The United States reported 83,757 new cases of COVID-19 Oct. 23, according to data compiled by Johns Hopkins University. The figure sets a record for single-day new cases in the U.S. and marks the fifth consecutive day of increased new case totals, according to the Wall Street Journal.
Broader areas of the country are reporting increased cases compared with the spring and summer surges in the U.S., when outbreaks were largely concentrated in a handful of states. As of Oct. 24, South Dakota, Idaho, Wyoming and Iowa had the highest positivity rates in the country, all topping 23 percent.
COVID-19 hospitalizations are up nationwide, currently at 41,485 — the most recorded in a single day since Aug. 21. The number of current hospitalizations are at record levels in Iowa, Kentucky, North Dakota and West Virginia, according to the COVID Tracking Project.
Hospitals and health systems in many rural areas, like Idaho, are feeling the strain. The state reported 193 COVID-19 hospitalizations Oct. 23, with 54 patients in the ICU. The relatively small figures can be deceptive: Idaho has about 18 people per each square mile compared to the national average of 87.
"We've essentially shut down an entire floor of our hospital. We've had to double rooms. We've bought more hospital beds," Robert Scoggins, MD, a pulmonologist with Kootenai Health in Coeur d'Alene, Idaho, told ABC News. "Our hospital is not built for a pandemic."
Kootenai's medical surgical units were 96 percent full Oct. 23, a spokesperson told ABC News.
Rural America has also been hit hard by hospital closures over the past 10 years: 120 rural hospitals closed between Jan. 1, 2010, and Dec. 31, 2019, as tracked by the Cecil G. Sheps Center for Health Services Research.