Here's how the COVID-19 coronavirus pandemic is impacting rural America:
from yet-to-be-identified malign actors, according to more than a dozen government officials, medical experts, and local residents.” Luckily, there is a silver lining to rural community communication.
As Graham explains, “One advantage when it comes to sharing information is that voices can be so much louder here than they can be in larger areas. When you have a group of doctors who are the primary care physicians for the county, and who each take care of 20% of the population, working together to make a statement about the nature of this pandemic and how it affects citizens, they are able to speak with one voice. People trust them and take them very seriously and listen to what they have to say.” But local physicians can only work with the information they have. The complete lack of information regarding just how widespread COVID-19 is in both rural and urban America as a result of insufficient numbers of testing kits has been a festering sore in the side of public health officials since the pandemic hit American shores. Despite repeated assertions by the Trump administration otherwise tests for COVID-19 are still not available in most places to many people who need them. Anthony Fauci, America’s leading immunologist, says “the system is not really geared towards what we need right now. That is a failing. Let’s admit it...we are not where we should be.” These lack of tests undermine epidemiological tracking of the disease and how it is spreading, as well as who may have been exposed, which means that it is only a matter of time before to number of exposure cases starts to rise.The concern then becomes rural medical facilities becoming overwhelmed with patients. This is especially dangerous in rural American because...“Our local hospitals are small, they're often understaffed, and they're going to be under prepared compared to a massive facility in a larger urban area,” says Graham, “None of our facilities are being overwhelmed yet, but we have to realistically expect that that's coming.”have closed out of 1,844 , in what has been referred to as ‘the rural hospital closure crisis’ and the problem does not seem to be letting up. That means that of the national average of 2.8 hospital beds per 1,000 Americans, the rate of access for rural Americans is even lower and continuing to decline. This puts even more pressure on hospitals who already work with lower levels of resources than their urban counterparts, as well as urban hospitals who will have to manage the overflow.CCRH VULNERABILITY RESEARCH, states in the Southeast and lower Great Plains bore the greatest brunt of the closure crisis with the highest number of rural hospital closures since 2010 being in; Texas , Tennessee , Oklahoma , Georgia , Alabama and Missouri . Furthermore, the study found that today, “453 rural hospitals are vulnerable to closure based on performance levels which are similar to rural hospitals at the time of their closure.” And they are all similarly in the Southeast and Iower Great Plains Region. Event more disconcerting for rural Americans, the study found one overwhelming factor that contributed to the increased risk of rural hospital closures - that “hospitals located in states that have not adopted Medicaid expansion have lower median operating margin and have a higher percentage of rural hospitals operating with a negative operating margin. Of the eight states with the highest levels of closures since 2010, none are Medicaid expansion states.” Which not only means that rural hospitals have been closing, they have been closing in areas where the rates of uninsured, as well as insured but financially vulnerable rural Americans are highest. As the study notes, “Rural populations are shown to be older, less healthy, and less affluent than their urban counterparts. Medicaid expansion creates opportunities for individual in rural communities to move away from the ranks of the medically uninsured.” Currently there are 19 states that have not adopted Medicaid expansion.“We likely won't see a spread of COVID-19 as quickly as urban areas just due to population density,” says Graham, “There are not a lot of areas in our community where you typically have 200 to 500 people gathered at a time. So that works to our advantage. However,” he continues, “the disadvantage is that people are leaving Appalachia in droves, which leaves us with a more elderly population and that presents a whole host of other challenges.”Pacific Press/LightRocket via Getty Images “When you have an elderly couple that lives 20-miles outside of the nearest town you, how are they going to get their medication during a lockdown?” COVID-19’s effects on rural elderly Americans go further than just whether or not they will contract the disease, but whether or not they can get through any potential lockdown should contagion numbers become untenable. “How will they get food and supplies efficiently?” says Graham. “We also live in an area where people rely on firewood or kerosene to heat their homes if it's cold. It's not just a matter of the electric company or the gas companies saying, ‘We're not going to shut anyone’s utilities off for nonpayment. It becomes a matter of life and death. If we hit a cold snap, we have to get supplies out for a lot of people who rely on propane, kerosene, or wood to burn in their stove. These are the kinds of issues that don't really come up in other parts of the country. How do you deal with that? Those are the questions we're answering right now.”Tensions in my own home came to a head Monday night when my parents were considering attending a small get together that Rooster Brew regulars were planning in light of the fact that the bar would be closed - the very same night that Beshear was imploring Kentuckians to avoid gatherings. It was then that one overwhelming fact was coming home to roost - too many rural Americans are still not taking this pandemic seriously enough , the effects of which will only prove to frustrate state and local action to contain, map, and monitor the spread of the virus. One extreme example of this lack of concern was found in an early case of COVID-19 when a 59-year old rural Nelson County man,and who is now being forcibly quarantined by sheriff's deputies 24/7 at his home by order of Beshear. “It's a step I hoped that I never had to take, but we can't allow one person — who we know has this virus — to refuse to protect their neighbors,” Beshear said during a Saturday news conference. While the Nelson County case is an extreme example, even small gatherings of people can prove insidious for epidemiological tracking. Besheara Pike County Bingo Hall who did not close its doors and attracted dozens of players Wednesday night. “We are protecting the most vulnerable, which means everybody has to be on board,” Beshear said. “If you are a bingo parlor in Pike County, you ought to be closed by the end of today. Those parlors cater to an older and more at-risk crowd.” Small gatherings frustrate epidemiological tracking for the same reason family trees become complicated quickly the more children a couple has. The amount of tracking required for a one-to-one interaction becomes ever more exponentially complicated with each person you meet up with in a group and each group increases risk of exposure.“Folks, use good judgement.” urged Beshear on Monday, “Sometimes we think, ‘Well, everyone, but my group.’ Please don’t be that individual and please don’t be that group that is putting your needs above the needs of the commonwealth. You may be allowing the Coronavirus to spread and you are frustrating the sacrifices other people are making to stop this virus. We are all Americans now.” State and local officials across America are working to contain COVID-19 and as has been seen in Wuhan, China, Italy, and now in San Fransisco, if need be, governments will take decisive action to lockdown effected areas.Given the tone deaf federal response to the pandemic and the unprecedented lack of tests for COVID-19 the number of infected are almost certainly going to get much worst before they get better. With the tightrope that rural Americans are walking between strained rural healthcare services and their own increased mortality risk if infected, as well as a myriad of other factors, wouldn’t it just be easier and kinder to our neighbours to stay at home?... [+]
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