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New cases of Covid-19 declined in rural counties last week, but rural areas continue to account for a disproportionate share of new infections and Covid-related deaths.

New infections in rural counties fell by 11% in the week ending Saturday, October 16 -- from about 141,000 two weeks to 125,000 cases last week. Metropolitan counties had a slightly bigger decline of 12%.

Covid-related deaths in rural counties fell by 6.1% last week, from 2,655 to 2,492. Metropolitan counties had a much sharper decline of 14.4%.

As the delta-variant surge cools, rural counties, on average, have continued to have infection rates about 80% higher than metropolitan areas. The gap is worse for Covid-related deaths. Last week’s rural death rate of 5.4 per 100,000 was twice the metropolitan rate of 2.7 per 100,000.

The graph below compares the percentage of the nation’s Covid-related deaths that have occurred in rural counties to the share of the U.S. population that is rural. Last week, rural counties, which contain 14% of the U.S. population, accounted for 25% of the Covid-related deaths.

Red-Zone Counties

  • The number of rural counties in the red zone (defined as have a weekly infection rate of 100 or more cases per 100,000 residents) feel by 78 last week, continuing a three-week decline.
  • States that were first to experience the delta-variant surge are now the ones shedding red-zone counties at the fastest rate. Missouri, which was the launching pad for the summer surge, dropped 19 counties from the rural red-zone list last week. Mississippi dropped 14, and Arkansas dropped nine.
  • Only nine states had more rural red-zone counties last week than two weeks ago. Gains were concentrated in the northern interior. South Dakota added five counties to its rural red-zone list. North Dakota and Montana added three.
  • Alaska, which had nation’s worst rural infection last week, added three county-equivalents to the red-zone list last week.
  • Texas, which had been shedding red-zone counties, added five rural counties last week.

Statewide Rates

  • Alaska’s rural infection rate climbed about 10% last week, to 782 per 100,000. The state’s metropolitan rate was even higher – 879 per 100,000.
  • Several northern states had some of the nation’s highest rural infection rates last week. North Dakota was second, behind Alaska. Montana and Wyoming were fourth and fifth respectively. Idaho was ninth.
  • Great Lakes states that avoided the delta variant surge for months now have some of the nation’s highest rural infection rates. Minnesota and Michigan had the sixth and seventh highest rates respectively.
  • Another hotspot is Central and Northern Appalachia. West Virginia had the nation’s third highest rural infection rate, while Pennsylvania had the eighth highest.
  • Several Southern and Midwestern states that were at the epicenter of the first stages of the delta-variant surge now have some of the lowest rural infection rates. These include Florida, Georgia, Louisiana, Missouri, Mississippi and Arkansas.

Black-Zone Counties

  • National improvement in the rural infection rate is reflected in the decline of “black-zone” counties. These are counties with very high infection rates – over 500 new cases per 100,000 residents in a single week. Rural black-zone counties declined from 312 two weeks ago to 224 last week.

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