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These Are the Top 25 COVID Hot Spots in the U.S.

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COVID-19 case counts in the U.S. have continued to fall week over week, based on provisional data from the Centers for Disease Control and Prevention.

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The U.S. tallied about 94,000 reported COVID-19 cases over the seven days ending April 19, and 1,160 deaths in that same time frame. The counts one week earlier were about 101,500 cases and 1,333 deaths. Both tallies have largely trended downward since the start of 2023.

For comparison, the largest loss of life during the pandemic was seen in mid-January 2021, when COVID-19 deaths in the U.S. totaled approximately 23,600 in one week. Weekly deaths dropped to about 1,700 in early July 2021 and hadn’t dipped below that level until recently. The April 19 weekly death count was the lowest it’s been in three years, since very early in the pandemic in March 2020.

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Among the top 25 COVID hot spots in the country of late – as measured by the highest average case counts over a week per 100,000 people – six were in the state of Texas, and four in Nebraska.

Because average case rates are calculated per 100,000 people, it’s worth noting that even a relatively small number of infections in a small community can lead to a higher case rate. San Juan County, Colorado, for instance, had a reported tally of just two cases over a week’s time, but with a recent population of about 700, that translates to an average rate of around 39 daily cases per 100,000 people, giving it among the highest rate of all counties nationwide.

The CDC also lists important caveats to its recent COVID-19 figures, including that five states – Arkansas, Florida, Iowa, Mississippi and Pennsylvania – did not report data in the last update.

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Recent case counts may be of limited use as a COVID surveillance measure, however, particularly given the rise of at-home tests. But other measures also can give a sense of the current state of the pandemic. For example, as the nonpartisan data center USAFacts explains, the CDC has a “community level” metric that looks not only at case rates but also incorporates COVID-19 hospital admissions and the average percentage of hospital beds occupied by COVID-19 patients.

Per CDC calculations based on recent data, across U.S. states, territories and the District of Columbia, 97.7% of “counties” were considered to be at a “low” COVID-19 community level. Less than 1% were at the “high” level, while 1.8% were at the “medium” level. Among its recommendations, the CDC says people living where there is a “high” COVID-19 community level should wear a high-quality mask or respirator.

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A total of 46 states had all counties listed at the “low” or “medium” community levels, including 28 states in which all counties were at the “low” level.

The CDC also lists caveats for its community-level data, including that data was not available for various states and territories.

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