As the rate of new cases of COVID-19 continues to drop, the effort to get back to “normal” has become a race between vaccination on one hand and a level of what many experts believe is a careless effort to reopen the economy on the other. The decision by Texas Governor Gregory Abbott to drop the mask mandate of the nation’s second-largest state caused particular consternation among those who want to allow vaccination rates to rise before public gatherings begin.

Confirmed COVID-19 cases in the United States number 29,337,446. The rate at which they rise on a daily basis has dropped by two-thirds in the past two months. However, the figure remains about 25% of the world’s total. Fatal cases total 531,398, which is a fifth of the global total.

The national vaccination rate has risen steadily for the past three weeks and has reached 18% for those who have received at least one dose. Just over 9% have had two shots. A total of 116,378,615 doses have been delivered, and from those 92,089,852 shots have been given.

Public health officials use measures other than raw numbers to determine the presence and spread of the disease. Often, the figures used are deaths and cases per 100,000 people. This allows comparisons from state to state and county to county on an apples-to-apples basis, because it adjusts for population counts.

The United States has more than 3,000 counties. Based on cases per 100,000 over the past 14 days, the hardest-hit one in America is Lyon County, Kentucky, with a number of 383.93. This county sits between Nashville and Paducah, just off Kentucky Lake. It has a population of 8,210, according to the U.S. Census, and nearly 90% of that population is white. The median household income for the county is $52,528, well below the national average. The poverty rate, at 14.5%, is well above.

Next on the list, Hartley County, Texas, has a figure of 210.56 and a population of 5,767. It can be found northwest of Amarillo, on the Texas border with New Mexico. Next, La Salle County, Texas, has a figure of 193.78 and 7,409 residents. It is southwest of San Antonio, toward the Mexican border.

Next on the list with a figure of 182.44 is Dallam County, Texas, which is located in the western part of the state. Its population is 7,243. Finally, on the list of the hardest-hit counties, Cimarron County, Oklahoma, has a figure of 163.15, as well as a population of 2,189. It is in the most northwest section of Oklahoma, just north of Amarillo, Texas.

The hardest-hit counties list shows how badly COVID-19 has hurt small, rural counties recently. It also shows how concentrated they are in and around West Texas.

Click here to read about the mistakes that could trigger a fourth wave of COVID-19.

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