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Rural hospitals struggle to handle the virus attack



WESSINGTON SPRINGS, SD (AP) – Rural Jerauld County in South Dakota has not seen a single case of coronavirus in more than two months ranging from June to August. But in the last two weeks, the rate of new cases per person has climbed to one of the highest in the country.

“It suddenly hit, and as it happened, it just exploded,” said Dr. Tom Dean, one of only three doctors working in the province.

As virus damage erupted in the Upper Midwest and northern Plain, the intensity of the explosions in rural communities was concentrated. Physicians and health officials in small towns are concerned that infections may overwhelm communities with limited medical resources. And many say they are still running against the attitudes of wearing masks that have hardened political lines and a misconception that rural areas are unavoidable from widespread infection.

Dean took the writing of a column in the local weekly newspaper, True Dakotan, to offer his guidance. In recent weeks, he has watched as one in almost every 37 people in his province is positive for the virus.

It was torn to pieces in a nursing home in Wessington Springs where his parents lived, killing his father. Six community deaths may have appeared slightly compared to the thousands who died in the cities, but they pushed the province by nearly 2,000 people at a death rate nearly four times higher than the nationwide rate.

Rural provinces across Wisconsin, North Dakota, South Dakota and Montana sat the highest in the country for new cases per capita in the last two weeks, according to Johns Hopkins University researchers. Overall, the country topped 8 million confirmed cases of coronavirus in university numbers on Friday; the actual number of infections is believed to be higher because many people have not been tested.

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

1; and the hits are close to home in crowded towns.

“One or two people with infections can have a big impact when you have a 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 a hub for generations of farmers and ranchers working in the surrounding land. Residents send their children to the same schoolhouse they have attended and maintain cultural offerings such as a Shakespearean garden and opera house.

They trust Dean, who for 42 years tends to have everything from broken bones to high blood pressure. When a patient needs a higher level of care, the family physician usually relies on moving to a hospital 130 miles (209 kilometers) away.

As the number of cases increases, hospitals in rural communities are having trouble finding beds. A recent request to transfer a “not desperate sick, but somewhat” sick patient COVID-19 was denied for several days, until the patient’s condition worsened, Dean said.

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

The outbreak that killed Dean’s father forced a single home in Wessington Springs to release a statewide request for nurses.

Thin resources and high mortality rates have plagued other small communities. Blair Tomsheck, interim director of the health department in Toole County, Montana, worries that small regional hospitals will have to start caring for serious COVID-19 patients after cases are recorded at the highest per capita of the country. One in every 28 people in the county tested positive in the last two weeks, according to researchers by Johns Hopkins.

“It’s very hard, challenging when your resource is poor – living in a small, rural province,” he said.

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

“Family dinners kill us Sunday,” Tomsheck said.

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

“It was like taking a warning to blizzard and then the blizzard didn’t hit that week, so next time, people said they wouldn’t worry about it,” said Kathleen Taylor, a 67-year-old senior author living in Redfield, South Dakota.

In the lands of the country adorned with flags in support of President Donald Trump, people have taken their cues in wearing masks from his often viral behavior. Dean drew a direct connection between Trump’s strategy and the lack of care in his town of 956 people.

“There is a silly idea that wearing a mask or denial is kind of a political statement,” Dean said. “It seriously interfered with our ability to control it.”

Even in the midst of the ascension, Republican governors in the region are reluctant to act. North Dakota Governor Doug Burgum recently said, “We were caught in the middle of a COVID hurricane” as he raised risk levels to counseling provinces across the state. But he refused to issue a mask mandate.

South Dakota Governor Kristi Noem, who has carved a reputation among conservatives through previous lockdowns, has blamed the influx of cases on trial increases, even though the state has the highest rate of positivity in the country in the last two weeks, according to the COVID Monitoring Project. Deposit rates are an indication of how widespread the infections are.

In Wisconsin, conservative groups have accused Democratic Governor Tony Evers of the mandate.

Whether the requirement remains the same does not matter to Jody Bierhals, a Gillett resident who doubts the effectiveness of wearing a mask. His province of Oconto, which stretches from the northern border of Green Bay to forests and farms, has the state’s second-highest growth in coronavirus cases per person.

Bierhals, a single mother with three children, is more concerned about the collapse of the business in her small salon. The region is dependent on tourists, but many move away during the pandemic.

“Do I want to keep the water, or do I want to put the food on the table?” he asked. “This is a difficult situation.”

Bierhals said he thought the virus was uncontrollable and it would be better to let it know in its course. But local behaviors like this have left the provincial health official, Debra Konitzer, desperate.

Konitzer warned that the uncontrolled spread of infections has taken over the province’s health systems.

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


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