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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

In photos: Black Friday shopping across the U.S.

Customers shop at Macys on Nov. 27 in New York City. Photo: Kena Betancur/AFP via Getty Images

Many Americans braved shopping malls and department stores to shop in-person on Black Friday.

Why it matters: Coronavirus infections are still on the rise across much of the U.S. during a season of travel and holiday gatherings. Hospitals across the country, especially in rural areas, are still overwhelmed.

22 hours ago - Health

WHO: AstraZeneca vaccine must be evaluated on "more than a press release"

A medical syringe and vial with fake coronavirus vaccine in front of the World Health Organization (WHO) logo. Photo Illustration: Pavlo Gonchar/SOPA Images/LightRocket via Getty Images

Top scientists at the World Health Organization on Friday called for more detailed information on a coronavirus vaccine developed by AstraZeneca and the University of Oxford.

Why it matters: Oxford and AstraZeneca have said the vaccine was 90% effective in people who got a half dose followed by a full dose, and 62% effective in people who got two full doses. AstraZeneca has since acknowledged that the smaller dose received by some participants was the result of an error by a contractor, per the New York Times.

Updated 21 hours ago - Sports

NFL reschedules Thanksgiving matchup for second time due to COVID outbreak

Photo: Rob Carr/Getty Images

The NFL has once again postponed a Baltimore Ravens-Pittsburgh Steelers matchup originally scheduled for primetime on Thanksgiving day due to a COVID-19 outbreak.

Why it matters: It's the first time the league has had to scrap a game since October, as the U.S. copes with another surge in coronavirus infections heading into the holidays.