Coronavirus in rural America (Part IV): California

The Los Angeles Times and Sacramento Bee both ran stories yesterday about the implications of the coronavirus for rural California.  Both discussed health care issues (the subject of recent posts here and here), but health care access in rural parts of the Golden State was the focus of the Bee story by Ryan Sabalow and Jason Pohl.  The headline proclaims the bad news bluntly:  "California’s rural hospitals can’t handle a coronavirus wave. ‘People will die,’ doctor warns."

Mammoth Hospital’s chief medical officer Dr. Craig Burrows didn’t hold back as he urged the 8,234 people living in his Sierra ski-resort town to stay home and avoid crowds. 

“Try to imagine 100 people getting sick all at once tomorrow,” Burrows said in an unscripted video message the Mono County hospital posted on YouTube. “If that happens, our small hospital, our small community, will be completely overwhelmed and people will die. 

“Let me say that again: People. Will. Die.”

Mammoth Hospital has 17 beds. If COVID-19 sweeps through that community, there won’t be room to treat everyone and doctors will have to make hard choices. It’s a grim reality that Mammoth shares with 33 other federally designated “Critical Access Hospitals” in California that have 25 or fewer beds.

The story goes on to list many of those other 33 "Critical Access Hospitals" in the Golden State.  They are in places like Fortuna (Humboldt County), Fall River Mills (Shasta County), Surprise Valley (Modoc County), Lone Pine (Inyo County), Tehachapi (Kern County) and Gridley (Butte County).  Here's more of the Bee story:

In 2015, officials from across California conducted a “tabletop exercise” designed to simulate the impacts of a major flu pandemic. Local emergency planners were given various projections of how many people would get sick and die and how many ventilation machines each county has to keep severely ill patients breathing. 

The results were sobering for Shasta County (population 180,000) and its county seat Redding, a regional medical hub: Anywhere between 39 and 445 people would need ventilators. 

State figures show that Shasta County hospitals have 86 ICU beds equipped with ventilators, including beds for newborns. Most beds are in Redding, home to two regional hospitals that receive patients from across the rural north state. 

The numbers are even bleaker at the three hospitals along the foggy north coast in Humboldt County, population 136,754, said Rex Bohn, a county supervisor. 

“We’re very fortunate (the hospitals) all work together really well, but with that, I think we have a total of maybe 22 ICU beds and 250 beds total,” Bohn said. “So if it comes time for us to push that red button (and request help from regional hospitals) … there’s no guarantee they’re going to answer because they’re already stretched.” 

He said the county is trying to prepare by renting rooms at local motels to house and isolate COVID-19 patients who don’t require critical care.

As with my last "health" post re corona virus, this one demonstrates the relationship between rural and urban, with the former at the mercy of the latter.  That's a reversal of the normal state of affairs, when urban folks rely on rural folks--for food, minerals, fish, timber and other products of rural-based extractive industries.

The Los Angles Times story also mentions Mammoth Lakes, but in this case as a destination urban folks are escaping to as they seek to avoid the densely populated areas where coronavirus is quickly spreading.  Here's the paragraph most salient to what is happening in the Eastern Sierra:

In Mammoth Lakes, a small Eastern Sierra town that survives primarily on skiing at Mammoth Mountain, the tourism board this week told nonresidents to keep out. “The reason is simple,” the board’s website announced. “As a small, remote mountain community our healthcare facilities lack the capacity to handle a widespread outbreak of COVID-19.” 

Another in-demand "rural" location (well, I'd say a form of rural gentrification) is Joshua Tree, in the Mohave Desert of San Bernardino County.  Louis Sahagun writes:

As the coronavirus pandemic tightens its grip on California’s largest cities, some residents are fleeing urban sprawl and seeking shelter in isolated communities in the Mojave Desert or rugged Sierra Nevada. Their hope, they say, is to avoid possible public unrest and limit their exposure to the virus. 

These new urban immigrants are not entirely welcome, however. Locals fear their arrival could overwhelm the public health systems of small towns already struggling to cope with the growing crisis, and public health officials worry the movement will lead to greater spread of the highly contagious virus. 

In Los Angeles, Mayor Eric Garcetti announced Thursday night that residents were forbidden from moving to or from vacation homes outside the city, along with a number of other health and safety restrictions aimed at fighting contagion. 

And that will stem the flow of people from urban to rural, and vice versa.  No doubt, this will not be the last post in this series on coronavirus' impacts on rural places and on the relationship between rural and urban.

P.S.  The story discussed above re: California's rural hospitals is the top item in Sacramento Bee print edition on the morning of March 24, 2020. 

Also from the Sacramento Bee online as of March 24, 2020:  "California Tourist Towns Demand Outsiders Stay Home:  'Someone is going to get shot.'"  Again Ryan Sabalow and Jason Pohl report, including from Mono County, population 14,168.