Three months after the Joplin region became the country's No. 1 hot spot for the average daily growth rate of COVID-19 cases over the previous seven days, it is creeping back in that direction, although this time the growth rate is much lower.

On Thursday, the Joplin area ranked 32nd among more than 300 regions in the country monitored by the Dartmouth Atlas of Healthcare Project, with an average daily growth rate of 1.6% over the past seven days. Springfield ranked sixth in the nation, with an average daily growth rate of 2.5%.

The Dartmouth project bases its analysis on what it calls "the natural markets where residents of the United States receive their care" and breaks the country into 306 hospital referral regions. County case and death rates are aggregated to each of those regions.

Tony Moehr, administrator of the Jasper County Health Department, said he also has noted the number of cases tracking upward.

He said the county's first cases were international travelers who came back and self-quarantined, with little spread initially. Then it spread to manufacturing and other companies, and there was a surge. At that point, he said, the county was seeing 50 to 60 cases a day.

By mid-to-late July and early August it had slowed down.

"We dropped down to where we were seeing eight to 10 cases a day," Moehr said.

But in mid-to-late August and into September, the number of cases has been climbing again.

"In the last 14 days we had 350 cases," he said. "That's probably 25 per day. What we're seeing is pretty much related to community spread."

Larry Bergner, administrator of the Newton County Health Department, also has seen a bump.

Throughout August, its rate of new cases was 19.9 per 100,000 population; now it is 31.14 per 100,000.

As of Thursday, the Joplin metro area of Jasper and Newton counties reported around 4,700 total cases since the pandemic began. The region crossed the 4,000-case count on Sept. 8, less than three weeks after the metro area topped 3,000 cases, which occurred around Aug. 20. The region topped 2,000 cases around July 15 and reached its first 1,000 cases on June 28.

On Thursday, the city of Joplin also reported a record high of 208 active cases.

Referral region

On June 15, the Joplin hospital referral region had the nation's highest growth rate of COVID-19 cases over the past seven days, hitting 10.4%. The region remained the nation's top spot for 10 of the next 11 days, peaking with a growth rate of 15.7% on June 21.

After that, Joplin continued to fall back, dropping to a low at one point of 236th place out of the 306 regions. That was on Aug. 5, with a 0.9% average daily growth rate for new COVID-19 cases over the previous seven days.

Since then, however, the region has been climbing back toward the top spot, although the area's growth rate has never gotten higher than 1.8% in recent weeks. The Joplin hospital referral region over the past week has bounced between 27th and 39th place among the 306 regions around the country.

On Thursday, the Joplin region also ranked 25th in the country for the number of new COVID-19 cases over the last 14 days per 100,000 residents. According to the Dartmouth project, the region reported 1,456 cases over the last 14 days, or a rate of 387 per 100,000 residents.

The region covers parts of Southeast Kansas, Southwest Missouri to the Arkansas line and parts of Northeast Oklahoma.

"I'd certainly like to be going into fall in better shape than we are right now," Moehr said, referring to the beginning of flu season.