As of 4/6/20 there has been at least one positive test in two-thirds of the rural counties, and at least one death due to COVID-19 in one-tenth of the rural counties in the USA. (Source: New York Times)
Confirmed cases per 100,000 population is less than urban areas, but this is on the increase in rural counties.
The NY Times reported a lingering attitude of denial: Being from a small town, you think it's never going to reach you. My own observation is that when the weather is nice, the boys still gather in the town park, shoot a few hoops, call up their buddies to join in, and soon there are 8 or 10 players on the outdoor court. (They look like the "the picture of health".)
The mayor of Mangum OK, population 6,000, Mary Jane Scott, tells how a visiting pastor from Tulsa came one Sunday to lead worship in a local church. Shortly after he returned to Tulsa, he got sick, and he became Oklahoma's first COVID-19 fatality. Then somebody at the local church got sick and tested positive. Several other church members tested positive. The local nursing home had a cluster of cases. In sum, the town of Mangum had 3 deaths, and 26 residents who tested positive to date.
Mayor Scott said, I thought I was safe here in Southwest Oklahoma. I did not think there would be a big issue with it, and all of a sudden, bam! Mangum now has an emergency shelter-in-place order and curfew. The mayor uses Facebook to post daily updates and advisories. At 7 PM nightly she asks residents of Mangum to step out on their front yards and and join in singing "God Bless America".