After adding over 654,000 new cases throughout the last week, the U.S. now has more than 47.4 million confirmed cases of COVID-19. There have been more than 760,000 COVID-19-related deaths — the highest death toll of any country.

New cases continue to rise, albeit at a slowing rate. In the past week, there were an average of 1.5 daily new coronavirus cases per 100,000 Americans — a decrease from the week prior, when there were an average of 12.9 daily new coronavirus cases per 100,000 people.

While COVID-19 has spread to nearly every part of the country, cities continue to be the sites of major outbreaks. Experts agree that the virus is more likely to spread in group settings where large numbers of people routinely have close contact with one another, such as colleges, nursing homes, bars, and restaurants. Metropolitan areas with a high degree of connectivity between neighborhoods and a large population may be particularly at-risk.

The Cleveland-Elyria, OH, metro area consists of Cuyahoga County, Lorain County, Lake County, and two other counties. In the past week, there were an average of 1.0 new coronavirus cases every day per 100,000 Cleveland residents, in line with the national figure. The metro area’s average daily case growth in the most recent week is a decrease from the week prior, when there was an average of 20.4 daily new cases per 100,000 Cleveland residents.

The spread of coronavirus depends on a variety of factors and can vary even between neighboring counties. Within the Cleveland-Elyria metro area, COVID-19 is growing the fastest in Cuyahoga County. There were an average of 1.2 new cases per day per 100,000 residents in Cuyahoga County during the past week, the most of the five counties in Cleveland with available data.

Case growth in the Cleveland metro area varies at the county level. In Medina County, for example, there were an average of 0.6 new cases per day per 100,000 residents in the past week — the least of any county in Cleveland and more than the case growth rate in Cuyahoga County.

While Cuyahoga County is driving the growth of COVID-19 in the Cleveland area, it does not have the highest incidence of cases overall. As of November 23, there were a total of 12,774.7 confirmed cases per 100,000 residents in Cuyahoga County, the fourth most of the five counties in the metro area. For comparison, the U.S. has so far reported 14,608.9 cases per 100,000 Americans nationwide.

In order to slow the spread of COVID-19, city and county governments have ordered the closure of thousands of consumer-facing businesses. These measures have led to widespread job loss and record unemployment. In Cuyahoga County, unemployment peaked at 22.9% in April 2020. As of June 2021, the county’s unemployment rate was 7.1%.

To determine the county in every metropolitan area where COVID-19 is growing the fastest, 24/7 Wall St. compiled and reviewed data from state and local health departments. We ranked counties according to the average number of new daily COVID-19 cases per 100,000 residents in the seven days ending November 23. To estimate the incidence of COVID-19 at the metropolitan level, we aggregated data up from the county level using boundary definitions from the U.S. Census Bureau. Population data used to adjust case and death totals came from the U.S. Census Bureau’s 2019 American Community Survey and are five-year estimates. Unemployment data is from the Bureau of Labor Statistics and is not seasonally adjusted.

These are all the counties in Ohio where COVID-19 is slowing (and where it’s still getting worse).

Rank in MSA	County	Population	New daily cases per 100,000, week ending November 23	New daily cases per 100,000, week ending November 16	Cumulative cases per 100,000	Cumulative deaths per 100,000
1	Cuyahoga County	1,247,451	1.2	18.2	12,774.7	207.5
2	Geauga County	93,843	0.9	24.4	10,938.5	182.2
3	Lake County	229,954	0.8	22.0	13,160.0	209.6
4	Lorain County	307,670	0.7	24.5	12,877.4	205.1
5	Medina County	177,980	0.6	24.7	13,735.3	192.7

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