The rates of new confirmed COVID-19 cases in America have risen in the past few days, which has taken daily counts to new levels. For several days in the past two weeks, the number jumped above 70,000. The winter may 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. Yet, the number of coronavirus fatalities has begun to near 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 5.91, well over five times 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, characterized by new cases that are “high and getting higher.”

The next hardest-hit county is Emporia, Virginia, with 5.20 deaths per 1,000 people on October 25. 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.

Hancock County, Georgia, had a death rate of 5.16 per 1,000 people. Hancock County sits east of Atlanta. Its average population over the past five years was 8,535. 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 4.09 on the 25th, 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 October 25, this figure was highest in Trousdale, Tennessee, where the number was 185.42. The county has a five-year average population of 9,573. Lincoln Country, Arkansas, was next at 168.38. Its five-year average population is 13,695.

Chattahoochee, Georgia, followed with a confirmed case rate of 161.79 and a population of 10,767. Next on this list are Lafayette, Florida, at 145.47 (population 8,744) and Lake, Tennessee, at 130.88 (population 7,526).

Each hard-hit county, with the exception of Jerauld, based both on confirmed death rates and on confirmed case rates, is in the South, as well as in relatively rural areas. Jerauld itself is nearly as rural as a county gets.

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