The hardest-hit states, based on trailing one-week new cases per capita, are now North Dakota, South Dakota, Montana, Wisconsin and Utah, according to the most recent data from Johns Hopkins University. Hospitalizations are also on the rise in all five, Covid Tracking Project data show.

President Donald Trump was set to return to the campaign trail this week after his own Covid-19 hospitalization, resuming rallies where mask and social-distancing guidelines have frequently been ignored.

Nationally, the seven-day average of new Covid-19 cases was 48,793, the highest since mid-August. Rural areas continue to be worst hit on the basis of per-capita cases, but towns and small cities are right behind. Metropolises look comparatively better, though cases have started to tick up from a low base in some major cities, too.