Coronavirus in rural America (Part CXXIII): the impact in rural California

Phillip Reese reports for Kaiser Health News under the headline, "California’s Rural Counties Endure a Deadly Covid Winter."  Here's an excerpt: 

Covid-19’s fierce winter resurgence in California is notable not only for the explosion in overall cases and deaths in the state’s sprawling urban centers. This latest surge spilled across a far greater geographic footprint, scarring remote corners of the state that went largely unscathed for much of 2020. (emphasis added; I thought the verb choice was noteworthy)

In the past two months, covid-related infection and death rates have jumped exponentially in California’s least populated counties.

* * *

For months, residents of the state’s remotest counties were able to move about more freely — and with less fear — than their urban peers. The covid death rate in the state’s 25 least populated counties was 90% lower from March through June than the rate in the rest of the state.

That began to shift in summer and changed dramatically during a third covid surge that exploded in late fall. In December, the 25 least populous counties collectively reported about 24,600 new covid infections — a 141% increase from November. In December, the death rate in those 25 counties roughly matched the rate in the state’s urban centers.

The rural death rate plateaued in January while the urban death rate continued to swell. Even so, the rural death rate in January was more than six times as high as in November.

The part of this story about how the virus spreads in rural communities is of particular interest to me because it reflects both the lack of anonymity in rural communities, the importance of ecotourism, and the related embeddedness of rural with urban. 

Epidemiologists point to several reasons for the shift. While these counties are remote, they are not walled off. Many rural residents regularly drive to urban areas for goods and services. They get tourists. Several of California’s rural counties are home to large state prisons, teeming facilities that have experienced some of the worst covid outbreaks in the nation. Those outbreaks infect not only inmates housed in close quarters, but also guards and other staffers who live and shop in the surrounding communities and carry the virus out with them.

Reese quotes Alan Morgan, chief executive officer of the National Rural Health Association:   

“In very small towns, you’ve got Dollar General, the coffee store, Walmart, church. ...You get the entire community going into three or four chokepoints, you’re going to infect the whole town.

The story is accompanied by great maps; don't miss them! Also, lots of details here about rural demographics and the struggle of rural health care providers.  

Postscript:  Here's Hailey Branson-Potts' latest for the Los Angeles Times on a family in Corning, California who all contracted COVID-19.  The headline is, "For a rural family, COVID-19 felt like a distant threat. Until it devastated them."