COVID Fears Rural

On The Brink, Rural Hospitals Brace For New Surge In COVID-19 Cases

NPR, July 3, 2020

In the Idaho mountain town of Grangeville, population 3,200, signs in windows on Main Street advertise that Border Days “is on.”

Up the street, at the 16-bed Syringa Hospital and Clinic, CEO Abner King says his staff is prepared for a possible surge in coronavirus infections in a couple of weeks.

“It’s pretty hard to do an egg toss in a socially distancing manner,” he chuckles.

Syringa doesn’t have an intensive care unit or even a ventilator. Most patients in need of critical care are transferred to larger regional hospitals, which so far during the pandemic have not been overwhelmed themselves as first feared.

Syringa staff members have been preparing and instituting precautions for months, yet to date they’ve not treated a single COVID-19 patient.

“That’s the tough part about all this, because you get all ready for this big emergency and then nothing happens and then you have to fight complacency a little bit,” King says. “We prepared for a flood, and then we were hit with a drought.”

That “drought” has severely affected Syringa’s bottom line. The irony is that small-town hospitals like this one are now on the brink of going broke during the pandemic. King says people just stopped coming into the hospital, its clinic and even its emergency room. All elective procedures were canceled. Since the pandemic took hold in March, revenue here has dropped by half.

Across the U.S., rural “critical access” hospitals were already closing at an alarming rate before the pandemic. Twelve have shuttered since the start of this year alone.

“Even without the pandemic, there’s not a lot of room for surprises and errors,” King said.

One of the main reasons that the hospital has stayed afloat since March is because of federal relief money. Among other things, it has helped pay for personal protective gear and other supplies as well as the construction of a temporary isolation ward for COVID-19 patients.


Imagining Rural Immunity

Anthropology News, June 2020

Thurka Sangaramoorthy and Adia Benton

Political myth-making about America’s rural “heartland” is doubly pernicious, increasing rural vulnerability to COVID-19 and ignoring the disintegration of rural health services.

In March 2020, Fairmont Regional Medical Center, the only hospital in Fairmont County, West Virginia, closed its doors amid increasing financial strains. Later that month, an ambulance was called to take an 88-year-old woman infected with COVID-19 to the hospital. Instead of making the usual two-minute drive to Fairmont Regional, the ambulance had to drive 25 minutes to the next-nearest facility. Days later, the woman became West Virginia’s first reported coronavirus death (Healy et al. 2020). While some may point to the woman’s age as a deciding factor in her declining health and eventual death, her fate more aptly underscores how the public health infrastructure in rural regions is potentially the most fragile aspect of the rural health care continuum.   The imagined immunity of rural America omits entire swathes of rural land in the South and Midwest, where many Black and Latino people reside and work; they do not include the rural residents of Native reservations; they do not recognize the vast influence of prison economies throughout rural America.

As the total number of COVID-19 cases in the United States surges past 1.5 million, much of the focus in news media and discussions among national experts has long been on large, urban metropolitan areas. The rationale is that their dense populations engaging in frequent interpersonal contact are at heightened risk of contracting the disease. When rural areas have been the focus of stories of community spread, the vectors of infection were often wealthy urbanites fleeing rising case counts in the city. The county commissioner of Tillamook County, Oregon, for example, took to the pages of the Washington Post opinion section to convey what he described as a “plea from rural America,” urging “COVID-19 urban refugees” to stay home. “Thousands of urban visitors descended on our villages, with cars lined up for miles on highways to the coast,” he wrote.