The coronavirus pandemic continues its deadly march through rural counties and small towns across the country, led by flareups in Southern and Midwestern states that are becoming new epicenters of the outbreak.
Almost 80 percent of Americans now live in counties where the virus is spreading widely, according to an analysis by the Brookings Institution demographer William Frey.
In the last week, 176 counties have started to see substantial spread of the virus. The vast majority of those, 159, are smaller exurban or rural counties. The increased transmission in those areas shows the virus's spread outward from its initial hubs in major cities like New York, Detroit, San Francisco, Seattle and New Orleans and into neighboring regions.
But the virus is also beginning to attack some cities that avoided an initial wave, a troubling reminder that it could still infect millions of Americans who have so far been safe.
Highly populated areas like Tampa and St. Petersburg, Fla., are now reporting dozens of new cases. Collin County, Texas, in the Dallas metroplex, and Wake County, N.C., are also showing signs of broader spread.
So are smaller, more rural communities like Yell County, Ark., and exurban areas outside of major cities like Minneapolis, Milwaukee and Columbus, Ohio.
"The U.S. is very large and diverse in terms of population density and movement. This is partially why we are seeing different experiences across the country," said Amira Roess, an epidemiologist at George Mason University's College of Health and Human Services. "In general, we are continuing to see outbreaks in less urban areas in the U.S."
In the last week, more than half the counties reporting widespread infection for the first time are suburban, and almost 30 percent are rural or small-town counties. Only 15 percent of those are urban cores like Tampa and St. Petersburg, Fla.
Most of the counties now reporting high prevalence, 59 percent, are in Southern states. Midwestern counties make up 22 percent of those newly worrying counties, and Western counties make up 17 percent. Only a few Northeastern counties — two in New York and one in Maine — have been added to the highly prevalent list, in part because the region was hit so hard in the virus's first wave.
As the virus spreads to more rural areas, it is increasingly presenting a risk to President TrumpDonald TrumpKinzinger says Trump 'winning' because so many Republicans 'have remained silent' Our remote warfare counterterrorism strategy is more risk than reward Far-right rally draws small crowd, large police presence at Capitol MORE's most ardent supporters. The 176 counties where the virus is newly spreading collectively gave Trump almost 53 percent of the vote in the 2016 presidential election, and gave Democratic nominee Hillary ClintonHillary Diane Rodham ClintonClinton lawyer's indictment reveals 'bag of tricks' Attorney charged in Durham investigation pleads not guilty Attorney indicted on charge of lying to FBI as part of Durham investigation MORE just 41 percent of the vote.
More than three times as many counties where the virus is spreading widely favored Trump over Clinton, according to Frey's analysis.
"There is a clear trend in the works among counties now experiencing a high COVID-19 prevalence for the first time," Frey wrote. "Compared to the counties where the pandemic first hit, these look much more like the rest of America, and in particular, reflect the kinds of areas that carried President Trump to victory in 2016."
The electoral calculus matters in part because those residents of more rural and conservative areas are the most likely to listen to and trust advice coming from Trump himself.
Trump has downplayed the threat of the virus from its earliest days, and in recent weeks, he has called on governors to begin unlocking their economies, hopeful that a rebounding economy would aid his reelection chances this year.
If the president tells Americans to continue practicing social distancing, even as economies reopen, he could possibly influence the people who are just now becoming more likely to be exposed to the virus.
The virus arriving in Trump country "suggests that rhetoric from some of the president's supporters against maintaining public health measures may become more muted," Frey wrote.