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Data: CSSE Johns Hopkins University, National Center of Health Statistics, U.S. Census Bureau; Chart: Andrew Witherspoon/Axios

This wave of coronavirus infections is hitting rural areas especially hard. While big cities have more total cases, rural areas are seeing more cases per capita — and they're at greater risk of running out of hospital capacity as cases pile up.

Why it matters: What started as an urban problem in the spring is now everyone's problem.

Between the lines: Rural communities in the U.S. have more vulnerable health care systems and more vulnerable populations. Many are on the verge of becoming overwhelmed by coronavirus patients as caseloads continue to grow.

  • Coronavirus patients are occupying the highest portions of hospital beds in Midwestern and Mountain West states. And hospitalizations tend to trail cases by a few weeks, meaning the burden on hospitals is only likely to get worse.
  • As the outbreak also continues to grow in big cities, rural systems may end up with nowhere to send patients after they run out of room to treat them.
  • Health care workers are less likely to be able to temporarily relocate to hotspots, as they'll be needed in their own communities.

Zoom in: Childress County, Texas, has the highest per capita case rate in the country, with 91 cases per day in a county of just over 7,200 people — or 1,265.3 cases per 100,000 people.

The bottom line: "We have legitimate reason to be very, very concerned about our health system at a national level," Lauren Sauer, an assistant professor of emergency medicine at Johns Hopkins University, told NPR.

Go deeper

Jan 30, 2021 - World

Germany to impose travel restrictions to curb spread of coronavirus variants

Border police officers check passports and COVID-19 tests at Frankfurt Airport. Photo: Thomas Lohnes via Getty Images

Germany announced Friday that it was imposing new travel restrictions in an effort to curb the spread of more contagious coronavirus variants.

Details: All non-German residents traveling from countries deemed "areas of variant concern," including the United Kingdom, South Africa, Portugal, Ireland, Brazil, Lesotho and Eswatini, will be banned from entering the country, even if they test negative for the coronavirus.

Jan 30, 2021 - World

Science helps New Zealand avoid another coronavirus lockdown

New Zealand Prime Minister Jacinda Ardern (L) visits a lab at Auckland University in December. Photo: Phil Walter/Getty Images

New Zealand has avoided locking down for a second time over COVID-19 community cases because of a swift, science-led response.

Why it matters: The Health Ministry said in an email to Axios Friday there's "no evidence of community transmission" despite three people testing positive after leaving managed hotel isolation. That means Kiwis can continue to visit bars, restaurants and events as much of the world remains on lockdown.

Jan 29, 2021 - Health

J&J says its one-shot vaccine is 66% effective against moderate to severe COVID

Photo: Thiago Prudêncio/SOPA Images/LightRocket via Getty Images

Johnson & Johnson announced Friday that its single-shot coronavirus vaccine was 66% effective in protecting against moderate to severe COVID-19 disease in Phase 3 trials, which was comprised of nearly 44,000 participants across eight countries.

Between the lines: The vaccine was 72% effective in the U.S., but only 57% effective in South Africa, where a more contagious variant has been spreading. It prevented 85% of severe infections and 100% of hospitalizations and deaths, according to the company.