The virus' presence became ubiquitous in the United States. In mid-May, 231 of the nation's 3,143 counties had reported no cases of COVID-19. The four counties in the United States that haven't reported a single COVID-19 case have some commonalities.
Americans watched as the novel coronavirus swept through the country this year, eyes glued to colorful maps tracking the virus like a storm as it blasted through New York, spread through meatpacking plants in the Midwest and ravaged schools and nursing homes in the South and West.
Rural and isolated areas are the opposite of a monolith. America's last COVID-free counties span the oil fields of Texas, high desert towns in Nevada, a popular Alaskan port city and a Hawaiian peninsula where historically, patients with leprosy were forced to live in isolation. It's a land of wide-open skies and few people. Until an oil boom that picked up about a decade ago, Carr said, there was nothing, not even telephones lines, to obscure the sunset.
Not counting the oil worker infections is a relic of the Trump administration's decision not to count COVID-19 cases from cruise ships in states' COVID-19 tallies, explained Caballero. Skagway Municipality, Alaska: 'You're trying to curse us.'"You’re trying to curse us," Brad Ryan, the city manager, told ABC News when asked about Skagway's zero COVID-19 cases.
Skagway is also doing a significant level amount of COVID testing for a rural area. As of mid-October, Skagway had conducted more than 700 tests at its three public COVID-19 testing sites, a number which doesn't include additional testing conducted by private providers.
"The average age is 86 and they have numerous medical conditions," Wasserman said of the remaining patients. Because their age and underlying conditions make patients especially vulnerable to COVID-19 complications, the settlement has strict policies in place to protect them. Patients and staff aren't allowed visitors and if they leave the settlement and return, they're required to quarantine. Staff temperatures are monitored and social distancing and mask wearing are enforced.
"We have to be prepared for getting cases of COVID-19 and in the meantime do our best to prevent any infections," he added."It only takes one person coming in who is infected."
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