The commonly cited map showing U.S. COVID-19 cases looks a lot like a general map of the nation’s largest metropolitan areas. With the scale of large urban-area infections much greater than the rural rate of infection, the rural cases are lost in the margins.
Today we found county-level data for COVID-19 cases at USAFacts.org. And that allows us to show in a little more detail the nonmetropolitan counties that have reported coronavirus infections.
As of yesterday, March 23, there were 41,096 cases of COVID-19 reported in U.S. counties. (This number doesn’t equal the total reported cases because not every case has been traced back to a specific county.) Of those cases, only 1,313, or 3%, were in a rural or nonmetropolitan county.
Fifteen nonmetropolitan counties have reported one death each from COVID-19. That’s just under 3% of the deaths in our data set.
The map above shows nonmetro counties with no reported coronavirus cases in green. Nonmetro counties with a case of COVID-19 are in orange. Nonmetro counties with a death are in red.
Metropolitan counties are shown in gray so we can highlight what’s being reported in rural America. Again, that’s not because metropolitan counties aren’t important or central to the pandemic.
In fact, the nation’s largest metropolitan counties are the hardest hit from the virus. Nearly 9 out of every 10 cases reported is in a major metropolitan county (a metropolitan area with 1 million or more residents). That’s even though those counties have only about 56% of the U.S. population.
That means the rate at which the disease is being transmitted in major metro counties is much higher than in other parts of the U.S. This chart shows the number of reported cases per million based on the size of metropolitan and nonmetropolitan areas. The nation’s largest metros have an infection rate of more than seven times the nonmetropolitan rate.
Rural areas have the lowest rate of cases, but medium and small-sized metropolitan areas don’t have rates that are that much higher than rural areas. So far, at least.
Now, for the disclaimers. There are a lot of questions about the testing procedures used from state to state. The common story we hear is that most people who think they have COVID-19 are being told to stay home and aren’t being tested. We’ve seen no numbers about the cases of assumed COVID-19. So without widespread testing, and with potentially different testing criteria in different localities, pinning down the geographic distribution of the coronavirus is problematic.
Second, the best data available is coming from state departments of health. That raises even more questions about uniformity in reporting criteria. Another issue is how cases are assigned to a county – by site of the testing or home of the infected person?
But for the time being, this is the best data we have. And we’re certain this won’t be our last attempt to quantify what’s happening in rural America.