Forty-nine states and territories are in an upward trajectory of new COVID-19 cases, according to an internal Health and Human Services memo obtained by ABC News.
Only three jurisdictions are at a plateau. Just three areas are reporting a case decrease.
The U.S. recorded 537,501 new coronavirus cases during the week ending Oct. 29 -- a 25.4% increase from the previous week, the memo said.
Deaths are up by 2.2% compared with the previous week.
The national test-positivity rate has increased from 6.1% to 6.3% in week-to-week comparisons, according to the HHS memo.
In Indiana, the hospitalization rate reached its highest point this week since April, the memo said.
Indiana hospitals are managing the patient surge but are concerned about adequate staffing, according to the memo.
In New Jersey, COVID-19 hospitalizations surpassed 1,000 patients this week for the first time since July, the HHS reported.
New cases doubled from one week to the next in neighboring counties Hunterdon (36 to 72 cases) and Warren (27 to 55 cases), the memo said.
In Rhode Island, officials reported a 65.5% week-to-week increase in new cases, the memo said.
Rhode Island saw a record-high hospitalization rate this week -- the highest in the last six months. Rhode Island had over 80 new COVID-19 hospital admissions during the week ending Oct. 25 -- nearly double the number of admissions from the previous week.
In Vermont, new cases have increased by 124.3% compared to the previous week.
Wisconsin reported twice as many new cases for the week ending Oct. 25 versus the week prior, the memo said.
In West Virginia, hospitalizations reached a four-month peak on Oct. 25, according to HHS.
Nearly one-third of West Virginia's COVID-19 patients were in the intensive care unit during the week ending Oct. 25, marking the highest percentage of COVID-19 patients in critical care in the region.