COVID-19 is spreading fast in nursing homes, homeless shelters, jails, and South Dakota

South Dakota is one of five states — all largely rural, all headed by Republican governors — that have not issued statewide shelter-in-place orders to limit the spread of the COVID-19 coronavirus. "South Dakota is not New York City," Gov. Kristi Noem (R) said earlier this month. On Monday, 57 more workers at a pork processing plant in Sioux Falls tested positive for COVID-19, bringing the total at the plant "well above 300 — and making it one of the country's largest clusters," along with Chicago's Cook County Jail and the USS Theodore Roosevelt, The Washington Post reports. South Dakota currently has 868 confirmed COVID-19 cases and six deaths in a state with fewer than 900,000 residents.

Rural areas are particularly vulnerable to the economic and medical costs of the pandemic. In justifying her decision to keep South Dakota off lockdown, Noem argued that individuals, not the state, "are primarily responsible for their safety" and "entrusted with expansive freedoms." That's not true of prisons, homeless shelters, and nursing homes, all of which are also becoming significant vectors of transmission.

"At least 2,300 long-term care facilities in 37 states have reported positive cases of COVID-19," and "more than 3,000 residents have died," USA Today reports, citing incomplete state data since the federal government isn't tracking cases in America's 15,600 nursing homes. But "nursing homes have emerged as a blind spot for COVID-19 around the world," Politico notes, and in the few countries that strictly report the figures, roughly half of COVID-19 deaths are in care homes.

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Coronavirus is also spreading quickly through the homeless populations of New York City, San Francisco, and other metropolitan areas, The New York Times and Stat News detail, putting specific strains on already overburdened homeless shelters and hospitals.

Cook County Jail stands as the largest single point of infection in the U.S., though, with more than 500 people testing positive so far. Illinois and local officials are releasing hundreds of non-violent offenders from the jail, but thousands won't be released, and social distancing and frequent hand-washing aren't possible in a crowded prison. "I feel for a lot of the guys in there that can't get out of there — knowing that they're going to die in there," a released Cook County Jail inmate named Linn told NPR.