Coronavirus in rural America (Part XXXIV): New Mexico

Simon Romero reported this story for the New York Times last week, dateline Albuquerque, under the headline, "How New Mexico, One of the Poorest States, Averted a Steep Death Toll."  The odds were against the state that calls itself the Land of Enchantment, which has fewer hospital beds per capita than most states.  It is also a high-poverty state, and many of its residents are elderly. 

Still, infectious disease specialists say New Mexico seems to have staved off disaster — for the moment, at least — with a coronavirus death rate that is lower than neighboring states like Colorado and Oklahoma.

New Mexico’s measures included shutting down schools before most states, aggressively expanding social distancing, ramping up testing beyond levels achieved in richer states and using a pioneering telemedicine initiative to quickly train rural health workers for coronavirus care.

Romero quotes Helen Wearing, a University of New Mexico mathematician who is an expert on disease ecology: 

Hundreds of lives were saved because of what the state did early on, and that’s using conservative estimates.  

Coronavirus in rural America (Part XXXIII): Leveling the playing field for rural K-12 students

Ever since most states send their public school kids home, numerous media outlets have renewed their attention to the digital divide.

One of the better stories I've read or heard is this one from NPR on April 24, "Even In Crisis Times, There Is A Push To Wire Rural America," reported by Kirk Siegler.  The dateline is Lockhart, Texas, population 12,698, and an excerpt follows:

As the COVID-19 crisis took hold and schools in Lockhart, Texas, had to close and shift to remote learning, the school district quickly conducted a needs assessment. 

They found that half of their 6,000 students have no high-speed Internet at home. And despite being a short drive south of Austin, a third of all the students and staff live in "dead zones," where Internet and cell service aren't even available. 

Mark Estrada is the superintendent at the Lockhart Independent School District, and the needs of his students and staff have not exactly caught him off guard.  Siegler quotes Estrada:

Students who have been historically underserved just continue to have that fate as technology becomes a bigger part of educational practices.

Siegler's report continues:

At a time when many of us are going online to do everything from work to school to shopping to health care, the COVID-19 crisis is shining a big light on the haves and have-nots when it comes to the Internet. The federal government estimates upwards of a third of all people in rural America have little or no access to the Internet, a statistic that could only worsen as the economic fallout from the pandemic continues.

Fortunately in Lockhart, Estrada and his staff were already shepherding through a plan to address this digital divide before COVID-19 hit. 

It's now being fast-tracked. 

With the help of a local Internet provider, the district is installing seven booster towers outside each of its schools. These will beam the Internet into every home that needs it across the 300-square-mile district. It will be free to families, costing the district just $30 a year per household.

A story of a less ambitious school district plan is this one, out of Elkins, Arkansas, as written about by a columnist in the Arkansas Democrat-Gazette.   Nevertheless, it seems this school administrator in a rural district in Washington County (which is metropolitan) was more forward thinking than most.  Elkins population is 2,648, but/and it is part of the Northwest Arkansas Metropolitan Area and not far at all from the outskirts of Fayetteville, home to the University of Arkansas' flagship and land grant campus.  What this school district is doing is more common, and that is outfitting busses as hotspots and then parking them strategically to facilitate student access.  That won't work for districts whose students are more far flung, like the one I attended K-12 in Jasper, Arkansas, two counties away from Elkins, though not too far as the crow flies.  In really spatially dispersed districts covering a lot of territory, you won't be able to park busses, no matter how strategic you are, to meet all the need--unless you have a whole lot of busses. 

This bus-as-hotspot strategy reminds me that Governor Gavin Newsom announced a few weeks ago that seven busses were being outfitted as hot spots for California school students, though I don't recall him saying what district those busses would be dispatched to.

This earlier story by the New York Times, "As School Moves Online, Many Students Remain Logged Out," from April 6, 2020, is pretty urban-centric, but does briefly nod to the rural with a few paragraphs about "rural" Minford, Ohio.

In rural Minford, a town of about 700 in southern Ohio near the border with Kentucky, the district is distributing laptops as well as work packets on paper to students without internet or technology access, estimated at 25 to 30 percent of the student body by the district’s superintendent. 

Regardless of whether Minford’s students can participate in online classes or turn in work, administrators expect to promote a majority of them to the next grade, said Marin Applegate, the district’s school psychologist. “We do not feel they are in control and cannot be held accountable,” she said.

In fact, the New York Times editorial board has published two editorials about the consequences of the school shutdowns for low-income kids.  The first is from March 27, 2020, "Locked Out of the Virtual Classroom, and the second is "50 Million Kids Can't Attend School.  What Happens to Them?" published on April 16, 2020.   The latter doesn't mention rural or urban, but the former includes this information about a program that sounds like the one the Texas school district, featured in the NPR story, is using:

[FCC] Commissioner Rosenworcel’s access plan focuses on expanding the federal program known as E-Rate, which helps qualifying schools, school systems and libraries acquire broadband at up to a 90 percent discount. E-Rate program funding is based on demand, up to an annual F.C.C.-established cap of $4.15 billion. It would be a simple matter for the commission to extend the program so that schools can buy hot spots that are then distributed to needy students.

But given the dire need in poor and rural communities, it would also be right to leverage E-Rate — or something like it — to bring permanent broadband into homes for millions of internet-deprived schoolchildren and subsistence workers.

Finally closing the digital divide — and bringing all Americans into the information age — will require a momentous effort on the scale of the federal project that brought electricity to darkened regions of the country during the New Deal. And it will be similarly worth the effort.

In any event, all of these tales of scrambling to supply students with broadband reflect poorly on federal priorities, which have failed to connect the nation--all of the nation--to broadband.  Coronavirus has cast into even sharper relief the digital divide, the rift between the "haves" and the "have nots." It's also reminding us that many of the "have nots" are rural.

Coronavirus in rural America (Part XXXII): Far NorCal counties seek to re-open

Here's the story from the Redding Record Searchlight, which is based in Shasta County, the most populous and one of few metropolitan counties north of Sacramento:

Modoc, Tehama and Siskiyou counties are hoping their scant coronavirus cases will mean they can reopen parts of the economy again sooner than the rest of California.

All three counties are working out plans for letting some aspects of life return to normal, but there's a big caveat: Gov. Gavin Newsom would still have to give the OK.

Tehama County has had one confirmed case of the virus, while Modoc hasn't had any and Siskiyou County has had five so far. Out of the three counties, only the one Tehama County patient has died.

While Modoc, Tehama and Siskiyou counties do attract tourists, their economies tend to be more ag and extraction-based and therefore to experience less population churn.  The counties surrounding Lake Tahoe, on the other hand, in Nevada and El Dorado counties, are highly gentrified by second-home owners.  In Truckee, near the north shore, the incidence of coronavirus is 7 to 10 times higher than elsewhere in the state.  The San Francisco Chronicle reports that this has pitted year-round residents against week-enders.

Coronavirus in rural America (Part XXXI): Big NYT feature on rural hospitals, closures

On the home page of the New York Times since this morning has been this cool map showing where Americans live in proximity to an emergency room.  I note that most of the folks spatially removed from an ED (emergency department) are in the west--not surprising given the greater population sparseness there.  But in my home state of Arkansas, the places where people tend to be that far from an ED include, yes, my home county, Newton County, Arkansas.  I know from first hand experience that the nearest ED is the hospital where I was born, at that time the Boone County Hospital, now the North Arkansas Medical Center.  Other places in Arkansas that are what we might consider health care deserts are west central Arkansas and a few places in the Mississippi River Delta.

The complementary feature to the map is this very long and deeply reported New York Times story on what is happening in rural America in relation to the coronavirus crisis.  It focuses on recent rural hospital closures, which number 120 in the past decade.  Some of those closures are attributable to consolidation, some in Appalachia (as previously reported).  Here are a couple of data intensive paragraphs from the story:

Across the United States, hospitals serving rural areas have spent decades trying to provide medical care and produce enough revenue to stay open. They have closed in increasing numbers in recent years as local populations have declined. About 170 rural hospitals have shut down since 2005.

* * *  

But for-profit hospitals are more likely to close than the others, one recent federal study showed. It found that for-profit facilities accounted for 11 percent of rural hospitals but 36 percent of closures among the group. Within the past year, rural hospitals have closed in Pennsylvania and Tennessee after selling to for-profit chains.

The story mentions the work of Jill Horwitz, Vice Dean of the UCLA School of Law, who studies hospital ownership and consolidation.  She has found that "for-profit rural hospitals were less likely to offer needed but unprofitable medical services, such as hospice and inpatient psychiatric care."  Here's a quote form Horwitz:

There is something very concerning to me about having more for-profit companies in rural health care. The more rural a hospital, the more people depend on it for lifesaving care.

* * * 

The goal of the for-profit is to make money. That doesn’t mean they’ll do anything to make a buck, but they have a different goal from nonprofits.

I'm glad to know that a very urban scholar in a city like Los Angeles is expressing concern about what is happening in rural America.  It reminds me of this recent scholarly article by Elizabeth Weeks. 

Here's an excerpt about Early County, Georgia, in the state's southwest corner, where five of the county's 11,000 residents have died, and 92 cases of coronavirus have been reported.  The mayor and police chief of the small town of Blakely are among those infected.  Here's a quote from the assistant police chief, Tonya Tinsley, that is heavy on small town lack of anonymity. 

Being from a small town, you think it’s not going to touch us.  We are so small and tucked away. You have a perception that it’s in bigger cities. 

That is all gone now. 

You say, wait a minute, I know them!. It’s, like, oh my God, I knew them. I used to talk to them. I knew their family. Their kids. It’s a blow to the community each time.

This comprehensive story mentions many U.S. regions and quotes Montana Senator Jon Tester about the situation in his state.  It's well worth a read in its entirety. 

Coronavirus in rural America (Part XXX): unemployment benefits, state variations, and cost of living

Here is a chart from the NYT a few days ago showing state-to-state variations in what the federal boost in unemployment benefits did to state unemployment benefits in place before the federal top up.  The story's lede explains: 

Before the coronavirus, people receiving unemployment benefits in most states got, on average, less than half their weekly salaries. 

Now, as millions file claims, many are poised to receive more money than they would have typically earned in their jobs, thanks to the additional $600 a week set aside in the federal stimulus package for the unemployed. 

That calculation is based on an analysis of the so-called replacement rate, which is the share of a worker’s wages that is replaced by unemployment benefits.

Bottom line, in about half the states, the $600/week is certainly sufficient to keep workers at home--one of its goals, depending on who you ask--because it means they earn more from the combination of the federal supplement of $600/week and the state unemployment benefits than they would if they were working. 

Of course, a person's ordinary income (barista wages of $10 to $15/hour versus more skilled/highly valued labor) and the state's cost of living are key variables when assessing the generosity and appropriateness of the current benefits. 

Here's a story from NPR about how these variations played out in Kentucky, a state that already had a generous unemployment benefit.  The dateline for this story is Harlan, Kentucky, a notoriously impoverished part of the state, and Scott Horsely reports, interviewing Sky Marietta who, with her husband, opened a coffee shop last year in Harlan with the goals of providing "good coffee, good Internet services, and some opportunity in a community that has been starved of all three."  The Mariettas hoped to "transform the downtowns and main streets of eastern Kentucky" and they provided much needed jobs, interviewing perhaps 100 applicants when they opened.  The Mariettas stayed open during  the first few weeks of the coronavirus shut down, which came just a few months after they opened the doors of their establishment.   

The No. 1 people that we're serving right now are health care workers. I feel like they don't have a lot of options, and they certainly deserve at least some coffee in this, right?

But once the $600/week payments started flowing, many employees asked to be laid off.  Marietta wrote on her blog:

Not because they did not like their jobs or because they did not want to work, but because it would cost them literally hundreds of dollars per week to be employed.

* * * 

We basically have this situation where it would be a logical choice for a lot of people to be unemployed.

* * *  

You also have to think, the benefit of not having to go to work, especially during a pandemic. It's not that we don't wish that we could pay our employees at that level all the time. You're always wanting to pay your staff the best you possible can. But to be put in a position where you can't compete with them being at home, unemployed. It's really tricky. It's a really difficult situation to be in.

Marietta wonders if she'll get her employees back in July, when the benefits run out. 

Coronavirus in rural America (Part XXIX): jails

Data for Progress posted this today by Lauren Sudeall, Jessica Pishko, and Aaron Littman on rural jails in the era of cornonavirus.  The executive summary follows, and the full report is here: 

Rural communities have certain traits that make them particularly vulnerable in a pandemic. On the whole, people living in rural regions are poorer, older, and less healthy. One in three rural counties has a poverty rate over 20%. More than half of all births at rural hospitals are covered by Medicaid. Rural communities are quickly losing hospitals and health care providers. Small newspapers are closing across the heartland, and internet access in rural areas is often limited, so rural residents may not have accurate information about the pandemic or how to best respond.

Many of these concerns are amplified in rural jails. People detained in rural jails are likely to be there because they cannot afford cash bail. Judges in rural courts often send people to jail for drug possession, in part because there are few diversion programs. Given the paucity of medical providers and other social services in rural areas, the criminal legal system is often used to address a range of social, emotional, and financial problems that elsewhere may be handled outside of the court system through community treatment or other programs. And people inside the jails may have prior substance use or other medical problems that are exacerbated in a pandemic.

Don't miss the maps, including those showing what percentage of inmates in particular states are in jails in counties that have not a single ICU bed.  In my home state of Arkansas, it's a quarter of inmates.  And that would include my home county, Newton, which has no hospital and therefore no ICU beds.   

Coronavirus in rural America (Part XXVIII): Montana's hi-line

Hi-Line is the moniker Montanans use for the strip of northern counties that border Canada, and one of those counties, Toole, population 5,324, is featured in a radio story that ran on NPR this morning.  The story was actually reported last week by Nate Hegyi, but just picked up nationally today as part of the America Amplified 2020 series.

Four of Montana's 10 coronavirus deaths have occurred in Toole County's seat, Shelby; these are mostly attributable to an outbreak at the county's only assisted living facility, called Marias.  Here's an excerpt focusing on the good news:  the county's preparedness, attributable to the fact that the Chicago to Seattle (and vice versa) Amtrak train stops in Shelby, the county seat, twice daily.  This means that, even though Shelby might seem like the middle of nowhere, it is connected by mass transportation to the rest of the world, and therefore vulnerable to coronavirus.  Hegyi quotes William Kiefer, CEO of Marias Medical Center:

We believe that everyone staying in their homes and following the guidance of the CDC is incredibly important.  To this point it's been very successful in Toole County.

Hegyi also addresses small-town ingenuity:

There's also something else that Marias Medical Center did that other U.S. hospitals should all take note of for future pandemics. It planned ahead before the virus even reached our shores. 

We have a group of dedicated people here that thought, 'Wow, if it does hit the United States, we're a very rural frontier facility and we should do everything in our power now."

Hegyi clarifies:

Back in January, Marias began purchasing and storing personal protective equipment. The excess masks, face shields and gowns reduced the chances of exposure for their staff after the outbreak in the hospital's assisted living facility took hold. However, Kiefer says he wishes they were wearing them regularly before the virus arrived in Shelby because once the first patient tested positive, many of the medical center's employees were unwittingly exposed to the virus. 

Thus Marias Medical Center in Shelby has been left short-staffed.  Further, it has just 21 beds and two ventilators, but it has formed an alliance with medical centers in other hi-line counties, including those in Kalispell, Browning, Conrad and Cut Bank.  Marias also has plans to air evac patients to Helena, as necessary. 

Kiefer comments:

Although we're small, we're not isolated.  People do move around quite a bit.

And as Hegyi concludes, in the context of a pandemic, "it's that movement that can kill." And that is why orders limiting movement --or at least screening those who are moving--are appropriate at times like these.

Here's the Billings Gazette's April 19 coverage of what is happening in Shelby and Toole County.  It's a very deeply reported story by Jeff Welsch, heavy on lack of anonymity and history, among other rural themes.  An excerpt quoting Dwaine Iverson, a CPA in Shelby, follows:

When you drive down Main Street and don’t see a car, it’s frightening.  Impacts are everywhere. And if we don’t do something to keep (businesses) alive, when we get all done with this ... Main Street now, with the shutdown, is going to look like that all the
time.

The story continues:

Iverson recalls his wife, Barbara, who works at the Heritage Center, and three daughters, all nurses in other Montana communities, initially warning him he "wasn't taking it seriously enough" when COVID-19 first gripped Seattle and surged toward Montana. Soon after, Barbara was in quarantine at home, even though she was off-duty when the virus hit.

Then the first three residents died.

More from Iverson: 

It feels real because you know the people who died.  They’re prominent people around here. They come from large families. They were personal friends of mine, clients of mine. That brings it home.

* * *

The biggest issue is families can’t even get together to grieve. That type of thing makes it so tough because the whole grieving process is so critical to go through and could affect the rest of your life. When you can’t give somebody a hug, how important is that?

Another resident, Michael Bashor, commented: "We all pretty much know who they are."

This Billings Gazette story features great photos, too, from Larry Mayer.

And here's a Montana Public Radio story from 1 April indicating that Governor Steve Bullock ordered health screenings of those arriving in Montana via train or plane.  An earlier post about coronavirus impacts in Montana is here, and an even earlier one is here.

My own very long 2010 law review article, featuring lots about Montana's human, political and physical geography in relation to the delivery of health and human services to children is discussed here.  What a treat it was for me to give talks at the University of Montana in Missoula in 2009 and 2016, and to vacation there in 2011 (Glacier National Park, Missoula, Ravalli County/Darby) and 2017 (Bozeman, Livingston, Gardiner).

I'm a huge fan of "the last best place" and Governor Bullock.  For still more on the Big Sky state, search "Montana" here on Legal Ruralism.

Canada's worst mass murder, this weekend in rural Nova Scotia

I've been pondering the relevance of rurality to this horrendous event since news of it broke on Sunday, and I've not yet reached any clear conclusions.  Prime Minister Justin Trudeau offered these thoughts on the impact on Nova Scotia, population 923,598 because of the high density of acquaintanceship there, as reported by the Associated Press:

Canadian Prime Minister Justin Trudeau noted how close-knit the small province of Nova Scotia is. 

“The vast majority of Nova Scotians will have a direct link with one or more of the victims. The entire province and country is grieving right now as we come to grips with something that is unimaginable,” Trudeau told a news conference.

Nova Scotia's population is small, but it is the second most densely province in Canada, which of course still doesn't make it very densely populated.

It seems the perpetrator first killed his former paramour and her new boyfriend, but that's not a particularly rural phenomenon.  The killing spree the murderer went on after that was arguably not mitigated, not stopped because of the relative lack of police presence.  I have written previously of the government/law/the state's struggle to adequately monitor large rural swaths, rendering them relatively lawless. Those are the sorts of swaths of territory that the killer covered as he murdered the next 20 people, apparently disguised as a member of the Royal Canadian Mounted Police, which is itself extraordinary.  The crimes took place in five different population clusters or villages, at 16 different locations.

Here's the New York Times report from today, and here is the NPR story. 

An excerpt from the NPR story follows:

During the attack, which lasted 12 hours, the suspect, identified as Gabriel Wortman, 51, wore an authentic RCMP uniform and one of the cars he used "was a very real look-alike" for a police vehicle, authorities said. 

* * * 

Since the attacks, questions have arisen over why the RCMP used Twitter to alert the public to the manhunt for the shooter, instead of activating the province-wide Alert Ready system. 

The warning system - which blares a siren by cellphone - was last used April 10 to warn people to stay home during the Easter weekend to prevent spread of the coronavirus, according to Canada's National Post newspaper. 

At a news conference on Monday, Chief Superintendent Leather said the force believed that Twitter was "a superior way to communicate" but will take a close look at that reasoning as part of its investigation.

The failure to use the warning system reminds me of recent reports of out New Zealand, where authorities chose to use the noisy and abrupt warning system to catch residents' attention re: the coronavirus shelter-in-place order.

The New York Times story provides profiles of many of those killed and focuses on the struggle to achieve socially-distanced funerals for the nearly two dozen who died this past weekend.

Coronavirus in rural America (Part XXVII): prisons as a rural hotspot

I've been trying to keep up with coronavirus data out of Arkansas, my home state, and today I even watched Arkansas Governor Asa Hutchinson's daily press conference for the first time.  Among other phenomena in what we used to call "The Land of Opportunity," now "The Natural State," I'm paying attention to the outbreak at "Cummins Unit," as it is often called, the state's prison farm, in southeast Arkansas, in the Delta.  Here's the Arkansas Democrat-Gazette's coverage that was making headlines a few days ago, and here is an excerpt from today's story, which explains that the ACLU and NAACP are suing for inmates release.  

Inmates at three state prisons filed a federal class-action lawsuit Tuesday over the spread of coronavirus within the system, seeking to force the release of elderly and medically frail inmates from crowded prisons, and better access to disinfectants and hygiene products. 

The lawsuit comes as infections at the state's largest prison, the Cummins Unit, flared to more than 600 cases, making it one of the densest coronavirus hot spots in the country.

The suit alleges that prison officials violated inmates' rights by forcing them to live together -- less than 6 feet apart -- in crowded barracks, without supplies of soap, hand sanitizer or other disinfectants to fight the virus. 

One plaintiff, a man in his 20s identified in the complaint as "John Doe," is claimed by his attorneys to be among the inmates at the Cummins Unit who tested positive for the virus and was quarantined.

Cummins is located in Lincoln County, population 14, 034, which is obviously now reporting a very high incidence of infection.

Lincoln County loomed large in this study I did about five years ago of the state's rural lawyer shortage.  Lincoln County has one of the most acute lawyer shortages in the state or, for that matter, the nation. 

Here's coverage of what is happening in Cummins from KATV out of Little Rock. 

We have also seen very high concentrations of coronavirus in jails, most notably in Chicago and New York, which media have paid quite a bit of attention to.  But it seems inevitable that some of the highest concentrations at the county level would be in rural places, where populations are low but incarcerated persons constitute significant proportions of populations as tracked by the U.S. Census.

This April 29, 2020 postscript, from the mayor of Pine Bluff, published in the Arkansas Democrat-Gazette, makes the point I made above.

Coronavirus in rural America (Part XXVI): the rural-coastal divide in California

Politico reported yesterday from the state's Central Valley under the headline, "How California’s coastal-rural divide could provide lessons for the nation."  Interesting that journalist Mackenzie Mays highlights the coastal-rural divide, rather than the urban-rural divide, though the two are largely synonymous, well excepting Sacramento and Fresno, which are the fourth and fifth largest cities in the state and both inland, and also excepting some far northern and central California coastal communities.  Now that I think about all the exceptions to the coastal-rural divide, I'm not sure it's a good proxy for rural-urban divide--not sure it's an accurate description of California geography.

In any event, Mays' report is datelined Sacramento and focuses on the heart of the Great Central Valley, the nation's most important agricultural region.  Here's an excerpt:

When California emerges from its coronavirus lockdown, the state's often overlooked rural counties could be the first to open up rather than the nationally trendsetting San Francisco Bay Area. 

Rural counties house roughly one-tenth of California's nearly 40 million residents but comprise more than half its land mass. A greater share of inland residents have continued to work in essential sectors under social isolation orders, and many think their thinly populated communities are less vulnerable to Covid-19 spread and shouldn't be held back by coastal cities. A distrust of Sacramento directives and a government helmed by liberal Gov. Gavin Newsom are also at play.

California's divide could become a harbinger for how rural and coastal states ease their restrictions in different ways with less populated areas lifting closures sooner than denser cities. Escalating frustration among conservatives over stay-at-home-orders’ impacts on the economy has led to protests across the country, and similar demonstrations have been organized in pockets of California.

* * * 

If rural counties open before densely populated coastal cities, health officials will watch closely to see whether different social distancing rules can coexist in the same state — and what health effects an isolated reopening would have locally and beyond.
Despite growing pressure to reopen, health officials worry about a lack of sufficient testing in rural communities — and the potential for disproportionate suffering due to socioeconomic barriers and health care shortages they faced pre-pandemic. 

In rural Tulare County, one of California's last Republican bastions, Supervisor Pete Vander Poel expects a “strong push” from the agricultural center to reopen as soon as possible. 

Mays quotes Vander Poel: 

We are not a highly concentrated urban area.  I believe that our businesses feel like they can accommodate social distancing and increase hygiene and sanitation much quicker and on a much more open basis.

But Tulare County, with a population of nearly half a million, is hardly rural.  So far, it's seen more than 300 cases, mostly from nursing homes.  Mays quotes Governor Gavin Newsom: 

For those that think this is just an urban construct, or densified in certain parts of the state, it exists and persists, Covid-19, throughout the state, including rural California.  None of us are immune from this disease, and if we stop taking it seriously, we will have serious consequences.

Here's a story out of Stanislaus County, also in the Central Valley, and here's a story of protests out of Del Norte County, in far northern California.  Contrary to Mays' construct, Del Norte County is coastal but very rural.  An earlier post about Del Norte County is here. 

And here's a comment from Governor Newsom's press conference today on the issue of some local governments moving to open before he gives the go-ahead:

I imagine there’ll be some examples of people just getting ahead of that collaborative spirit. And we may have to dial a little bit of that back.

Coronavirus in rural America (Part XXV): Trends look bad in many "rural" states without shelter-in-place directives

Here and Now (an NPR program) just reported on coronavirus trends out of Iowa, Nebraska, North and South Dakota, and Arkansas, none of which have shelter-in-place orders.  Not surprisingly, the trends are bad news right now in all of those states except in Arkansas, where the situation seems reasonably under control.  In Arkansas, 41 people have died since the first case was reported on March 11, and some 1800 residents have tested positive for the virus.  

In Iowa, Nebraska, South Dakota and North Dakota, however, cases are up, though the tend to be concentrated in certain cities and, even more precisely, among meatpacking workers in those cities.  In South Dakota and Nebraska, these cases are primarily in meat processing facilities in Sioux Falls and Grand Island, respectively.  Here's a story about the Grand Island outbreak, from the Omaha World Herald, "Grand Island's rate of COVID-19 cases is higher than Michigan's, close to Louisiana's, by Henry J. Cordes.  The lede follows:

The Grand Island area — by far Nebraska’s biggest coronavirus hot spot — now has rates of illness comparable to some of the hardest-hit states in the country. 

Not only does surrounding Hall County now have more cases than any county in Nebraska, its per capita case rate is almost 12 times that of Douglas County [population 517,000 and home to Omaha] and more than 25 times that of Lancaster County [population 285,000 and home to Lincoln], a World-Herald analysis found.  

Updated news out of South Dakota, from the Argus Leader is here. Lisa Kaczke writes:

The number of confirmed coronavirus cases in South Dakota increased by 50 on Monday as legislative leaders learned the state will receive federal funds in excess of $1.5 billion to help cover costs associated with the virus' sp. [sic] 

Cases in Minnehaha county increased by 43 to 1,405 and by five in Lincoln County to 95, according to the South Dakota Department of Health. South Dakota has a total of 1,685 coronavirus cases. That doesn't include people who show symptoms but are not tested.

* * * 

The state's death toll remains at seven, according to the state health department. Recoveries increased by 65 to 709, and 13 more people have been hospitalized. The state says 87 people have been hospitalized at certain times since the state first reported cases.

Here's a headline from the Des Moines Register, "16 workers test positive for COVID-19 at Prestage pork processing plant."

Prestage Foods of Iowa says 16 employees at its Eagle Grove pork processing plant have tested positive for COVID-19. 

The plant’s operations will be limited while of its all employees and on-site service providers are tested over the next two days and the results are returned, officials with Prestage, which is based in North Carolina, said in a release Monday.

Wright County officials and the company agreed to test 62 employees who live in Black Hawk County and commute daily to the plant, given a growing number of COVID-19 positives in Black Hawk. 

Sixteen of the 62 tested positive for COVID-19 but all were asymptomatic, Wright County said. 

Prestage said that some of those commuting employees had been in contact with others in Black Hawk County who tested positive for the coronavirus.

Here's North Dakota news from Sydney Mook of the Grand Forks Herald, "3 more deaths reported in North Dakota; COVID-19 cases associated with LM Wind Power continue to rise."

The number of COVID-19 cases associated with the LM Wind Power plant in Grand Forks continues to rise as the state health department reports three more deaths Monday, April 20.

The North Dakota Department of Health says there are now 128 total positive cases associated with the LM Wind Power plant. Those associated cases include employees and close contact individuals. 

Of those numbers, 99 people tested positive for COVID-19 through a large-scale testing event that was performed at LM Wind Power last week. A total of 426 people were tested at the event -- 323 people tested negative and four tests were unable to be run. The state says that of the 99 positives 72 are LM employees, 19 are still under investigation and eight were not workers.

All of that said, look at what's happening in Wyoming, which also does not have a shelter-in-place order but which has suggested doing so is a good idea.  (Read Governor Mark Gordon's March 29 statement here, where he notes that Wyoming is a "rural" state in relation to its paucity of hospital beds and medical personnel to handle any surge.)  This report is from Robert Klemko of the Washington Post, dateline Cheyenne, population 60,000 and the state capital, tucked away in the southeast corner of a state that encompasses nearly 10,000 square miles populated by fewer than 600,000 residents, making it the 49th least dense state (the prize for sparseness no doubt going to Alaska).  The story features 67-year-old Ken Bingham, a man who both owns a jewelry store and drives a public transit bus.  His wife, who is undergoing chemotherapy, has not been within six feet of him for the past month.  Here's an excerpt from Klemko's very atmospheric report, which notes that Bingham has not closed his jewelry store and then quotes him:

Jewelry isn’t really essential, unless you’re about to lose the diamond off your ring. Then it gets real essential.

I can take care of myself. And most people can, and most people will. The government should stay out as much as they possibly can. I’m not willing to give up my freedoms for ­security.

Thus far, the coronavirus death toll in Wyoming is two, Klemko notes.  While the state has no stay-at-home order, it does have a ban on gatherings larger than 10 and the governor has urged people to stay at home, essentially to "do the right thing."  At an event today, Governor Mark Gordon reported that some cases from the Jackson area have been sent to neighboring Idaho and Utah because of lack of hospital capacity in Teton County. 

The Klemko story in the Post features several quotes from Marion Orr (R), the mayor of Cheyenne, who seems like she might not be a Trump disciple.  What follows are several of Orr's comments: 

At the end of the day, everybody has dinners to cook, homes to clean, kids to feed. So a lot of people just don’t follow up on the science and what we’re learning, because we’re dealing with real life. And that’s why we as communities have to be able to rely on health-care experts and top policymakers to do the right job.

There’s no playbook. This isn’t a tornado or a flood or, God forbid, a school shooting. So we’re throwing everything at the wall and seeing what sticks.

The message that I’m really trying to communicate is that the feeling that if the president says to open the country we should just open the floodgates and start having baseball and softball tournaments and symphony performances and everything will be fine again is misguided. 

Klemko continues:

Orr worries that such thought will increase with calls to “liberate” Wyoming. Even her family has resisted: Her son went on a camping trip with a few friends for his 21st birthday this month.

And then there is this great responding quote from Orr:

If my kids are going to insist on going out and partying during this, then I’m going to insist they don’t see their grandparents.  Because I like my parents, and I want them to live.

And here's a lack of anonymity angle on what is going on:

Two weeks ago, Orr’s brother in Laramie told her a fly-fishing shop in town had numerous guests requesting licenses from out of state, including counties in Colorado with much higher rates of infection. Orr reached out to the Wyoming Game and Fish Department, which soon after issued a temporary suspension of out-of-state fishing licenses. 

Coronavirus in rural America (Part XXIV): far northern California

Here's a Los Angeles Times story out of Del Norte County, California, population  28,610, about political and public health consequences of the coronavirus crisis.  The lede of Susanne Rust's story follows:

In Del Norte County, which lies along California’s northern coast, officials are straddling a tenuous line: On the one side, they are desperate to keep their residents free of a deadly virus raging across the globe; on the other, they can’t ignore their community’s libertarian tendencies and traditions. 

“For people living here, we kind of naturally social distance already,” said the county’s sheriff, Erik Apperson, who noted that many of the county’s residents lived here precisely because they wanted to avoid the crowds and traffic found elsewhere in the state. 

“But, if we start pushing too far onto people’s civil rights and personal liberties — their ability to move freely, or get out onto the ocean to fish — well, what are we doing here?” he said, referring to his office’s role in defending and enforcing the U.S. Constitution. 

Crescent City, the county seat, is roughly 20 miles south of the Oregon border. It’s wedged between the Pacific Ocean and an expansive range of steep, densely forested mountains. Poor and remote, it is known for having experienced 41 tsunamis since 1933, and somehow coming back after each one.

Coronavirus in rural America (Part XXIII): more on "the South"

Here's an excerpt from the essay by physician and writer Edwin Leap in The Atlantic, under the headline, "A Doctor’s Warning From the Rural South: Small community hospitals already operate on the very edge of disaster every day."

Life in the rural South is tied closely to nature. Live here long enough and you can tell that a storm is rising by the way the leaves roll in the wind. A strange silence can precede bad weather, as the birds shelter on the ground and the air pressure changes throughout the house. In my part of rural South Carolina, we are experiencing a new kind of silence: a kind of breath-holding, sky-watching, prayer-whispering pause as we wait for COVID-19 to arrive in earnest. 

Dr. Leap works in rural South Carolina, where he reports that his county has 15 cases so far.  His short (but important) essay concludes:

If COVID-19 strikes rural America with the fury it has unleashed in more populous places, many more lives will be lost, especially if the resources are already committed elsewhere. If this happens, rural southerners will do what they always have done in times of trial: Band together, do their best, and try to survive. Then bury the dead in family plots, weep, and carry on. 

Rural hospitals have been limping along for decades. The rural South—rural America in general—deserves a robust medical system, including a series of small hospitals intentionally located to mitigate disaster and save lives. Pandemic or not.

Postscript:  The State newspaper out of Columbia, South Carolina, posted this story on April 19.  It's deeply reported, but still a standard rural angle on the coronavirus crisis.  An excerpt with some data on rural counties versus urban ones (as measured by a county population of 70K) follows:

A lack of adequate testing and protective equipment, poverty that discourages trips to the doctor, relatively few doctors and nurses, higher percentages of people in poor health and limited information about the dangers of COVID-19, the disease caused by the novel coronavirus, are among the issues affecting rural areas dealing with the coronavirus.

But as the disease takes its toll, these challenges need addressing, say advocates for the state’s rural areas. Often neglected, rural South Carolina faces a problem like none it has seen before. 

The impact of the virus, increasingly well documented in bigger counties like Richland, is now being felt in rural, smaller counties that in some cases are underequipped to handle the crisis. Three of the top five counties in rates of infection have populations of under 70,000, according to the S.C. Department of Health and Environmental Control. 

Those are Clarendon, Lee and Kershaw, where the outbreak first was identified in large numbers. Sumter County, also in the top five, has just over 100,000 people, but large swaths of rural areas. 

The journalists quote Rep. Lonnie Hosey, D-Barnwell: 

Do you want us to give up our territory and move to metro Columbia, Charleston or Greenville?  No? Then why don’t you help us? We don’t have the amenities you have. But we are still part of America.

Coronavirus in rural America (Part XXII): cattle

Two excellent stories about cattle ranching and cattle sales caught my attention in the past few days. The first is by Madelyn Beck with Boise Public Radio, reported on March 30 but picked up by  Marketplace just yesterday.  The headline is "From Livestock Auctions To Packing Plants, COVID-19 Has A Big Impact On Beef." 

Amid the COVID-19 crisis, livestock auctions like his are staying open to help maintain the food supply chain. They’re considered essential like hospitals and groceries stories and gas stations.

That doesn’t mean these auctions will keep operating like normal. In rural communities they’re often social gathering places, but now many have limits. Sellers are asked to just drop off cows and leave. 

Beck quotes Jake Billington of the Twin Falls, Idaho Livestock Auction regarding spectators:   

We have limited it down to just serious buyers only. You know, one person per family.

Then, from Chelsea Good, vice president of government and industry affairs for the Livestock Marketing Association, the trade group encouraging these precautions while "also working to keep the beef moving."

We’ve worked with both our federal officials, but then also our states and local communities to help get them that critical food supply designation and allow them to continue operating in this important time.

Good also noted that "[t]hese auctions are vital to rural communities nationwide."  Further, "while some ranchers might be able to market cows online ... it’s important to have multiple bidders in the room. That’s what drives prices up so ranchers can make a profit.

Good concluded: 

Candidly, that’s what livestock auctions are all about. We’ve got an auctioneer, we’ve got a competition and bidding, we’re working for that producer.

And "producer," of course, means farmer or rancher.  This story is perhaps particularly interesting for me because my father, who spent most of his working life as a truck driver, hauled cattle for a time. That means I spent some time around sale barns in my childhood. 

The second is today's story by Bob Moffitt for Capital Public Radio here in Sacramento, "Spring Cattle Work Brings COVID-19 Guidelines For Ranch Hands From UC Cooperative Extension."  The story begins by observing that it's a busy time of year for cattle ranchers.  Moffitt includes quotes from a UC Cooperative Extension Agent and from some ranchers in the Sierra Nevada.  They offer strategies for getting the work done without undue risks that the ranch hands will infect one another.  Estimated losses so far from the coronavirus pandemic for cattle ranchers:  $13.6 billion. 

Meanwhile, more bad news out of the meatpacking industry here (South Dakota) and here (Colorado).  

Coronavirus in rural Australia: Resistance from remote Queensland

From the Australian Broadcasting Corporation comes this headline, "Coronavirus rules need to be relaxed in remote areas, pubs should reopen, locals say."  Francene Norton reports from Diamantina Shire, Queensland, population 292, on the border with South Australia:

Diamantina Shire Mayor Robbie Dare, who returned to the job after retiring from local government in 2012, called for pubs to reopen given there were no known cases of COVID-19 in some areas. 

Norton quotes Mr. Dare: 

We're very lucky we're isolated already just by the nature of being out here in the outback and everyone out here has been doing the right thing.  

We all know we haven't got it and yet our pubs have closed down the road. 

I think they look at our remote areas at least and think about letting them back in, because the same people are walking into the shop and filling their vehicles up. 

Why can't they just walk into the hotel and have a beer? We haven't got any strangers in town.

Coronavirus in rural America (Part XXI): the greatest income disparity in the U.S.

That would be Teton County, Wyoming, home to Jackson Hole.  Here's an excerpt from the New York Times story headlined "Where the Very Rich Fly to Hide," by Justin Farrell, author of Billionaire Wilderness:

The chasm between the rich and the rest in Teton County is bridged by an uneasy alliance between the wealthy owners of vacation homes and the lower-income residents who depend on them for their livelihoods. The county has the country’s widest disparity in income between the top 1 percent and the bottom 99. Now the pandemic is laying bare the tensions of that relationship as service workers must choose between continuing to do jobs that may expose them to the virus, or risk the loss of wages, health insurance and eviction. All three of the area’s ski resorts shut down about a month early because of the pandemic, and restaurants and the national parks are closed.

One Jackson, Wyoming airport worker commented:

It’s disgraceful to see people not understand the severity of the problems. It makes it uneasy to provide the services we do to these kinds of people. I live paycheck to paycheck and I don’t have much saved up in my account to handle a serious illness.

And here's a New York Times opinion piece from about 10 days ago on why the wealthy fear pandemics.  In it, Walter Scheidel, a professor at Stanford University, draws parallels between the coronavirus and the bubonic plague and discusses how that earlier health crisis diminished laborers' willingness to do crappy work for crappy pay.

Retrospective on a rural physician

I heard a story on NPR a few days ago out of Logan, Ohio, population 7,152.  I believe the journalist in that story interviewed a public education administrator in Logan; he talked about how the school district is scrambling to serve rural and low-income students.  I have not, however, been able to track down that story to blog about it.  What I did come across in trying to find that recent story about public education in the age of coronavirus is this extraordinary story from just two months ago (though it feels, in the age of coronavirus, like it could be two years ago) about a family physician, Scott Anzalone, who has worked in Logan, Ohio for two decades.  It's part of Marketplace's series on work in the 21st century economy.  An excerpt follows:

[Anzalone] describes himself as the “last physician standing in private practice in the region,” as others have retired or been bought out by large health care systems. Maintaining a private practice in rural community isn’t easy. He balances the needs of his patients with the demands of operating the business, serving as president of the local school board and a part-time position with Ohio University’s school of medicine. His university and school board positions offer retirement benefits, something that can be tough to get when you’re self-employed. In the two decades he’s lived in Logan, Anzalone has seen the community change by the arrival of Walmart, declines in the manufacturing economy, and more recently by the opioid crisis.

Coronavirus in rural America (Part XX): Another story of economic devastation

This one, from the New York Times, is out of Bristol, New Hampshire, population 3,054.  David Gelles reports under the headline, "This Is Going to Kill Small-Town America," about the economic destruction that preceded local health care impacts of the coronavirus pandemic:

By the end of March, with just a few local cases confirmed, gift shops, yoga studios and restaurants had all shut their doors. Hundreds lost jobs, contributing to a record surge in national unemployment claims. 

But at least the Freudenberg factory was running at full strength. The factory, which employs 350 people and makes bonded piston seals and other components for carmakers around the world, has an outsize impact on Bristol’s economy. 

Besides paying employees their salaries and the town taxes, the factory — part of a German industrial conglomerate — is the largest customer of Bristol’s sewage and water systems, a linchpin of the annual budget.

Nik Coates, the town administrator, said in an interview on April 2:

Freudenberg is our lifeblood. If that plant was ever to close or significantly reduce operations, that would put us in a world of hurt.

The next day, Freudenberg fired more than 100 workers and announced it is shutting down some of its Bristol operation.  That makes another quote form Coates particularly poignant:

We’re not rich by any means.  We’re pretty poor, in fact.

That said, the story Gelles tells is also one of the community rallying around its own.

Coronavirus in rural America (Part XIX): connecting (and correcting) a community amidst a pandemic

Lack of anonymity is the characteristic associated with rural communities that jumped out at me when I saw this report today from the Los Angeles Times about a community radio station in rural Ely, Nevada, population 4,255.  Here's an except illustration that rural phenomenon: 

This town is stubbornly slow-paced, an outpost where keeping a secret is like trying to hide the sun, where the desert wind is more howl than whisper, and where the unsettling news of a deadly virus arrived like everything else: on the radio voices of Karen Livingston and Jodi McShane. 

Calming as the two women may be, people got a little worried. So the mayor wandered down to KDSS-FM and took to the airwaves. 

“I received an email last night that I need to clear up,” Nathan Robertson said, leaning toward the black microphone. “Someone heard a rumor that I was planning on imposing martial law. That is not true.” 

“Thanks for clearing that up,” Livingston said.

* * *

Surrounded by 250 miles of desert, the rural northern Nevada town of Ely, often cited as the most remote place in the lower 48 states, turns to KDSS when things are going good, bad or any other way.

Eventually, Robertson was going on the air each day to provide coronavirus updates--sorta like Andrew Cuomo in New York and Gavin Newsom in California.

I appreciate Melissa Etehad of the Times staff for this story.  I have never been to Ely, but I suspect based on what I know of other rural places that she captured the essence quite nicely.  That said, I'd say Ely is more central Nevada than northern Nevada, but maybe I'm splitting hairs. 

Coronavirus in rural America (Part XVIII): South Dakota

South Dakota is attracting particular attention today because of the temporary closure of a Smithfield pork processing plant in Sioux Falls.  Griff Witte for the Washington Post reports here.  

As governors across the country fell into line in recent weeks, South Dakota’s top elected leader stood firm: There would be no statewide order to stay home.

Such edicts to combat the spread of the novel coronavirus, Gov. Kristi L. Noem said disparagingly, reflected a “herd mentality.” It was up to individuals — not government — to decide whether “to exercise their right to work, to worship and to play. Or to even stay at home.”

And besides, the first-term Republican told reporters at a briefing this month, “South Dakota is not New York City.”

But now South Dakota is home to one of the largest single coronavirus clusters anywhere in the United States, with more than 300 workers at a giant ­pork-processing plant falling ill. With the case numbers continuing to spike, the company was forced to announce the indefinite closure of the facility Sunday, threatening the U.S. food supply.

Increasingly exasperated local leaders, public health experts and front-line medical workers begged Noem to intervene Monday with a more aggressive state response.

“A shelter-in-place order is needed now. It is needed today,” said Sioux Falls Mayor Paul TenHaken, whose city is at the center of South Dakota’s outbreak and who has had to improvise with voluntary recommendations in the absence of statewide action.

According to Alexa Lardieri for U.S. News and World Report:

The company said on Sunday that its plant in Sioux Falls, South Dakota, will remain closed "until further notice." The plant processes 4% to 5% of America's pork production, supplying nearly 130 million servings of food per week. It employs about 3,700 people, and more than 550 farmers supply the facility. The company is based in Virginia and employs 40,000 people across the U.S. 

The New York Times reported that 296 of the plant's employees tested positive for the novel coronavirus.

Journalists are quoting experts--especially those who focus on the food sector of financial markets--talking about how a food supply crisis may be impending.  See reporting for the New York Times here and here.   One quote from a New York Times story that calls out the rural angle is this one, quoting Karen Girotra, a Cornell University supply-chain expert:

Labor is going to be the biggest thing that can break.  If large numbers of people start getting sick in rural America, all bets are off.

I'd be interested to know the percentage of folks working at the Smithfield plant in Sioux Falls who are immigrants, documented or not.  The Washington Post characterizes the immigrants employed at the plant as "many" and indicates it produces some 18 million servings of pork each day.

More on the coronavirus situation in South Dakota is here, regarding a trial re: the efficacy of malaria meds.

Coronavirus in rural America (Part XVII): Who is going to feed us?

A great deal of news coverage about food and how it reaches consumers is on offer during this coronavirus pandemic. 

The first story I want to highlight is this one, by Frank Martin for NPR, suggesting that the supply chain may be "loosening."  The idea is that because folks are stocking up on on food and other necessities, they won't continue to need truckers--at least not for several months--once their need is met.  Here's a key excerpt:

But David Ross, a logistics analyst at Stifel Financial Corp., said that after weeks of consumers stuffing so many groceries into pantries and freezers, the logistics industry might soon have to slam on the brakes. 

Ross comments:

At some point, folks will have all of the ground beef they need until July, all of the toilet paper they will need until November.  And over the coming weeks, the demand for that should drop off significantly.

Martin's story continues:

Then, truckers who have been busting their humps for weeks trying to fill orders could see demand evaporate.

Ross and others predicted a rough year for the trucking and railroad industries this year even before the coronavirus upended the world. Now their prognosis is worse. 

On Monday, Beaver Express Services, an Oklahoma-based trucking firm that had survived 77 years in the logistics business, called it quits. Its owner, Mike Stone, said the coronavirus helped whip up a "perfect storm" that crushed the company. Ross expects more stories like this in the deep recession that the pandemic is expected to trigger. 

"Any time consumer confidence is cracked and people stop buying stuff, you're not going to be moving a lot of goods," Ross said.

That story, now a few weeks old, is not exclusively about food, but it is about one of the ways that food (along with other goods) reaches consumers. 

The second--and equally sobering story--is this NPR report about the Trump administration trying to suppress wages for farm laborers.  An excerpt from the report by Franco Ordonez follows:

New White House Chief of Staff Mark Meadows is working with Agriculture Secretary Sonny Perdue to see how to reduce wage rates for foreign guest workers on American farms, in order to help U.S. farmers struggling during the coronavirus, according to U.S. officials and sources familiar with the plans. 

Opponents of the plan argue it will hurt vulnerable workers and depress domestic wages.
The measure is the latest effort being pushed by the U.S. Department of Agriculture to help U.S farmers who say they are struggling amid disruptions in the agricultural supply chain compounded by the outbreak; the industry was already hurting because of President Trump's tariff war with China. 

"The administration is considering all policy options during this unprecedented crisis to ensure our great farmers are protected, and President Trump has done and will do everything he can to support their vital mission," a White House official told NPR. 

The nation's roughly 2.5 million agricultural laborers have been officially declared "essential workers" as the administration seeks to ensure that Americans have food to eat and that U.S. grocery stores remain stocked. Workers on the H-2A seasonal guest-worker program are about 10% of all farmworkers.

The third story I'll highlight is only moderately more uplifting.  It is by Kim Severson of the New York Times about how organic and artisanal farmers are finding ways forward as their typical customers--restaurants and patrons of farmers markets--are lost to them.  Here's an excerpt focusing on California, though the story touches on small-scale farmers in New York and Kentucky, too. 

In the spirit of the sustainable food movement’s roots, some farmers have decided to go hyperlocal. Randy Stannard runs Root 64 Farm with his partner, Sarah McCamman, on an acre of land in Sacramento. They were planning to sell their early crop of radishes and arugula to local restaurants and at a farmers’ market. The virus put an end to that. 

Instead, last Saturday they opened a little drive-through farm stand in front of their house, and are raising money with others in their community to provide 20 boxes of produce a week through December to needy families whose children attended their neighborhood elementary school. 

“We could sell everything to people who are well-off and would drive miles to come here,” he said. “But we want to make sure we get really good, high-quality food to people who need it the most and live nearby.”

A contrast to that story is this Wall Street Journal story from April 9 about farmers dumping milk and eggs that they can no longer sell to restaurant patrons.

And to that WSJ story from April 9, the New York Times responded with this on April 11, by David Yaffe-Bellany and Michael Corkery, for which part of the very depressing headline is "Food Waste in the Pandemic":

After weeks of concern about shortages in grocery stores and mad scrambles to find the last box of pasta or toilet paper roll, many of the nation’s largest farms are struggling with another ghastly effect of the pandemic. They are being forced to destroy tens of millions of pounds of fresh food that they can no longer sell. 

The closing of restaurants, hotels and schools has left some farmers with no buyers for more than half their crops. And even as retailers see spikes in food sales to Americans who are now eating nearly every meal at home, the increases are not enough to absorb all of the perishable food that was planted weeks ago and intended for schools and businesses. 

The amount of waste is staggering. The nation’s largest dairy cooperative, Dairy Farmers of America, estimates that farmers are dumping as many as 3.7 million gallons of milk each day. A single chicken processor is smashing 750,000 unhatched eggs every week.

The Minnesota Star-Tribune's story on the phenomenon is somewhat more optimistic, reporting that Minnesota dairy farmers are not (yet) dumping milk.

At the other end of the food supply chain are grocery stores, and reports are starting to emerge, including stories here and here, about their employees dying from COVID19.

The last story I'll highlight in this post is about the Trump administration backing off new,  tougher eligibility rules for SNAP (formerly food stamps), in light of the severe economic downturn.  That's a relief.  One could debate the wisdom of work requirements in the best of times (as I have done here), but there's surely no doubt that work requirements make no sense when the unemployment rate is as high as it suddenly is.

Coronavirus in rural America: (Part XVI): the South

As news coverage of coronavirus' consequences for rural America ramps up, one theme has been what is happening in the American south, which is our nation's most rural region.  Margaret Renkl's column in the New York Times last week was headlined, "In the American South, a Perfect Storm is Gathering."  Renkl, who is based in Nashville, writes a weekly column.  This is about the fact that many southern governors--in the very places that didn't expand Medicaid--have been slow to issue shelter-in-place orders, which is likely to result in fast coronavirus spread.  Renkl uses Tennessee and its neighbor Kentucky to "compare and contrast":

Kentucky, which not only elected a Democratic governor but also expanded Medicaid under the Affordable Care Act, is an outlier in the South. Most Southern states, like Tennessee, did not expand Medicaid, and in those states a perfect storm has gathered force. What does it mean to live though a pandemic in a place with a high number of uninsured citizens, where many counties don’t have a single hospital, and where the governor delayed requiring folks to stay home? Across the South, we are about to find out.

Then there are these very dire stories out of Alabama, from Ramsey Archibald at AL.com.  The first notes that Alabama was, as of April 4, predicted to have the highest coronavirus death rate in the nation, though that was revised downward on April 5 to be the 21st highest death rate among states. 

But some estimates predict a more dire situation here, as a recent epidemiological model shows Alabama could have the highest per capita death rate in the country, and the fourth highest total death count. 

If the worst were to happen - if Alabamians refuse to follow social distancing measures, the state’s intensive care units become overfull with the most ill coronavirus patients, or even if people here are unlucky - nearly 10,000 Alabamians could die from COVID-19 by the middle of next month. 

That’s according to projections released earlier this week from the Institute for Health Metrics and Evaluation at the University of Washington. IHME released projections for every U.S. state on April 1, and will continue to update them.

And here's a story, also by Archibald, about the impact of the coronavirus pandemic on rural economies.  It's now more than a week old, from April 3, 2020.

More than 80,000 Alabamians filed for unemployment insurance last week. That represents an increase of more than 2,100 percent since the start of this year, and many Alabama counties have seen even larger spikes. 

And Alabama isn’t alone. People from all over the country have lost their jobs since the onset of the virus, as the U.S. as a whole saw a spike of more than 3,000 percent from pre-pandemic levels. 10 million people have filed for unemployment nationwide in just the last two weeks.

Of course, Louisiana has received a great deal of media attention as a coronavirus "hot spot."  Time will reveal the consequences of the slow-to-close strategy embraced by most southern governors, including those of Georgia, Texas, Arkansas, Mississippi, and Florida (which is at least partly "southern"). 

Postscript:  Here's a Tweet from April 2 poking fun at the Southern governors' decision re: coronavirus and linking those decisions to Reconstruction Era thinking.

Coronavirus in rural America (Part XVI): governing a "rural state"

Charlie Warzel has an op-ed in today's New York Times titled "What It’s Like to Run a Rural State During a Pandemic," featuring an interview with Montana Governor Steve Bullock.  Here's the lede, which points up characteristics of Montana that make it a governing challenge:

Guiding a state like Montana through a pandemic is difficult because Montana is a complicated state in a precarious position. Its significant Indigenous population is spread across seven reservations whose resources are spread thin even in non-pandemic times. When bidding on critical resources, the state can’t compete with the bigger needs of coastal states like New York or California. 

As a tourism hub and second-home escape for the wealthy, Montana is vulnerable to increased outbreaks brought in from those looking to flee crowded cities. Many of the state’s rural counties have health care infrastructure that would easily be overwhelmed if hit by a full-fledged Covid-19 outbreak. Testing capacity is stretched thin and should supply chains fall down — even for a day — the state could find itself unable to catch up with the virus. 

Warzel characterizes Governor Bullock's leadership thus far as "decisive."

Postscript:  Joel Rose reports from Montana on Friday evening for NPR.  The story highlights how that low-population state has been cut off from federal stores of PPE supplies and ventilators.  Here's a quote from the story:

"When you look at those five or six national distributors, Montana is sure as heck not getting much luck out of them," Gov. Steve Bullock said in an interview. 

The market for medical supplies across America has become chaotic. States and hospitals are competing with each other and with the Federal Emergency Management Agency for the same scarce resources. Also, the administration can invoke a federal law to prioritize its orders over others.

* * *

"If the private market supply chains aren't necessarily working for the states, and we're just bidding up prices against one another in a scarcity, I think it makes it that much harder for us to do our job," Bullock said. 

Montana has a relatively low number of coronavirus cases, but it does have a serious outbreak in the Bozeman region. And that drew the attention of Dr. Deborah Birx, the coordinator of the White House coronavirus task force. 

"There were some — a few standouts that we were concerned about, which was Vermont, New Hampshire, Idaho, and Montana," Birx said at a press briefing this week. "These were micro-outbreaks that occurred due to ski events, weddings, and nursing homes." 

Emergency responders in Montana have told the governor they need half a million N95 surgical masks. Montana requested 80,000 masks from the federal government, but Bullock says his state received only 10,000. 

"I've gotten five times more supplies of N95 masks from North Dakota than I have from the Strategic National Stockpile," Bullock said.

Meanwhile, reports out of Colorado indicate that Trump announced sending some supplies to the state because of U.S. Senator Cory Gardner (R), while interfering with the efforts of Governor Jared Polis (D) to purchase 500 ventilators for use in the state.  The Denver Post has written an editorial under the headline, "Trump is playing a disgusting political game with our lives."  Here's an excerpt:

We are left to believe that if Colorado didn’t have a Republican senator in office, our state would not be getting these 100 ventilators. How many ventilators would we be getting if we had a Republican governor and a second Republican senator? Would that indicate we had more Republican lives in our state worth saving for Trump and resources would start flowing? Should Utah be concerned that Sen. Mitt Romney voted to remove the president from office? 

This behavior comes, of course, weeks after Trump informed states they would have to compete against one another in the procurement of medical supplies at a time of global shortages due to the coronavirus pandemic. 

The federal government should be procuring medicine, masks, and ventilators and distributing them to states on a set formula based on population, rate of infection and need. Instead, Trump’s messaging makes it feel as though he will watch with glee from the White House as people suffer in states being led by his enemies.

And here's a post-script from Sunday morning, a Tweet from Governor Andrew Cuomo of New York suggesting that it is states like his that aren't getting a fair shake:

I can't help wonder if the allocations to Montana and Nebraska may account for those states' inability to achieve economies of scale because of their relatively small populations, spread across vast territories.  Or maybe it's just Trump continuing to exact revenge on New York, formerly his home state.

Immigration removal proceedings in rural communities

Transactional Records Access Clearinghouse has just released a report looking at immigration removal proceedings along the rural-urban continuum.  Here are some of the takeaways:

Although the Immigration Courts with the largest backlogs of cases are located in large cities, the latest Immigration Court records show that when adjusted for population, many rural counties have higher rates of residents in removal proceedings than urban counties. In fact, of the top 100 US counties with the highest rates of residents in removal proceedings, nearly six in ten (59%) are rural. In these communities, residents facing deportation may find themselves in rural "legal deserts," where there are few qualified immigration attorneys, longer travel times to court, and high rates of poverty.

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TRAC recently mapped the Immigration Court's current active backlog—over 1.1 million cases—to show the number of residents in each county who are awaiting their day in court. In this follow-on report, TRAC used the same data set to map the proportion of residents ("rate") with pending immigration cases as a fraction of total residents.

When the total number of backlog cases is mapped, urban areas such as Los Angeles, New York City, and Chicago emerge as areas with large numbers of pending cases. This makes sense, because the total number of immigration cases is driven by the geographic concentration of large numbers of people in urban areas. However, when the number of pending immigration cases is mapped relative to county population, a different picture emerges. Many large urban counties are revealed to be more average, while many rural counties are shown to have much higher concentrations of removal cases. 

In these rural counties, residents may have a heightened sense that immigration enforcement is impacting their community. This, in fact, would be an entirely rational perception since the odds are indeed greater. 

Figure 1 below includes a map of the proportion of residents in each county currently in the backlog (top) and the total number of cases in each county in the backlog (bottom, reprinted from our previous report). The county-level rate is represented as the number per 100,000 residents who are currently in removal proceedings. 

Particularly striking is how many counties in Southern California and the New York City-Boston corridor, which are prominent in the map of the number of cases, look more typical once population is taken into account. Also striking is how counties in the Great Plains regions from Southwest Minnesota to western Oklahoma pop off the map as places where higher percentages of the community are facing deportation proceedings today.

As for the heightened sense of vulnerability that rural communities have, I'm reminded of events like the Postville, Iowa raid and these immigration raids in rural Mississippi last summer, as well as the community consequences of those raids.  Here's a 2018 post about cross-ethnic solidarity around immigration out of Tennessee.