Wednesday, June 24, 2020

Coronavirus in rural America (Part LXIV): Rural hospitals overwhelmed(?)

Two stories today discuss the issue of rural hospitals getting overwhelmed with COVID-19 patients as the pandemic spreads to rural America.  The first is out of Georgia, by the Atlanta Journal Constitution, headlined "Georgia shifts 80 overflow beds southward amid rural virus outbreaks." Johnny Edwards reports that the beds are going to Milledgeville, population 17,715, but when you look at a map, you see that Milledgeville is only about and hour and half drive from Atlanta, even less from the greater metro area.  Here's an except from Edwards' story:
The Georgia Emergency Management and Homeland Security Agency said Wednesday that it will move beds out of the little-used temporary facility at the Georgia World Congress Center and set them up 100 miles southeast inside a shuttered youth military academy. As the downtown Atlanta site was designed to do, Milledgeville’s makeshift hospital will treat patients with mild to moderate symptoms who don’t need ventilators or critical care, relieving hospitals that could be overrun in another surge.
The story quotes Governor Brian Kemp's news release, which says Milledgeville
is more centrally located for many medical facilities throughout Georgia.  We continue monitoring the virus data to enable us to ‘right size’ the resources and response so we can ensure every COVID-19 patient gets the care they need.
Edwards also quotes Amber Schmidtke, an assistant professor of microbiology at Mercer University School of Medicine in Macon.  She said:
I think it’s mainly motivated to help with some of the rural hospital burden, because there are many counties that don’t have a hospital ... And especially in Region H, the hospitals can be two counties away, and some of these counties take 45 minutes to an hour to drive through.
The other piece is an op-ed in the New York Times by two employees of a rural Texas hospital.  Donna Boatright and Jennifer Liedtke authored "In Texas, 6 Critically Ill Covid-19 Patients Would Overwhelm This Hospital."  They write from Sweetwater, Texas, population 10,906, in west Texas, the southern part of the panhandle.  Sweetwater is, the authors explain, best known as the "World's Largest Rattlesnake Roundup."  Here is an excerpt from their op-ed:
With just two ventilators, Rolling Plains Memorial Hospital in Sweetwater, Texas, has been terrified of Covid-19 ever since March. ... Even the slightest outbreak would overwhelm Rolling Plains, which sits on a major highway that carries tens of thousands of travelers a day. 
Rural hospitals in America have been fighting for survival for years, mostly because of their relatively high numbers of uninsured patients.
The piece provides a great deal of additional context on the rural healthcare crisis, and it is well worth a read in its entirety. Lots of local color and empathy-inducing detail.  Plus, there is a video to accompany the op-ed.

Postscript from WyoFile, featuring a hospital out of Campbell County, Wyoming, population 48,133. This is deeply reported story by Dustin Bleizeffer and Mason Adams, providing lots of context on rural hospital closures, particularly in coal country like this area which, like Appalachia, has been struggling with an economic downturn for some time. 

And here is a June 26, 2020 story from the Houston Chronicle, featuring Big Bend National Park in west Texas.  Jeremy Wallace reports, but it's behind a paywall.

Noam Levy reports for the Los Angeles Times in this related story also dateline June 26, 2020. This story, which references what is happening in Texas, Arizona,  Florida, and California, is not especially rural focused, but it does note the major outbreak in Imperial County, population 174,528, the state's most southeasterly county, bordering Mexico and Arizona.  Hospitals as far north as Sacramento are taking patients out of Imperial County, whose hospitals are overwhelmed.   Interestingly, Levy reports an urban-to-rural patient reversal out of Texas, a phenomenon I'd not previously seen:
“We can see the storm coming,” said John Henderson, who heads the Texas Organization of Rural and Community Hospitals. 
Henderson noted that several member hospitals in suburban and rural areas around Houston are already being called on to take very ill patients from overburdened medical centers in the city, which is experiencing among the worst coronavirus outbreaks.
Another postscript: Two stories about rural hospitals and clinics were filed on June 29, 2020.  One is on Capital Press, by Sierra Dawn McClain, dateline Bend, Oregon, about the travails of that state's rural hospitals in the COVID-19 era.  I was not familiar with Capital Press but its subhead is "Empowering Producers of Food and Fiber."  Here's an excerpt:
In rural Oregon, a healthcare crisis is festering. Gov. Kate Brown labeled healthcare providers "essential" during COVID-19, but the pangs of the lockdown have thrashed providers. 
In March and April, many rural hospitals and clinics sat nearly empty with outpatient procedures and elective surgeries postponed. Delayed care may have health impacts for patients, and the revenue drop battered already-fragile rural health systems.
The second story was posted on North Carolina Health News and is by Liora Engel-Smith.  The lede follows: 
Federal support to rural hospitals helped some of the state’s most cash-strapped facilities through the first phases of the coronavirus pandemic, but advocates say providers will likely need more support down the line. 
Through the federal coronavirus aid package known as the CARES Act, hospitals got money for care and testing of uninsured people for coronavirus, but urban hospitals, which generally have a larger share of coronavirus patients, got the bulk of that aid.

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