176	74
Bethel	18,040	1,736	12	9,623	67
Southeast Fairbanks	6,876	263	3	3,825	44
Anchorage	296,112	16,378	128	5,531	43
Kusilvak	8,198	436	3	5,318	37
Arizona
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Apache	71,522	8,376	262	11,711	366
Navajo	108,705	12,894	378	11,861	348
Gila	53,400	5,203	157	9,743	294
Yuma	207,829	31,789	601	15,296	289
Santa Cruz	46,584	6,807	127	14,612	273
Arkansas
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Fulton	12,139	1,264	59	10,413	486
Newton	7,848	689	30	8,779	382
Independence	37,264	4,118	127	11,051	341
Little River	12,417	1,093	41	8,802	330
Chicot	10,826	1,482	35	13,689	323
California
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Imperial	180,216	24,566	449	13,631	249
Inyo	18,085	773	27	4,274	149
Stanislaus	539,301	39,615	699	7,346	130
Los Angeles	10,098,052	926,295	12,674	9,173	126
Merced	269,075	22,172	285	8,240	106
Colorado
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Morgan	28,257	2,274	85	8,048	301
Otero	18,325	1,733	55	9,457	300
Bent	5,809	1,240	17	21,346	293
Huerfano	6,583	283	18	4,299	273
Logan	21,689	3,433	55	15,828	254
Connecticut
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Hartford	894,730	55,710	1,978	6,226	221
New Haven	859,339	55,665	1,680	6,478	195
Fairfield	944,348	65,000	1,821	6,883	193
Middlesex	163,368	8,007	289	4,901	177
Litchfield	183,031	8,750	244	4,781	133
Delaware
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Sussex	219,540	17,758	316	8,089	144
Kent	174,822	10,809	183	6,183	105
New Castle	555,133	38,451	495	6,926	89
Florida
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Union	15,239	1,578	68	10,355	446
Jackson	48,472	5,160	122	10,645	252
Lafayette	8,744	1,474	22	16,857	252
Calhoun	14,444	1,410	32	9,762	222
Highlands	102,101	5,668	225	5,551	220
Georgia
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Hancock	8,535	702	48	8,225	562
Wilcox	8,846	406	39	4,590	441
Randolph	7,087	380	31	5,362	437
Early	10,348	779	43	7,528	416
Terrell	8,859	475	35	5,362	395
Hawaii
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Honolulu	987,638	19,462	244	1,971	25
Hawaii	197,658	2,037	45	1,031	23
Maui	165,281	1,473	19	891	11
Kauai	71,377	169	1	237	1
Idaho
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Shoshone	12,526	908	30	7,249	240
Owyhee	11,455	935	21	8,162	183
Lincoln	5,321	458	9	8,607	169
Washington	10,025	1,065	16	10,623	160
Lewis	3,845	357	6	9,285	156
Illinois
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Stark	5,500	490	20	8,909	364
Ford	13,398	1,348	47	10,061	351
Greene	13,218	1,229	42	9,298	318
Whiteside	56,396	5,133	172	9,102	305
Marion	38,084	3,886	111	10,204	291
Indiana
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Decatur	26,552	2,350	81	8,851	305
Pulaski	12,660	931	36	7,354	284
Wayne	66,613	5,766	154	8,656	231
Daviess	32,937	2,528	70	7,675	213
Vermillion	15,560	1,407	33	9,042	212
Iowa
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Ida	6,916	731	30	10,570	434
Harrison	14,143	1,518	61	10,733	431
O’Brien	13,911	1,673	54	12,026	388
Tama	17,136	1,835	57	10,708	333
Wayne	6,413	413	21	6,440	327
Kansas
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Gove	2,619	285	22	10,882	840
Ness	2,955	205	15	6,937	508
Nemaha	10,104	829	50	8,205	495
Norton	5,486	1,156	25	21,072	456
Comanche	1,780	71	8	3,989	449
Kentucky
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Robertson	2,143	164	7	7,653	327
Lee	6,751	1,087	18	16,101	267
Monroe	10,634	1,067	28	10,034	263
Owsley	4,463	348	10	7,797	224
Adair	19,241	1,315	43	6,834	223
Louisiana
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
East Feliciana	19,499	2,620	96	13,437	492
Franklin	20,322	2,200	91	10,826	448
Bienville	13,668	1,358	60	9,936	439
Red River	8,618	729	29	8,459	337
West Carroll	11,180	1,034	35	9,249	313
Maine
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Oxford	57,325	1,472	29	2,568	51
Somerset	50,710	902	24	1,779	47
Waldo	39,418	413	18	1,048	46
Androscoggin	107,444	3,370	48	3,137	45
Hancock	54,541	655	23	1,201	42
Maryland
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Allegany	71,977	5,799	163	8,057	226
Garrett	29,376	1,647	57	5,607	194
Kent	19,593	886	31	4,522	158
Prince George’s	906,202	60,972	1,151	6,728	127
Baltimore	827,625	42,810	1,027	5,173	124
Massachusetts
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Hampden	469,116	31,393	1,114	6,692	237
Essex	781,024	68,261	1,827	8,740	234
Bristol	558,905	42,507	1,185	7,605	212
Plymouth	512,135	29,858	1,072	5,830	209
Worcester	822,280	51,038	1,667	6,207	203
Michigan
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Baraga	8,507	567	29	6,665	341
Iron	11,212	872	37	7,777	330
Dickinson	25,570	2,263	70	8,850	274
Ontonagon	5,968	315	16	5,278	268
Gogebic	15,414	1,060	40	6,877	260
Minnesota
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Kittson	4,337	362	19	8,347	438
Chippewa	12,010	1,306	32	10,874	266
Renville	14,721	1,356	39	9,211	265
Pipestone	9,185	915	22	9,962	240
Lac qui Parle	6,773	651	16	9,612	236
Mississippi
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Neshoba	29,376	3,282	149	11,172	507
Issaquena	1,328	155	6	11,672	452
Sharkey	4,511	416	17	9,222	377
Clarke	15,928	1,345	60	8,444	377
Covington	19,091	2,054	71	10,759	372
Missouri
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Clinton	20,475	1,385	60	6,764	293
Grundy	10,039	751	27	7,481	269
Gentry	6,665	665	16	9,977	240
New Madrid	17,811	1,693	39	9,505	219
Gasconade	14,746	766	31	5,195	210
Montana
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Big Horn	13,376	2,207	69	16,500	516
Roosevelt	11,228	1,410	52	12,558	463
Wibaux	1,175	113	5	9,617	426
Carter	1,318	139	5	10,546	379
Meagher	1,968	114	7	5,793	356
Nebraska
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Grant	718	23	4	3,203	557
Perkins	2,907	247	11	8,497	378
Hooker	691	48	2	6,946	289
Morrill	4,841	431	14	8,903	289
Nance	3,554	358	10	10,073	281
Nevada
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Pershing	6,611	851	15	12,872	227
Churchill	24,010	1,599	44	6,660	183
Carson	54,467	5,415	83	9,942	152
Lander	5,746	406	8	7,066	139
Clark	2,141,574	194,220	2,716	9,069	127
New Hampshire
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Hillsborough	411,087	21,476	485	5,224	118
Belknap	60,640	2,317	70	3,821	115
Coos	32,038	861	19	2,687	59
Merrimack	149,452	5,752	83	3,849	56
Rockingham	305,129	13,116	162	4,299	53
New Jersey
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Essex	793,555	56,824	2,459	7,161	310
Passaic	504,041	46,517	1,524	9,229	302
Union	553,066	45,916	1,607	8,302	291
Hudson	668,631	53,632	1,769	8,021	265
Bergen	929,999	58,354	2,397	6,275	258
New Mexico
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
McKinley	72,849	10,700	370	14,688	508
Sierra	11,135	629	39	5,649	350
Cibola	26,978	2,447	83	9,070	308
Socorro	17,000	1,017	46	5,982	271
San Juan	127,455	11,765	318	9,231	249
New York
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Bronx	1,437,872	95,345	3,637	6,631	253
Queens	2,298,513	144,226	5,523	6,275	240
Kings	2,600,747	141,535	5,586	5,442	215
Richmond	474,101	41,814	931	8,820	196
Rockland	323,686	30,557	611	9,440	189
North Carolina
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Hertford	24,153	1,567	52	6,488	215
Rutherford	66,532	5,302	137	7,969	206
Montgomery	27,338	2,309	52	8,446	190
Cleveland	97,159	8,115	165	8,352	170
Scotland	35,262	2,848	59	8,077	167
North Dakota
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Dickey	4,970	710	32	14,286	644
Foster	3,290	536	19	16,292	578
Pierce	4,210	502	22	11,924	523
Renville	2,495	281	12	11,263	481
Towner	2,246	286	10	12,734	445
Ohio
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Noble	14,443	1,153	38	7,983	263
Wyandot	22,107	1,865	47	8,436	213
Mercer	40,806	4,172	85	10,224	208
Putnam	33,969	3,565	70	10,495	206
Clark	135,198	10,235	260	7,570	192
Oklahoma
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Cotton	5,929	502	12	8,467	202
McCurtain	32,966	3,206	57	9,725	173
Roger Mills	3,708	317	6	8,549	162
Greer	5,943	423	9	7,118	151
Jackson	25,384	2,548	38	10,038	150
Oregon
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Malheur	30,431	3,100	51	10,187	168
Jefferson	23,143	1,649	24	7,125	104
Wasco	25,866	1,025	23	3,963	89
Hood River	23,131	922	20	3,986	86
Umatilla	76,898	6,470	64	8,414	83
Pennsylvania
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Mifflin	46,362	3,851	131	8,306	283
Northumberland	92,325	5,935	258	6,428	279
Juniata	24,562	1,540	68	6,270	277
Cambria	134,550	9,824	307	7,301	228
Bedford	48,611	3,289	103	6,766	212
Rhode Island
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Providence	634,533	67,526	1,479	10,642	233
Bristol	48,900	3,251	78	6,648	160
Kent	163,861	11,802	228	7,202	139
Washington	126,242	5,521	125	4,373	99
Newport	83,075	3,578	11	4,307	13
South Carolina
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Bamberg	14,600	1,073	42	7,349	288
Marion	31,562	2,437	79	7,721	250
Fairfield	22,712	1,564	56	6,886	247
Lee	17,606	1,367	43	7,764	244
Clarendon	34,017	2,058	81	6,050	238
South Dakota
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Jerauld	2,029	265	16	13,061	789
Gregory	4,201	493	26	11,735	619
Hamlin	6,000	640	37	10,667	617
Turner	8,264	1,009	49	12,210	593
Faulk	2,322	317	13	13,652	560
Tennessee
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Pickett	5,088	653	19	12,834	373
Clay	7,686	900	25	11,710	325
Perry	7,912	922	24	11,653	303
Houston	8,176	919	22	11,240	269
Crockett	14,499	1,785	38	12,311	262
Texas
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Lamb	13,262	1,775	72	13,384	543
Dawson	12,964	1,551	59	11,964	455
Motley	1,156	79	5	6,834	433
Floyd	5,872	623	25	10,610	426
Brooks	7,180	664	29	9,248	404
Utah
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
San Juan	15,281	1,594	35	10,431	229
Salt Lake	1,120,805	119,222	611	10,637	55
Wasatch	30,523	3,613	16	11,837	52
Utah	590,440	77,010	238	13,043	40
Davis	340,621	28,810	106	8,458	31
Vermont
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Franklin	49,025	640	32	1,305	65
Chittenden	162,052	3,300	77	2,036	48
Windham	43,150	658	9	1,525	21
Orleans	26,911	312	5	1,159	19
Washington	58,477	968	10	1,655	17
Virginia
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Emporia	5,381	463	30	8,604	558
Galax	6,638	900	37	13,558	557
Northampton	11,957	525	31	4,391	259
Southampton	17,939	1,526	42	8,507	234
Franklin	8,211	722	18	8,793	219
Washington
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Yakima	249,325	22,311	340	8,949	136
Garfield	2,224	100	3	4,496	135
Asotin	22,337	1,096	23	4,907	103
Columbia	4,001	92	4	2,299	100
Franklin	90,660	9,526	87	10,507	96
West Virginia
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Mineral	27,278	2,270	72	8,322	264
Hancock	29,680	2,228	66	7,507	222
Logan	33,801	2,018	64	5,970	189
Marshall	31,645	2,454	57	7,755	180
Brooke	22,772	1,680	41	7,377	180
Wisconsin
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Iron	5,715	436	19	7,629	332
Florence	4,337	411	12	9,477	277
Forest	9,018	893	22	9,902	244
Menominee	4,579	760	11	16,598	240
Waupaca	51,444	4,350	102	8,456	198
Wyoming
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Washakie	8,129	830	23	10,210	283
Big Horn	11,901	892	22	7,495	185
Fremont	40,076	4,213	71	10,513	177
Goshen	13,438	1,065	19	7,925	141
Natrona	80,610	6,939	103	8,608	128

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