Friday, September 24, 2021

Coronavirus in rural America (Part CLIII): Yesterday's winner is today's loser

That is a tenet of investing that my financial advisor has often endorsed.  Rececntly, I've seen that it applies to the coronavirus.  Alaska was an early winner, especially in the race to get folks vaccinated, as discussed here and hereDitto West Virginia.  

Now, however, Alaska's health care system is struggling, as the New York Times reports here.  This excerpt focuses on those in rural and remote areas of the state, where many are Alaska Natives: 

Jared Kosin, the head of the Alaska State Hospital and Nursing Home Association, called the surge “crippling” in an interview on Tuesday. He added that hospitals were full, and health care workers were emotionally depleted. Patients recently were kept waiting for care in their cars outside overwhelmed emergency rooms.

There is growing anxiety in outlying communities that depend on transferring seriously ill patients to hospitals in Anchorage, Mr. Kosin said. Transfers are getting harder to arrange and are often delayed, he said.

“We are all wondering where this goes, and whether that transfer will be available, even tomorrow,” Mr. Kosin said.

Critically ill people in rural areas, where many Alaska Natives reside, often have to be taken by plane to a hospital that can provide the treatment they need, said Dr. Philippe Amstislavski, an associate professor of public health at the University of Alaska Anchorage.

“Unlike in the lower 48, you don’t have that ability to move people quickly, because of the distances and remoteness,” said Dr. Amstislavski, who was formerly the public health manager for the Interior Region of Alaska, focusing on rural and predominantly Alaska Native communities.

West Virginia is also facing a new coronavirus wave, as NPR reported here.  Just 46% of the state's 1.8 million residents are vaccinated.  This excerpt leads with a quote from Governor Jim Justice, who touts the vaccine nearly every day:

JUSTICE: If you have chosen to be unvaccinated, in my opinion, it was a bad choice. And you know what we're going to be? We're going to be respectful of that till the cows come home. The reality is, no matter what we say here, a lot of what we say is falling on deaf ears.

[Journalist June] LEFFLER: The importance of vaccines is clear. In West Virginia, those who aren't vaccinated make up 85% of COVID-19 hospital admissions. Many smaller hospitals have maxed out their bed capacities. When that happens, patients can be sent to other hospitals. Jim Kaufman, the president of the West Virginia Hospital Association, says transferring patients might not be an option soon.

JIM KAUFMAN: You're actually seeing a bed crunch pretty much across the state. So what they're trying to do is basically stabilize the patients, take care of the patients where they can because the ability to transfer has been greatly restricted.

LEFFLER: More than 800 people are hospitalized with COVID-19 in West Virginia. Kaufman expects that number to reach 1,000 in just a few weeks. 

An earlier story about West Virginia's vaccine efforts is here, this one from the non-profit news source, 100 Days in Appalachia.  

Another state with substantial rural reaches, where COVID has been raging, is Idaho.  I don't know that Idaho had a prior honeymoon period with the coronavirus, but it's certainly struggling now, as documented here, here, and here.  The latter is about Washington governor Jay Inslee's plea to Idahoans to "stop clogging up" his state's hospitals.  

Postscript:  Here's Anne Zink, Alaska's chief medical office, on NPR on Sept. 25, 2021, with more on the state's COVID strain.  She says this is the worst surge Alaska has seen during the whole pandemic, with one in five of those in the hospital suffering from COVID.  An interesting factoid:  the average Alaskan travels 150 miles to access care.  Zinke explains the logistical challenges in terms of Bethel and the Kuskokwim River Delta:   

The YKHC Delta, which is this big, beautiful region, serves 60 villages in that region. And so they are really struggling with, who do they ship in via flight to their hub hospital, Bethel? And then who do they get out into Anchorage based on just the lack of bed availability, the lack of staffing?

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