The U.S. has reported more than 32.0 million confirmed COVID-19 cases as of May 4, 2021. More than 570,000 Americans have died of COVID-19 — the highest death toll of any country.

The virus has spread throughout the country in a way that has been difficult to predict, surging in one region, then showing signs of improvement, and then reappearing in other regions. Though local outbreaks may ebb and flow, the current surge in cases has been felt nearly nationwide, leading to new travel restrictions and business closures around the country.

Nationwide, there were an average of 15.6 daily new coronavirus cases per 100,000 Americans in the week ending May 4, 2021. Cumulatively, the U.S. has reported 9,806.5 cases per 100,000 Americans, and 174.8 deaths per 100,000 Americans.

The extent of the spread of the novel coronavirus continues to vary considerably from state to state, and even from county to county. Even as the number of daily new cases is flattening or even declining in some parts of the country, new cases are surging at a growing rate in others.

The coronavirus has spread to different parts of the country in different stages throughout the pandemic. In the spring, the worst hit states were in the Northeast, as New York City became the epicenter of the nation’s crisis. The virus spread to states throughout the Sun Belt in the summer, and hit states in the Midwest and West during the fall. By November 2020, nearly every state was categorized as a COVID-19 hot spot, according to definitions based on new cases per capita from the nonprofit health organization Kaiser Family Foundation.

In Virginia, there were an average of 12.3 daily new coronavirus cases per 100,000 residents in the week ending May 4, 2021. The Virginia case growth rate ranks as the 20th lowest of all 50 states.

While the nation’s largest counties were hit hardest in the early months of the pandemic, nearly every county has suffered from the coronavirus. Outbreaks can occur quickly in places where large numbers of people tend to congregate, leaving counties with colleges, correctional facilities, and nursing homes particularly at risk.

In Caroline County, there were an average of 53.2 new confirmed cases per day per 100,000 residents in the week ending May 4, 2021 — the highest rate of any county in Virginia. Since the pandemic began, the county has reported 2,555 confirmed cases, or 8,464.7 cases per 100,000.

There have been 35 deaths, or 116.0 deaths per 100,000 residents.

To determine the county in each state with the highest rate of daily cases of the virus, 24/7 Wall St. compiled and reviewed data from state and local health departments. We ranked counties according to the average new number of cases per 100,000 residents per day during the week ending May 4, 2021. Population data used to adjust case and death totals came from the U.S. Census Bureau’s 2018 American Community Survey and are five-year estimates.

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

No.	County	Population	New daily cases per 100,000	Total cases	Total deaths	Cases per 100,000	Deaths per 100,000
1	Caroline County	30,184	53.2	2,555	35	8,464.7	116.0
2	Galax city	6,638	48.0	1,155	51	17,399.8	768.3
3	Fluvanna County	26,282	47.1	1,904	17	7,244.5	64.7
4	Norton city	3,990	34.8	283	7	7,092.7	175.4
5	Smyth County	31,059	33.2	2,890	91	9,304.9	293.0
6	Bristol city	16,843	33.1	1,465	33	8,698.0	195.9
7	Wythe County	28,940	26.6	2,604	78	8,997.9	269.5
8	Petersburg city	31,827	26.3	3,812	84	11,977.3	263.9
9	Warren County	39,449	25.5	2,907	55	7,369.0	139.4
10	Fredericksburg city	28,469	25.4	2,093	23	7,351.9	80.8
11	Grayson County	15,811	24.3	1,444	34	9,132.9	215.0
12	King William County	16,497	23.8	1,197	11	7,255.9	66.7
13	Cumberland County	9,786	23.1	473	9	4,833.4	92.0
14	Shenandoah County	43,045	23.0	4,260	130	9,896.6	302.0
15	Carroll County	29,738	23.0	2,603	69	8,753.1	232.0
16	Hopewell city	22,408	22.8	2,559	71	11,420.0	316.9
17	Prince George County	37,894	22.1	3,489	27	9,207.3	71.3
18	Richmond County	8,878	21.4	1,492	15	16,805.6	169.0
19	Alleghany County	15,286	20.7	1,336	48	8,740.0	314.0
20	Giles County	16,814	20.0	1,257	21	7,475.9	124.9
21	Colonial Heights city	17,593	20.0	1,682	61	9,560.6	346.7
22	Buena Vista city	6,399	19.8	897	19	14,017.8	296.9
23	Frederick County	85,153	19.4	7,847	100	9,215.2	117.4
24	Radford city	17,630	18.1	2,112	18	11,979.6	102.1
25	Spotsylvania County	131,412	17.9	9,733	115	7,406.5	87.5
26	Stafford County	144,012	17.7	11,106	75	7,711.9	52.1
27	Amelia County	12,854	17.6	881	31	6,853.9	241.2
28	Orange County	35,612	17.6	2,165	39	6,079.4	109.5
29	Washington County	54,406	17.5	4,838	106	8,892.4	194.8
30	Page County	23,749	17.3	2,011	57	8,467.7	240.0
31	Danville city	41,512	17.3	4,348	134	10,474.1	322.8
32	Pulaski County	34,234	16.6	2,612	61	7,629.8	178.2
33	Portsmouth city	95,311	16.6	8,926	188	9,365.1	197.2
34	Craig County	5,113	16.4	309	5	6,043.4	97.8
35	Lynchburg city	80,131	15.5	7,625	146	9,515.7	182.2
36	Salem city	25,519	15.2	2,134	47	8,362.4	184.2
37	Chesterfield County	339,447	14.6	27,290	423	8,039.5	124.6
38	Lexington city	7,110	14.4	1,171	32	16,469.8	450.1
39	Wise County	39,025	14.3	3,127	96	8,012.8	246.0
40	Chesapeake city	237,820	14.3	20,674	289	8,693.1	121.5
41	Virginia Beach city	450,135	14.3	35,470	386	7,879.9	85.8
42	Henrico County	325,642	14.2	25,038	602	7,688.8	184.9
43	Newport News city	180,145	14.2	13,794	224	7,657.2	124.3
44	Mecklenburg County	30,847	14.1	2,270	66	7,358.9	214.0
45	Waynesboro city	21,926	14.1	2,347	38	10,704.2	173.3
46	Rappahannock County	7,332	13.9	347	2	4,732.7	27.3
47	Lunenburg County	12,278	13.8	761	13	6,198.1	105.9
48	Prince William County	456,749	13.5	44,663	482	9,778.5	105.5
49	Hampton city	135,583	13.5	10,275	172	7,578.4	126.9
50	Campbell County	55,170	13.5	4,407	84	7,988.0	152.3
51	Harrisonburg city	53,391	13.2	6,458	95	12,095.7	177.9
52	Goochland County	22,482	13.1	1,434	23	6,378.4	102.3
53	Louisa County	35,380	13.0	1,954	32	5,522.9	90.4
54	Hanover County	104,449	13.0	8,000	154	7,659.2	147.4
55	Manassas Park city	16,423	12.9	1,214	12	7,392.1	73.1
56	Tazewell County	42,080	12.9	3,592	67	8,536.1	159.2
57	Loudoun County	385,143	12.8	27,391	274	7,111.9	71.1
58	Prince Edward County	22,956	12.8	2,125	34	9,256.8	148.1
59	Norfolk city	245,592	12.7	17,401	254	7,085.3	103.4
60	Westmoreland County	17,638	12.7	1,265	24	7,172.0	136.1
61	Clarke County	14,365	12.6	967	19	6,731.6	132.3
62	Suffolk city	89,160	12.3	7,834	186	8,786.5	208.6
63	Montgomery County	97,997	12.2	9,292	91	9,481.9	92.9
64	Powhatan County	28,574	11.8	1,891	16	6,617.9	56.0
65	Winchester city	27,789	11.8	2,826	44	10,169.5	158.3
66	Charles City County	6,995	11.7	498	15	7,119.4	214.4
67	Sussex County	11,486	11.5	1,182	21	10,290.8	182.8
68	Patrick County	17,859	11.5	1,339	43	7,497.6	240.8
69	Rockingham County	79,444	11.5	6,689	105	8,419.8	132.2
70	New Kent County	21,103	11.4	1,480	16	7,013.2	75.8
71	Buckingham County	17,004	11.0	2,119	30	12,461.8	176.4
72	Culpeper County	50,450	10.8	4,550	61	9,018.8	120.9
73	Fauquier County	69,115	10.7	4,631	64	6,700.4	92.6
74	Richmond city	223,787	10.7	16,823	257	7,517.4	114.8
75	King George County	25,890	10.6	1,662	19	6,419.5	73.4
76	York County	67,587	10.6	3,697	52	5,470.0	76.9
77	Scott County	22,009	10.6	1,809	52	8,219.4	236.3
78	Isle of Wight County	36,372	10.2	3,114	66	8,561.5	181.5
79	Charlotte County	12,095	10.1	843	18	6,969.8	148.8
80	Albemarle County	106,355	10.0	5,708	83	5,366.9	78.0
81	Greensville County	11,659	10.0	1,569	25	13,457.4	214.4
82	Franklin city	8,211	9.9	1,132	32	13,786.4	389.7
83	Bath County	4,393	9.8	270	10	6,146.1	227.6
84	Greene County	19,410	9.7	1,243	17	6,403.9	87.6
85	Augusta County	74,701	9.6	5,727	70	7,666.6	93.7
86	Arlington County	231,803	9.5	15,121	252	6,523.2	108.7
87	Rockbridge County	22,509	9.5	1,513	46	6,721.8	204.4
88	Bland County	6,447	9.5	669	10	10,376.9	155.1
89	Amherst County	31,882	9.3	2,907	35	9,118.0	109.8
90	Roanoke County	93,583	9.1	8,139	139	8,697.1	148.5
91	Bedford County	77,908	9.1	6,275	99	8,054.4	127.1
92	James City County	74,153	9.0	4,556	72	6,144.1	97.1
93	Fairfax County	1,143,529	9.0	75,942	1,073	6,641.0	93.8
94	Alexandria city	156,505	8.9	11,671	133	7,457.3	85.0
95	Accomack County	32,742	8.9	2,812	41	8,588.4	125.2
96	Covington city	5,582	8.8	591	13	10,587.6	232.9
97	Pittsylvania County	61,676	8.8	5,493	78	8,906.2	126.5
98	Southampton County	17,939	8.8	1,970	56	10,981.7	312.2
99	Roanoke city	99,621	8.7	8,377	190	8,408.9	190.7
100	Martinsville city	13,101	8.7	1,583	76	12,083.0	580.1
101	Madison County	13,139	8.7	608	16	4,627.4	121.8
102	Surry County	6,600	8.7	421	9	6,378.8	136.4
103	Dinwiddie County	28,308	8.3	2,099	42	7,414.9	148.4
104	Appomattox County	15,577	8.0	1,583	24	10,162.4	154.1
105	Buchanan County	22,138	7.6	1,410	38	6,369.1	171.7
106	Staunton city	24,452	7.5	2,503	70	10,236.4	286.3
107	Russell County	27,408	7.4	2,244	38	8,187.4	138.6
108	Northampton County	11,957	7.2	797	36	6,665.6	301.1
109	Halifax County	34,779	7.0	2,782	77	7,999.1	221.4
110	Nottoway County	15,500	7.0	1,900	48	12,258.1	309.7
111	Floyd County	15,666	6.9	845	21	5,393.8	134.0
112	Williamsburg city	14,788	6.6	758	12	5,125.8	81.1
113	Brunswick County	16,665	6.2	1,298	21	7,788.8	126.0
114	Falls Church city	14,067	6.2	423	9	3,007.0	64.0
115	Botetourt County	33,222	5.8	2,504	36	7,537.2	108.4
116	Manassas city	41,457	5.7	4,304	47	10,381.8	113.4
117	Henry County	51,588	5.7	4,498	121	8,719.1	234.6
118	Gloucester County	37,161	5.5	2,180	48	5,866.4	129.2
119	Essex County	11,036	5.0	753	9	6,823.1	81.6
120	Franklin County	56,233	4.9	3,997	74	7,107.9	131.6
121	Highland County	2,214	4.6	108	1	4,878.0	45.2
122	Nelson County	14,812	4.4	887	12	5,988.4	81.0
123	Lee County	24,134	4.4	2,413	46	9,998.3	190.6
124	Dickenson County	14,960	4.4	921	15	6,156.4	100.3
125	King and Queen County	7,052	4.3	388	8	5,502.0	113.4
126	Northumberland County	12,223	4.2	741	20	6,062.3	163.6
127	Poquoson city	12,039	4.1	871	16	7,234.8	132.9
128	Fairfax city	23,865	3.1	550	19	2,304.6	79.6
129	Emporia city	5,381	3.0	669	42	12,432.6	780.5
130	Charlottesville city	47,042	2.8	4,017	55	8,539.2	116.9
131	Mathews County	8,796	2.6	595	12	6,764.4	136.4
132	Lancaster County	10,804	2.1	710	16	6,571.6	148.1
133	Middlesex County	10,700	1.7	569	20	5,317.8	186.9

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