Texas:Only one county in the United States still has zero reported cases of COVID-19 in mid-November, after more than eight months of the pandemic.

Coronavirus cases are trending upwards in all but one U.S. state and have infected Americans in all but one locality: Loving County, Texas. With a population of 169 people, according to the most recent U.S. Census numbers, Loving County, Texas, is the lone municipality never to record a single positive case of coronavirus. Loving County is the second-least populous in the U.S., behind Hawaii’s Kalawao County, but the least populated in the lower 48 states.

Newsweek reached out to several officials including Judge Skeet Lee Jones in Loving County, Texas, Saturday morning for reaction. A county official noted most local offices have “not been open on a weekend since the Cold War.”

Texas health department data shows the the state surpassed one million COVID-19 cases last week, as Governor Greg Abbott expressed concern about the increasing spread of the virus. Dallas County Judge Clay Jenkins said DFW Hospital Council statistics show they have reached 94 percent of their peak hospital room. Regional health officials say it’s unclear if any Loving residents have taken recent COVID tests.

“The rate of community spread has our local health authority and our regional hospital administrators concerned that we are quickly approaching caseloads that will be unbearable for our facilities and personally catastrophic for our families,” Abbott announced Friday.

As of Friday, hospitalizations for COVID-19 set a national record for a fourth straight day, with 68,516 people currently receiving major treatment, the latest COVID Tracking Project data shows.

Meanwhile, Nevada Governor Steve Sisolak tested positive for coronavirus on the same day one of the country’s last two tiny communities not touched by the virus—Nevada’s Esmeralda County—recorded its first case.

As the Reno Gazette Journal reported Friday, Nevada broke its own previous pandemic record with 1,857 new coronavirus cases there in the past 24 hours. Esmeralda County election officials said the penultimate place to receive a coronavirus infection was likely from a poll worker who was working during last week’s election.

“In response to that, we have shut down the courthouse. And the people that were working with the volunteers with the election are all going to get tested. So we’re just kind of waiting to see what the results are,” Esmeralda County Commissioner Tim Hipp told.

Sisolak’s positive coronavirus testing result makes him the fifth U.S. state leader to have that diagnosis over the past eight months of the pandemic. But Nevada is among 49 states that are seeing cases trend upwards across even the most remote parts of the country this week. North Dakota Governor Doug Burgum on Friday ordered a statewide mask mandate and imposed several new restrictions on local businesses after the hospital capacity hit a breaking point.

New Mexico and Oregon state leaders also announced new social distancing restrictions as their case numbers, deaths and hospitalizations also began moving upwards in recent weeks.

One upshot after eight months of the pandemic, according to the University of Washington’s Institute for Health Metric and Evaluation model, is that hospitals across the U.S. are getting much better at treating the virus. Improved treatments have decreased COVID-19’s fatality rate by 30 percent since April.

President Donald Trump on Friday remarked that Operation Warp Speed, the White House Coronavirus Task Force’s project to create a coronavirus vaccine, “is unequaled and unrivaled anywhere in the world.” He expects several vaccinations within a matter of days. Trump did not mention the upward trend in new cases in 49 states during his Rose Garden address.