After adding over 637,000 new cases throughout the last week, the U.S. now has more than 44.3 million confirmed cases of COVID-19. There have been more than 710,000 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 28.1 daily new coronavirus cases per 100,000 Americans — a decrease from the week prior, when there were an average of 33.4 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 St. Louis, MO-IL, metro area consists of St. Louis County, St. Charles County, the city of St. Louis, and 12 other counties. In the past week, there were an average of 21.2 new coronavirus cases every day per 100,000 St. Louis residents, less than the national figure. The metro area’s average daily case growth in the most recent week is essentially unchanged from the week prior, when there was an average of 26.0 daily new cases per 100,000 St. Louis residents.

The spread of coronavirus depends on a variety of factors and can vary even between neighboring counties. Within the St. Louis metro area, COVID-19 is growing the fastest in Calhoun County, Illinois. There were an average of 48.6 new cases per day per 100,000 residents in Calhoun County during the past week, the most of the 15 counties in St. Louis with available data.

Case growth in the St. Louis metro area varies widely at the county level. In St. Louis city, for example, there were an average of 11.9 new cases per day per 100,000 residents in the past week — the least of any county in St. Louis and far more than the case growth rate in Calhoun County.

While Calhoun County is driving the growth of COVID-19 in the St. Louis area, it does not have the highest incidence of cases overall. As of October 14, there were a total of 14,016.6 confirmed cases per 100,000 residents in Calhoun County, the 10th most of the 15 counties in the metro area. For comparison, the U.S. has so far reported 13,646.9 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 Calhoun County, unemployment peaked at 17.1% in April 2020. As of June 2021, the county’s unemployment rate was 4.9%.

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 October 14. 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 Missouri 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 October 14	New daily cases per 100,000, week ending October 7	Cumulative cases per 100,000	Cumulative deaths per 100,000
1	Calhoun County	4,830	48.6	30.4	14,016.6	41.4
2	Macoupin County	45,463	41.2	50.0	15,056.2	228.8
3	Lincoln County	56,477	40.4	48.7	15,997.7	116.9
4	Jefferson County	223,951	32.1	38.5	14,096.8	142.9
5	Clinton County	37,634	31.3	25.8	18,695.9	271.0
6	Madison County	264,776	24.8	32.6	14,993.1	221.3
7	Franklin County	103,191	23.8	35.2	13,719.2	207.4
8	Warren County	34,453	23.1	40.0	14,280.3	127.7
9	Jersey County	21,937	23.0	30.3	15,189.0	241.6
10	St. Charles County	394,290	22.4	27.7	13,965.1	135.4
11	Bond County	16,589	22.4	26.7	15,233.0	144.7
12	St. Clair County	262,338	18.7	21.2	13,741.4	224.9
13	Monroe County	34,168	18.5	19.9	15,277.5	292.7
14	St. Louis County	996,919	18.2	22.4	12,750.3	251.1
15	St. Louis city	308,174	11.9	13.1	10,057.3	193.7

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