Recent research conducted by David Peters, associate professor of sociology and Extension rural sociologist, indicates that rural places may still be at risk for COVID-19 even in the absence of cases, as the pandemic may just be taking hold. This makes rural places statistically invisible, creating a false sense of rural immunity. There is an immediate need to assess the risk of serious COVID-19 complications at the county-level before such cases become widespread. Knowing overall and specific types of COVID-19 risks ahead of time allows local and state health officials to plan and allocate resources accordingly. To this end, a COVID-19 relative risk scale is created using 10 indicators linked to serious complications of the disease.