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 in January. Currently, total confirmed cases in the United States stand at 18,184,737 and fatalities at 322,343.

Some parts of the country are much worse off than others. The states in the upper Midwest now are taking the brunt of the disease. This includes Iowa, Minnesota, Montana, North and South Dakota and Wyoming. 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 at 36,147.

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 eventually 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 grimmer 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 stay outside as much as possible when talking. Just as important, do not gather inside in groups of more than a few people.

COVID-19: This Is the Hardest Hit City in America

This list shows the five counties in each state where the cases per 100,000 are the highest. It provides an idea 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
Franklin	31,542	3,021	36	9,577.71	114
Jackson	52,094	4,689	31	9,001.04	60
DeKalb	71,200	6,408	51	9,000.00	72
Clarke	24,387	2,182	24	8,947.39	98
Marshall	95,145	8,380	71	8,807.61	75
Alaska
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Bethel	18,040	1,614	8	8,946.79	44
Anchorage	296,112	16,517	106	5,577.96	36
Kusilvak	8,198	429	3	5,232.98	37
Northwest Arctic	7,734	349	0	4,512.54	0
North Slope	9,797	430	2	4,389.10	20
Arizona
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Yuma	207,829	24,592	465	11,832.80	224
Santa Cruz	46,584	5,362	87	11,510.39	187
Apache	71,522	6,862	218	9,594.25	305
Navajo	108,705	10,301	300	9,476.11	276
Gila	53,400	4,005	119	7,500.00	223
Arkansas
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Lincoln	13,695	2,909	24	21,241.33	175
Jackson	17,225	3,166	19	18,380.26	110
Lee	9,398	1,410	22	15,003.19	234
Sevier	17,193	2,396	21	13,935.90	122
Chicot	10,826	1,441	30	13,310.55	277
California
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Lassen	31,185	3,595	7	11,527.98	22
Imperial	180,216	20,711	394	11,492.32	219
Kings	150,075	14,474	103	9,644.51	69
San Bernardino	2,135,413	159,883	1,327	7,487.22	62
Kern	883,053	55,118	481	6,241.75	54
Colorado
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Crowley	5,630	1,576	12	27,992.89	213
Bent	5,809	867	10	14,925.12	172
Logan	21,689	3,030	52	13,970.21	240
Lincoln	5,548	749	2	13,500.36	36
Fremont	47,002	4,012	14	8,535.81	30
Connecticut
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Fairfield	944,348	50,614	1,628	5,359.68	172
New Haven	859,339	41,723	1,425	4,855.24	166
Hartford	894,730	40,611	1,733	4,538.91	194
Windham	116,538	4,153	51	3,563.64	44
Litchfield	183,031	6,515	205	3,559.51	112
Delaware
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Sussex	219,540	13,460	284	6,131.00	129
New Castle	555,133	29,126	422	5,246.67	76
Kent	174,822	7,910	156	4,524.60	89
Florida
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Lafayette	8,744	1,403	20	16,045.29	229
Miami-Dade	2,715,516	274,117	4,066	10,094.47	150
Jackson	48,472	4,355	110	8,984.57	227
Union	15,239	1,365	65	8,957.28	427
Suwannee	43,924	3,680	93	8,378.11	212
Georgia
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Chattahoochee	10,767	2,129	3	19,773.38	28
Stewart	6,042	600	17	9,930.49	281
Whitfield	103,849	9,823	111	9,458.93	107
Hall	195,961	15,625	215	7,973.53	110
Echols	3,994	304	3	7,611.42	75
Hawaii
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Honolulu	987,638	17,054	218	1,726.75	22
Hawaii	197,658	1,803	44	912.18	22
Maui	165,281	899	17	543.92	10
Kauai	71,377	137	1	191.94	1
Idaho
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Madison	38,705	5,073	10	13,106.83	26
Cassia	23,615	2,449	19	10,370.53	80
Minidoka	20,615	1,953	22	9,473.68	107
Washington	10,025	925	14	9,226.93	140
Twin Falls	83,666	7,655	110	9,149.48	131
Illinois
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Fayette	21,724	2,502	46	11,517.22	212
Cass	12,665	1,425	28	11,251.48	221
Clinton	37,628	4,156	77	11,044.97	205
Effingham	34,174	3,607	49	10,554.81	143
Lawrence	16,189	1,703	24	10,519.49	148
Indiana
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Elkhart	203,604	21,706	294	10,660.89	144
Cass	38,084	3,921	36	10,295.66	95
Dubois	42,418	3,929	37	9,262.58	87
Marshall	46,595	4,215	65	9,046.04	139
Clinton	32,301	2,897	30	8,968.76	93
Iowa
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Buena Vista	20,260	3,535	22	17,448.17	109
Plymouth	25,039	3,238	46	12,931.83	184
Jones	20,568	2,521	38	12,256.90	185
Sioux	34,825	4,192	41	12,037.33	118
Henry	19,926	2,396	21	12,024.49	105
Kansas
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Norton	5,486	1,122	N/A	20,452.06	N/A
Ellsworth	6,293	921	N/A	14,635.31	N/A
Sheridan	2,506	319	N/A	12,729.45	N/A
Ford	34,484	4,302	N/A	12,475.35	N/A
Seward	22,692	2,540	N/A	11,193.37	N/A
Kentucky
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Lee	6,751	1,016	18	15,049.62	267
Elliott	7,517	743	1	9,884.26	13
Monroe	10,634	880	19	8,275.34	179
Marion	19,232	1,434	17	7,456.32	88
Warren	126,427	9,218	83	7,291.16	66
Louisiana
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
East Carroll	7,225	913	14	12,636.68	194
East Feliciana	19,499	2,375	90	12,180.11	462
Madison	11,472	1,207	16	10,521.27	139
Franklin	20,322	1,929	73	9,492.18	359
Allen	25,661	2,346	71	9,142.28	277
Maine
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Androscoggin	107,444	2,152	42	2,002.90	39
Cumberland	290,944	5,745	83	1,974.61	29
York	203,102	3,773	48	1,857.69	24
Oxford	57,325	869	12	1,515.92	21
Franklin	30,019	384	5	1,279.19	17
Maryland
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Allegany	71,977	5,050	140	7,016.13	195
Somerset	25,737	1,577	16	6,127.37	62
Prince George’s	906,202	50,319	1,036	5,552.74	114
Baltimore city	614,700	29,331	664	4,771.60	108
Garrett	29,376	1,306	34	4,445.81	116
Massachusetts
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Essex	781,024	50,902	1,586	6,517.34	203
Suffolk	791,766	48,654	1,315	6,145.00	166
Nantucket	11,101	661	0	5,954.42	0
Bristol	558,905	29,428	995	5,265.30	178
Hampden	469,116	22,776	1,003	4,855.09	214
Michigan
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Dickinson	25,570	2,079	64	8,130.62	250
Delta	36,190	2,820	73	7,792.21	202
Iron	11,212	789	37	7,037.10	330
Menominee	23,234	1,571	23	6,761.64	99
Branch	43,584	2,903	57	6,660.70	131
Minnesota
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Nobles	21,839	3,463	43	15,856.95	197
Kandiyohi	42,658	5,214	55	12,222.79	129
Rock	9,413	998	10	10,602.36	106
Lyon	25,839	2,708	26	10,480.28	101
Stearns	156,819	16,422	159	10,471.95	101
Mississippi
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Issaquena	1,328	140	4	10,542.17	301
Neshoba	29,376	2,738	133	9,320.53	453
Bolivar	32,592	3,035	92	9,312.10	282
Montgomery	10,198	923	30	9,050.79	294
Winston	18,358	1,650	44	8,987.91	240
Missouri
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Sullivan	6,317	618	9	9,783.13	142
Cole	76,740	7,192	77	9,371.91	100
Perry	19,146	1,771	15	9,249.97	78
St. Francois	66,342	6,070	58	9,149.56	87
Madison	12,205	1,097	10	8,988.12	82
Montana
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Big Horn	13,376	2,011	57	15,034.39	426
Toole	4,976	670	8	13,464.63	161
Roosevelt	11,228	1,365	42	12,157.11	374
Powell	6,861	788	5	11,485.21	73
Rosebud	9,250	1,001	27	10,821.62	292
Nebraska
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Dakota	20,317	3,393	51	16,700.30	251
Colfax	10,760	1,396	17	12,973.98	158
Saline	14,288	1,684	3	11,786.11	21
Platte	33,063	3,413	39	10,322.72	118
Madison	35,164	3,623	36	10,303.15	102
Nevada
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Carson City	54,467	4,516	43	8,291.26	79
Washoe	450,486	32,830	407	7,287.69	90
Clark	2,141,574	153,951	2,162	7,188.68	101
Elko	52,252	3,637	32	6,960.50	61
Lander	5,746	360	6	6,265.23	104
New Hampshire
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Hillsborough	411,087	14,965	386	3,640.35	94
Rockingham	305,129	9,053	125	2,966.94	41
Merrimack	149,452	3,952	47	2,644.33	31
Belknap	60,640	1,523	41	2,511.54	68
Strafford	128,237	2,778	20	2,166.30	16
New Jersey
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Passaic	504,041	37,488	1,392	7,437.49	276
Union	553,066	34,251	1,504	6,192.93	272
Hudson	668,631	39,769	1,660	5,947.82	248
Essex	793,555	43,793	2,331	5,518.58	294
Camden	507,367	25,781	757	5,081.33	149
New Mexico
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
McKinley	72,849	9,044	323	12,414.72	443
Chaves	65,459	6,181	79	9,442.55	121
Luna	24,264	2,233	38	9,202.93	157
Lea	70,126	6,013	75	8,574.57	107
Curry	50,199	3,775	39	7,520.07	78
New York
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Rockland	323,686	25,275	563	7,808.49	174
Westchester	968,815	62,940	1,606	6,496.60	166
Richmond	474,101	30,505	847	6,434.28	179
Nassau	1,356,564	76,322	2,325	5,626.13	171
Orange	378,227	21,072	481	5,571.26	127
North Carolina
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Sampson	63,561	4,503	57	7,084.53	90
Avery	17,501	1,230	15	7,028.17	86
Greene	21,008	1,437	27	6,840.25	129
Scotland	35,262	2,372	51	6,726.79	145
Duplin	59,062	3,915	65	6,628.63	110
North Dakota
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Eddy	2,313	391	6	16,904.45	259
Foster	3,290	534	19	16,231.00	578
Morton	30,544	4,532	84	14,837.61	275
Walsh	10,802	1,564	21	14,478.80	194
Burleigh	93,737	13,366	160	14,259.04	171
Ohio
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Marion	65,344	6,289	93	9,624.45	142
Pickaway	57,420	5,492	50	9,564.61	87
Mercer	40,806	3,700	76	9,067.29	186
Putnam	33,969	3,054	62	8,990.55	183
Darke	51,734	3,786	74	7,318.20	143
Oklahoma
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Alfalfa	5,857	855	3	14,597.92	51
Texas	21,121	2,829	15	13,394.25	71
Woodward	20,967	2,302	10	10,979.16	48
Okfuskee	12,115	1,281	15	10,573.67	124
Craig	14,493	1,317	5	9,087.15	34
Oregon
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Malheur	30,431	2,739	49	9,000.69	161
Morrow	11,215	774	7	6,901.47	62
Umatilla	76,898	5,164	54	6,715.39	70
Jefferson	23,143	1,259	14	5,440.09	60
Marion	335,553	12,543	195	3,738.01	58
Pennsylvania
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Mifflin	46,362	3,034	92	6,544.15	198
Cambria	134,550	7,958	198	5,914.53	147
Blair	123,842	6,988	142	5,642.67	115
Huntingdon	45,421	2,550	76	5,614.14	167
Lebanon	138,674	7,693	141	5,547.54	102
Rhode Island
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Providence	634,533	51,871	N/A	8,174.67	N/A
Kent	163,861	8,436	N/A	5,148.27	N/A
Bristol	48,900	1,816	N/A	3,713.70	N/A
Washington	126,242	3,713	N/A	2,941.18	N/A
Newport	83,075	1,965	N/A	2,365.33	N/A
South Carolina
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Pickens	122,746	8,955	129	7,295.55	105
Newberry	38,068	2,585	70	6,790.48	184
Dillon	30,871	2,067	54	6,695.60	175
Greenville	498,402	32,207	464	6,462.05	93
Marlboro	27,131	1,749	23	6,446.50	85
South Dakota
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Bon Homme	6,969	1,427	21	20,476.39	301
Dewey	5,779	1,170	7	20,245.72	121
Buffalo	2,053	401	10	19,532.39	487
Aurora	2,759	391	7	14,171.80	254
Beadle	18,374	2,426	32	13,203.44	174
Tennessee
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Trousdale	9,573	2,074	12	21,665.10	125
Lake	7,526	1,340	12	17,804.94	159
Wayne	16,649	2,241	16	13,460.27	96
Haywood	17,779	2,008	34	11,294.22	191
Obion	30,520	3,335	67	10,927.26	220
Texas
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Childress	7,226	1,149	6	15,900.91	83
Hale	34,113	4,841	114	14,191.07	334
Crockett	3,633	486	8	13,377.37	220
Lubbock	301,454	38,890	502	12,900.81	167
Culberson	2,241	288	3	12,851.41	134
Utah
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Utah	590,440	58,955	186	9,984.93	32
Wasatch	30,523	2,814	15	9,219.28	49
Salt Lake	1,120,805	95,917	487	8,557.87	43
San Juan	15,281	1,275	32	8,343.69	209
Summit	40,511	2,695	5	6,652.51	12
Vermont
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Washington	58,477	848	6	1,450.14	10
Chittenden	162,052	2,330	57	1,437.81	35
Essex	6,208	75	0	1,208.12	0
Bennington	35,920	379	2	1,055.12	6
Orange	28,937	295	1	1,019.46	3
Virginia
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Galax	6,638	731	31	11,012.35	467
Greensville	11,659	976	16	8,371.22	137
Radford	17,630	1,389	7	7,878.62	40
Franklin	8,211	629	17	7,660.46	207
Harrisonburg	53,391	4,063	40	7,609.90	75
Washington
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Franklin	90,660	8,161	76	9,001.76	84
Adams	19,452	1,549	16	7,963.19	82
Yakima	249,325	17,438	305	6,994.08	122
Chelan	75,757	4,483	33	5,917.60	44
Douglas	41,371	2,396	14	5,791.50	34
West Virginia
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Mineral	27,278	1,989	55	7,291.59	202
Marshall	31,645	1,781	48	5,628.06	152
Grant	11,641	651	16	5,592.30	137
Hancock	29,680	1,546	20	5,208.90	67
Ohio	42,547	2,214	31	5,203.66	73
Wisconsin
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Menominee	4,579	685	10	14,959.60	218
Dodge	87,776	10,017	107	11,412.00	122
Jackson	20,506	2,227	13	10,860.24	63
Shawano	41,009	4,025	54	9,814.92	132
Fond du Lac	102,315	9,942	61	9,717.05	60
Wyoming
County	Population	Cases	Deaths	Cases per 100k	Deaths per 100k
Fremont	40,076	3,814	54	9,516.92	135
Albany	38,102	3,380	9	8,870.93	24
Teton	23,059	2,002	2	8,682.08	9
Washakie	8,129	699	11	8,598.84	135
Campbell	47,708	3,917	22	8,210.36	46

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