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Midwestern hospitals in rural areas struggling to deal with virus tension



WESSINGTON SPRINGS, SD (AP) – Rural Jerauld County in South Dakota did not see a single case of coronavirus for more than two months, stretching from June to August. But over the last two weeks, the number of new cases per Person to one of the highest in the country.

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

As the bulk of the virus has blown into the Upper Midwest and Northern Plainsthe severity of outbreaks in rural areas has come into focus. Doctors and health officials in small towns are afraid that infections could overwhelm communities with limited medical resources. And many say they are still running against attitudes to wear masks that have hardened along political lines and a false notion that rural areas are immune to widespread infections.

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

It tore through the nursing home in Wessington Springs, where both his parents lived and killed his father. The community̵

7;s six deaths may seem minimal compared to thousands who have died in cities, but they have driven the county of about 2,000 people to a death rate that is about four times higher than the nationwide rate.

Rural areas in Wisconsin, North Dakota, South Dakota and Montana are among the top in the country for new cases per. per capita over the past two weeks, according to Johns Hopkins researchers. In counties with only a few thousand people, the number of cases per Inhabitant rise with even a small eruption – and tolls hit close to home in closely linked cities.

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

Wessington Springs is a hub for generations of farmers and ranchers working with the surrounding land. Residents send their children to the same schoolhouse they attended and have preserved cultural offerings such as a Shakespeare garden and an opera house.

They trust Dean, who for 42 years has tended to have everything from broken bones to high blood pressure. When a patient needs a higher level of care, the GP is usually dependent on a transfer to a hospital 209 kilometers away.

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

“We are proud of what we got, but it has been a struggle,” he said of the 16-bed hospital.

The outbreak that killed Dean’s father forced Wessington Springs’ only nursing home to make a request for nurses across the country.

Thin resources and high deaths have plagued other small communities. Blair Tomsheck, interim director of the Health Department in Toole County, Montana, worried that the region’s small hospitals would begin caring for serious COVID-19 patients after cases rose to the nation’s highest per capita rate. Inhabitant. One in every 28 people in the county has tested positive in the past two weeks, according to Johns Hopkins researchers.

“It’s very, very challenging when your resources are poor – living 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, go to the same school, or worship at a handful of churches.

“Sunday family dinners kill us,” Tomsheck said.

Although outbreaks threaten to get out of control, doctors and health officials said they are struggling to convince people of the seriousness of a virus that took months to take effect.

“It’s like getting a snowstorm warning, and then the snowstorm doesn’t hit that week, so the next time people say they don’t want to worry about it,” said Kathleen Taylor, a 67-year-old writer living in Redfield, South Dakota. .

In the shards of the country decorated with flags supporting President Donald Trump, people took their joints in wearing masks from his often cavalier stance on the virus. Dean draws a direct link between Trump’s approach and the lack of precautionary measures in his city of 956 people.

“There’s the silly idea that wearing a mask or rejection is some kind of political statement,” Dean said. “It has seriously disrupted our ability to get it under control.”

Even in the midst of the rise, Republican governors in the region have been reluctant to act. North Dakota Gov. Doug Burgum recently said, “We are caught in the middle of a COVID storm” as he raised the advisory risk level in counties across the state. But he has refused to issue a mask mandate.

South Dakota Gov. Kristi Noem, who has cut a reputation among the Conservatives by taking lockdowns, blamed the rise in cases by test increases, even though the state has had the highest positivity rate in the nation in the past two weeks, according to the COVID Tracking Project. Positivity rates are an indication of how widespread infections are.

In Wisconsin, conservative groups have sued over the masked mandate of the Democratic government Tony Ever.

Whether the claim survives does not matter to Jody Bierhals, a Gillett resident who doubts the effectiveness of wearing a mask. Her home county of Oconto, which stretches from the northern border of Green Bay to forests and farmland, has the state’s second-highest growth in the case of coronavirus per capita. Person.

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

“Do I want to keep the water on, or will I be able to put food on the table?” she asked. “It’s a difficult situation.”

Bierhals said she thought the virus could not be stopped and it would be best to let it run. But such local attitudes have left the county health officer, Debra Koniter, desperate.

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

“I’m just waiting to see if our society can change our behavior,” she said. “Otherwise, I do not see the end in sight.”


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