Rural Midwestern hospitals are battling COVID surges


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WESSINGTON SPRINGS, SD (AP) – No case of coronavirus was observed in rural Jerauld County, South Dakota, for more than two months from June to August. But in the last two weeks, the number of new cases has risen to the highest in the nation.

“Suddenly it hit and like it exploded, it just exploded,” said Dr. Tom Dean, one of three doctors working in the county.

How to have a virus blown into the Upper Midwest and North Plains, attention was drawn to the severity of outbreaks in rural communities. Doctors and health officials in small towns are concerned that infections could overwhelm communities with limited medical resources. And many say they still oppose the approach to wearing masks hardened by political lines and the misconception that rural areas are not immune to widespread infections.

Din set out to write a column for the local weekly Trakai Dakotan to offer his advice. In recent weeks, he has watched as one in about 37 people in his county found the virus not positive.

This robbed Wington’s source grandparents’ home, where both of his parents lived, and killed his father. Six community deaths may appear minimal compared to thousands in urban areas, but they have resulted in approximately 2,000 more deaths in the county than in the nationwide.

The rural counties between Wisconsin, North Dakota, South Dakota and Montana are in between the summit of the nation new cases per capita in the past two weeks, say Johns Hopkins researchers. In counties with a population of just a few thousand, the number of cases per capita may increase even in the event of a small outbreak – and tolls are available close to home in nearby cities.

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

Wessington Springs is the center of farmers and generations of farmers working the surrounding land. Residents send their children to the same school house they visited and have preserved cultural offerings such as Shakespeare’s 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 a patient needs a higher level of care, the family doctor usually relies on a transfer to the hospital for a distance of 130 miles (209 kilometers).

Over time, rural community hospitals have difficulty finding beds. A recent request to transfer a COVID-19 patient who was not “desperately ill but rather ill” was rejected for several days until the patient’s condition worsened, Dean said.

“We’re proud of what we got, but it was a struggle,” he said of the 16-bed hospital.

The outbreak, which killed Dean’s father, forced the only Wessington Springs nursing home to make a state application to nurses.

Thin resources and high mortality tormented other small communities. Blair Tomsheck, interim director of the health department in Toole County, Montana, was concerned that small hospitals in the region would need to start caring for serious COVID-19 patients after the number of cases rose to the country’s largest population. According to Johns Hopkins researchers, one in 28 counties in the county has had a positive result in the past two weeks.

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

Infections can also spread quickly in places like Toole County, where most people shop at the same grocery store, attend the same school, or pray at multiple churches.

“Sunday’s family dinner kills us,” Tomsheck said.

Even when outbreaks threaten out of control, doctors and health officials said they are trying to convince people of the seriousness of the virus, which took months to take effect.

“It’s like you get a warning about a blizzard and then the blizzards don’t reach that week, so next time people say they won’t care about it,” said 67-year-old author Kathleen Taylor, who lives in Redfield, South Dakota.

In countries adorned with flags supporting President Donald Trump, people have drawn attention to wearing masks because of his often cavalry approach to the virus. Dean singles out a direct link between Trump’s attitude and the lack of precautionary measures in his city of 956 people.

“There is a stupid idea that wearing or giving up masks is a kind of political statement,” Dean said. “It seriously hampered our ability to control it.”

Even as the region’s Republican governors gained momentum, they were reluctant. North Dakota Governor Doug Burgum recently said, “We are caught in the middle of a COVID storm,” when he raised the level of advisory risk in the counties of the county. But he refused to issue a mask mandate.

South Dakota Governor Kristi Noem, who, after protracted closure, has earned a reputation among the Conservatives, blamed the wave of cases the number of tests is increasing, although the state has had the highest positivity rate in the country in the last two weeks, according to the COVID monitoring project. Positivity rates indicate the prevalence of infections.

Wisconsin – Conservative groups sued on the mandate of the mask of Democratic Governor Tony Evers.

Whether the claim will remain doesn’t matter to Jody Bierhals, a resident of Jeddah who doubts the effectiveness of wearing the mask. In its native county of Oconto, stretching from the northern border of Green Bay to forests and arable land, the state has the second highest number of coronavirus cases per person.

Bierhals, a single mother with three children, is more worried about declining business in her small salon. The region is dependent on tourists, but many were left out during the pandemic.

“Do I want to keep water, or do I want to be able to put food on the table?” she asked. – Difficult situation.

Bierhals said he believed the virus had failed to stop, and it would be best to let him run away. However, such a local approach made the county health official Debra Koniter desperate.

Konitzer warned that the uncontrolled spread of infections had shocked 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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