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Rural hospitals are struggling to cope with the virus wave

WESSINGTON SPRINGS, SD (AP) – The rural district of Gerald in South Dakota has not seen a single case of coronavirus for more than two months, stretching from June to August. But in the last two weeks, the percentage of new cases per person has risen to one of the highest in the country.

“It hit suddenly and eventually just exploded,” said Dr. Tom Dean, one of only three doctors working in the county.

As the severity of the virus increases in the Upper Midwest and the northern plains, the severity of outbreaks in rural communities is in focus. Doctors and health officials in small towns are worried that infections could invade communities with limited medical resources. And many say they still face the attitude of wearing masks that have hardened politically and the misconception that rural areas are immune to widespread infections.

Dean began writing a column in the local weekly The True Dakotan to offer his guidelines. In recent weeks, he has watched one in approximately every 37 people in his county test positive for the virus.

It tore through a nursing home in Wesington Springs, where both his parents lived, killing his father. The six deaths in the community may seem minimal compared to the thousands who died in the cities, but they have pushed a county of about 2,000 people to a death rate approximately four times higher than the national rate.

According to researchers at Johns Hopkins University, the rural counties of Wisconsin, North Dakota, South Dakota and Montana are among the first in the country for new cases per capita in the last two weeks. In total, the country exceeded 8 million confirmed cases of coronavirus in the university count on Friday; it is believed that the true number of infections is much higher because many people have not been tested.

In counties with only a few thousand people, the number of cases per capita can jump even with a small outbreak ̵

1; and tolls reach close to home in cohesive cities.

“One or two people with infections can really make a big impact when you have a grocery store or a gas station,” said Misty Rudebusch, a medical director at a network of health clinics in South Dakota called Horizon Health Care. “There is such an effect of pulsations.”

Wesington Springs is a center for generations of farmers and ranchers who cultivate the surrounding land. Residents send their children to the same school house they attended and have preserved cultural offerings such as the Shakespeare Garden and the Opera House.

They trust Dean, who has been prone to everything from broken bones to high blood pressure for 42 years. When the patient needs a higher level of care, the family doctor usually depends on a transfer to a hospital at a distance of 209 kilometers.

With the increase in cases, hospitals in rural communities have problems finding beds. A recent request to transfer a “not desperately sick, but quite sick” patient to COVID-19 was denied for several days until the patient’s condition worsened, Dean said.

“We are proud of what we received, but it was a struggle,” he told the 16-bed hospital.

The epidemic that killed Dean’s father forced the only nursing home in Wesington Springs to apply for nurses across the country.

Thin resources and high mortality plague other small communities. Mr Blair Tomshek, interim director of the health department in Tull County, Montana, is worried that small hospitals in the region will have to start caring for serious patients with COVID-19 after cases jump to the highest number in the country per capita. of the population. According to every researcher from John Hopkins, one in 28 people in the county has had a positive result in the last two weeks.

“It’s a very, very challenge when your resources are poor – you live in a small rural district,” she said.

Infections can also spread quickly to places like Tull County, where most shop at the same grocery store, attend the same school, or worship in a handful of churches.

“Sunday family dinners are killing us,” Tomshek said.

Although the outbreaks are threatening to spiral out of control, doctors and health officials say they are struggling to convince people of the seriousness of the virus, which took months to take effect.

“It’s kind of like getting a blizzard warning, and then the blizzard doesn’t hit this week, so next time people say they won’t worry about it,” said Kathleen Taylor, a 67-year-old author who lives in Redfield, South Dakota. .

In parts of the country adorned with flags in support of President Donald Trump, people took remarks on the wearing of masks by his often cavalier attitude to the virus. Dean makes a direct link between Trump’s approach and the lack of precautions in his city of 956 people.

“There is a stupid idea that wearing masks or refusing is some kind of political statement,” Dean said. “This severely impairs our ability to control it.”

Even against the backdrop of the wave, Republican governors in the region are reluctant to act. North Dakota Gov. Doug Burgham said recently, “We’re caught in the middle of a COVID storm,” as he raises advisory risk levels in state counties. But he refused to issue a mandate.

South Dakota Gov. Christie Noem, who has built a reputation among conservatives through previous blockades, blamed the increase in cases of increased tests, even though the state has the highest positive rate in the country in the past two weeks. The degree of positivity is an indicator of how widespread the infections are.

In Wisconsin, conservative groups have filed lawsuits over the term of Democrat Governor Tony Evers.

Whether the requirement survives doesn’t matter to Jodie Bierhals, a Gillette resident who doubts the effectiveness of wearing a mask. Her home county of Okonto, which stretches from the northern border of Green Bay to forests and farmland, has the second highest increase in human coronavirus cases.

Bierhals, a single mother with three children, is more worried about the decline in business in her small salon. The region depends on tourists, but many of them stayed away during the pandemic.

“Do I want to save the water or do I want to be able to put food on the table?” She asked. “It’s a difficult situation.”

Bierhals said he believes the virus cannot be stopped and it would be best to let it go its own way. But local attitudes like this have left the county’s desperate health worker, Debra Konitzer.

The concierge warned that the uncontrolled spread of infections has overwhelmed the county’s health systems.

“I’m just waiting to see if our community can change our behavior,” she said. “Otherwise, I don’t see the end.

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