The rates of new confirmed COVID-19 cases in America have risen sharply in the past few days, taking daily case counts to record levels. For several days in the past two weeks, the number jumped above 100,000. Yesterday, cases rose by 187,597 to 11,801,472. 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 over 1,000 a day recently. Total fatal cases in the United States now total 255,496, after a one-day gain of 1,556

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. The next county is Emporia, Virginia, with 5.20 deaths per 1,000 people on November 18. It 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 Dickey County, North Dakota, at 4.43. It has a five-year population average of 4,970.

Another measure of how hard a county has been hit is confirmed cases per 1,000. On November 18, this figure was highest in Trousdale, Tennessee, where the number was 196.07. The county has a five-year average population of 9,573.

Norton County, Kansas, follows with 178.82 confirmed cases per 1,000 people. Its five-year average population is 5,486. Bon Homme County, South Dakota, is next with 178.36 confirmed cases per 1,000. Its five-year population average stands at 6,969

Chattahoochee, Georgia, ranked fourth for confirmed cases per 1,000 at 177.02. Its population is 10,767. Next comes Lincoln County, Arkansas, at 173.57 and a population of 13,695.

Jerauld, Bon Homme, Norton and Dickey are in the hard-hit areas of the upper Midwest, based on the lists of confirmed death rates and confirmed case rates. The others are in the South. Without exception, they are in rural areas.

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