SANTA FE, N.M. (AP) — As the coronavirus rages across the United States, mainly in large urban areas, more than one-third of U.S. counties have yet to report a single positive test result for Covid-19 infections.
Data compiled by Johns Hopkins University show that 1,297 counties have no confirmed cases of Covid-19 out of 3,142 counties nationwide. But the number of counties without a positive coronavirus case has declined rapidly. Of the counties without positive tests, 85% are in rural areas — from predominantly white communities in Appalachia and the Great Plains to majority Hispanic and Native American stretches of the American Southwest — that generally have less everyday contact between people that can help transmit the virus.
Counties with zero positive tests for Covid-19 also have a higher median age and higher proportion of people older than 60 — the most vulnerable to severe effects of the virus — and far fewer intensive care beds, should they fall sick. Median household income is lower, too, potentially limiting health care options.
The demographics of these counties hold major implications as the Trump administration develops guidelines to rate counties by risk of the virus spreading, empowering local officials to revise social distancing orders that have sent much of the U.S. economy into freefall. President Trump on Sunday extended the country's voluntary national shutdown for a month, significantly changing his tone on the coronavirus pandemic.
Experts in infectious disease see an opportunity for slowing the spread of coronavirus in remote areas of the country that benefit from natural social distancing and isolation, if initial cases are detected and quarantined aggressively. That can buy rural health care networks time to provide care and reduce mortality.
But they also worry that sporadic testing for coronavirus could be masking outbreaks that, left unattended, might overwhelm rural health networks.
"They'll be later to get the infection, they'll be later to have their epidemics," said Christine K. Johnson, a professor of epidemiology at the University of California, Davis. "But I don't think they're going to be protected because there's nowhere in the U.S. that's isolated."
Counties that have zero confirmed Covid-19 cases could raise a red flag about inadequate testing, she said.
"I hope the zeroes are really zeroes — I worry that they're not doing enough testing in those regions because they're not thinking they're at risk," she said.
In New Mexico, a state with 2 million residents in an area the size of Italy, Democratic Gov. Michelle Lujan Grisham has moved aggressively to contain the coronavirus with a statewide school shutdown and prohibition on most gatherings of over five people.
Nearly half of the state's 33 counties are free of any reported coronavirus cases. New Mexico is among the top five states in coronavirus testing per capita, though some virus-free counties aren't yet equipped with specialized testing sites beyond samplings by a handful of doctors’ offices.
Torrance County Manager Wayne Johnson said plans are being made for the first three dedicated Covid-19 testing sites in the high-desert county of 15,000 residents that covers an area three times the size of Rhode Island.
A statewide stay-at-home order is keeping many residents from commuting to jobs in adjacent Bernalillo County, home to Albuquerque and the epicenter of the state's Covid-19 infections, with 93 confirmed cases out of a state government tally of 208 as of Saturday night.
