Americans watched as the novel coronavirus swept through the country this year, eyes glued to colorful maps tracking the virus like a storm as it blasted through New York, spread through meatpacking plants in the Midwest and ravaged schools and nursing homes in the South and West.
The virus' presence became ubiquitous in the United States. In mid-May, 231 of the nation’s 3,143 counties had reported no cases of COVID-19. By mid-October, only six U.S. counties reported being COVID-free. This week, as the virus rages toward a third peak, with new infections concentrated in the Midwest and upwards of 50,000 cases a day nationwide, that number shrunk to four.
The four counties in the United States that haven’t reported a single COVID-19 case have some commonalities. They’re sparsely populated and geographically isolated. They’re solidly middle-class. In two counties, tourism has ground to a sudden halt because of the pandemic. But testing in areas without strong health infrastructure can complicate the picture, experts warn. You can’t report COVID-19 cases if you don’t test for them, and rural America has historically lacked access to health resources available in more populated areas.
Rural and isolated areas are the opposite of a monolith. America’s last COVID-free counties span the oil fields of Texas, high desert towns in Nevada, a popular Alaskan port city and a Hawaiian peninsula where historically, patients with leprosy were forced to live in isolation.
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