The deadly virus is spreading to small cities that once seemed safe from an outbreak. Some Americans, however, have not accepted the need to wear a mask.
In Boise, Idaho, public health officials were planning to vote on a mask requirement measure. But they had to quickly end their meeting because of fears for their safety.
Anti-mask protesters had gathered outside the building and even at the homes of officials.
One health board member cried as she announced she had to go home to be with her child because of the protesters. They were outside her home playing a recording of gunfire.
"I am sad. I am tired. I fear that, in my choosing to hold public office, my family has too often paid the price," said Ada County Commissioner Diana Lachiondo.
"There is an ugliness and cruelty in our national rhetoric that is reaching a fevered pitch here at home, and that should worry us all," Lachiondo added.
Boise police said they arrested three protesters at her home.
In South Dakota, the mayor of Rapid City said City Council officials were threatened over plans for a citywide mask requirement. The law did not pass. Hospitals across the state are filled with COVID-19 patients.
The United States recorded over 3,000 deaths on December 9, reported the COVID Tracking Project. That marked a single-day record. New cases each day have risen to an average of more than 200,000. The number of patients hospitalized with COVID-19 reached nearly 105,000 on December 8, an all-time high.
At the same time, protesters in Montana's Gallatin County have gathered for two weeks outside the home of county health officer Matt Kelley. The protesters are against new requirements, including a statewide requirement to wear a mask. They have carried signs reading, "We refuse to be your experiment."
Last week, around 80 people lined Bozeman's Main Street to support Kelley and other health officials.
In Montana's Flathead County, officials recorded 17 coronavirus-related deaths over 18 days. Yet resistance to masks is strong. One public health official there is resigning at the end of the year. She said there was little support from local officials for actions that would control the spread.
In Helena, the capital of Montana, Republicans control the legislature. They denied a request by Democratic lawmakers to require that masks be worn inside their own building.
In the American state of Missouri, Greene County officials recorded 51 COVID-19 deaths in the first eight days of December. Hospitals are full and hundreds of health care workers are quarantined. The area's two major hospitals asked the city of Springfield to renew the city's mask requirement before it ends in January. Neither the state nor the county has a mask requirement.
As the deaths increase, Springfield Mortuary Services owner Brian Simmons is caring for the dead as his own 48-year-old daughter battles the virus. Simmons' daughter spent the past week hospitalized on a ventilator in one of the city's nearly full hospitals.
"You are just helpless," he said. "There is nothing you can do about it. We haven't seen her since she's gone in."
The state of South Dakota has suffered through the country's worst rate of COVID-19 deaths over the last week. But Governor Kristi Noem has continued to refuse to require masks or to use other strong measures to slow the infection's spread.
Hospitals in South Dakota are in crisis and patients are being flown out of the state to get treatment.
Dr. Stephen Neabore works in the biggest hospital system in the area. He said that trying to tell people they must wear masks has been a frustrating process.
He said, "I still see people out here that will tell me they don't believe it's any worse than a common cold."
I'm Susan Shand.