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Exactly one year after the rural Covid-19 infection rate first exceeded the urban rate, rural counties have moved back to the front edge of the pandemic.

The rate of new infections last week was a third higher in rural counties than urban ones, a Daily Yonder analysis shows. The current trend began the week of August 14.

The last time the rural rate of new infections was this much higher than the metro rate was the second week of August 2020. After surpassing the metro rate for the first time that week, the rural rate of new infections remained higher than the metro rate for nearly five months – through the end of 2020.

The number of new infections in rural counties grew by 17% last week, to 189,183 – the highest number since early January. Metro infections grew by 8%, to about 870,000 new cases.

The rural infection rate – which is expressed as new cases per 1,000 residents – was 411 last week. The metropolitan rate was 308.

The higher infection rate comes just as rural America surpassed 100,000 total deaths from Covid-19. The current death toll among rural Americans stands at 101,035. Last week, 1,779 rural Americans died from Covid-19, an increase of about 18% from two weeks ago.

Rural residents who contract Covid-19 are slightly more likely to die from the illness than metropolitan residents. While rural residents account for about 14.4% of all infections, they represent 16.2% of the nation’s Covid-related deaths. Previous studies have pointed to several factors that could raise risk for rural populations, including age and complicating conditions such as type 2 diabetes.

This week’s report covers Sunday, August 22, through Saturday, August 28. Data is from USA Facts.

  • The Deep South remained the regional hotspot for the current surge, which is driven by the highly contagious Delta variant. But infection rates are up across the nation.
  • Nine out of every 10 U.S. counties are on the red-zone list, meaning they have a weekly infection rate of at least 100 new cases per 100,000. The White House coronavirus task force has advised local governments to take additional mitigation measures when infection rates reach this level.
  • Just two months ago, less than a fifth of U.S. counties were on the red-zone list.
  • Fourteen states have all their rural counties in the red zone. (On the map, the red zone includes red [rural] and light red [metro] counties, plus black [rural] and gray [metro]. Black and gray counties have very high rates of infection – 500 or more new cases per 100,000 residents for the week.)
  • An additional 12 states have more than 90% of their rural counties on the red-zone list.
  • Just nine states (all but two of which are in the South) account for half of all new rural infections last week. These are Texas (14,822 new rural infections), Kentucky (14,635), Mississippi (11,701), Tennessee (11,701), North Carolina (10,829), Georgia (9,483), Indiana (7,520), Florida (7,222), and Ohio (7,071.)
  • Florida had the nation’s worst rural infection rate, at more than 1,000 new cases per 100,000 residents. That means the equivalent of 1% of rural Florida contracted Covid-19 in just the last week.
  • Kentucky was second highest, with a rural infection rate of 801 per 100,000, followed by Tennessee with 768 per 100,000. (Roll over the statewide map to see information on rural infection rates and more.)
  • Connecticut, which has only one rural county, had the best new infection rate – 119 per 100,000 – still high enough to be in the red zone.
  • Other New England states also had low rural rates of infection compared to the rest of the U.S. Maine, New Hampshire, and Vermont, which are also near the top of the list in vaccination rates, had the next best rural rates of infection. Michigan had the fifth best rate, followed by Massachusetts.

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