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New Covid-19 infections in rural America increased about 10% last week, while Covid-related deaths declined by about 20%.

Rural counties were evenly split between those that had better infection rates compared to two weeks ago and those that had worse. Twenty states saw an improvement in their rural infection rates, while 27 had worse rates last week. (Delaware, New Jersey, and Rhode Island do not have any nonmetropolitan counties.)

Rural counties reported 117,000 new infections last week, up about 11,000 from two weeks ago. Urban counties had about 450,000 new infections last week, an increase of 55,000. The rural infection rate remained significantly higher than the metropolitan infection rate – a trend that goes back about three months.

In 38 states, the rural infection rate was higher than the urban infection rate.

Rural counties reported 2,100 Covid-related deaths last week, a decrease of 20% from two weeks ago. Metropolitan counties reported 6,100 deaths, a decrease of 15% from two weeks ago. The rural death rate remains two times higher than the metropolitan death rate, a trend that started in mid-August.

Regional Trends

Significant new patterns have emerged in the Northeast in recent weeks.

  • Pennsylvania has the highest rural infection rate in the country. The state’s rural infection jumped nearly two-thirds last week. Pennsylvania has 21 rural counties with very high infections rates (over 500 new cases per 100,000 in a one week period). (These counties are shown in black on the map above; metro high-infection-rate counties are shown in gray.) That’s an increase of 18 from two weeks ago. These counties cluster in the western half of the state. The rural infection rate (nearly 600 per 100,000) is two-thirds higher than the metropolitan infection rate (360 per 100,000).
  • New York and Vermont both increased their rural infection rates by more than 20% last week. Vermont now has the eighth highest rural infection rate in the country (453 per 100,000 for one week), and New York ranks 15th. In New York, the rural infection rate is more than two times higher than the metropolitan infection rate.

Another pattern is emerging in the central part of the nation.

  • Indiana had a 72% increase in its rural infection rate last week – the biggest percentage increase in the country. The state went from having no rural counties with very-high infection rates to having eight.
  • Nebraska’s rural infection rate climbed 50% last week, and the state jumped from having 14 rural counties with very high infection rates to having 34. The state’s rural infection rate of 532 per 100,000 for a week is about 50% higher than the metropolitan infection rate.
  • Kansas’ rural infection rate climbed by nearly a third last week and is about two times higher than the urban infection rate.

Improvement

  • States that saw a cooling in their rural infection rates included California, which had a 50% drop in rural infections, Oregon (-38%), Arkansas (-35%), and Georgia (-30%).
  • Colorado, New Hampshire, Louisiana, North Dakota, and South Carolina, Montana, and Idaho all improved their rural infection rates by more than 20%
  • Minnesota, which had the second-highest rural infection rate in the country, improved modestly last week. The rural infection rate fell by 13%. A brighter note was sounded in the reduction of rural counties with very high infection rates. That number fell from 44 two weeks ago to 27 last week – a decrease of 17.
  • Seventy rural counties reported no new infections last week.

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