MOUNTAINOUS US STATE FACES UPHILL BATTLE
▶ Health authorities in West Virginia must tackle misinformation and poor vaccination rates as Delta variant takes toll on vulnerable population
Dr Clay Marsh sat in his office at West Virginia University and stared at two large monitors displaying the US state’s latest Covid-19 case numbers and vaccination rate.
Neither figures are good. West Virginia is coming out of a third wave of infection during which hospitals ran out of beds and intensive care units were filled with patients suffering from severe cases of the disease.
“It’s been really tough,” Dr Marsh told The National. He is leading the state’s efforts to tackle Covid-19.
“It’s also tough because this was something that we knew was coming and we started to kind of sound the alarm bells a month and a half before we really even had that many cases of the Delta variant.”
Despite authorities issuing warnings about the Delta variant and its high transmissibility, only about four in 10 West Virginians are vaccinated against Covid-19.
The strain swept through the rural, mountainous eastern US state of about 1.8 million people, infecting as many as 2,300 a day.
West Virginia’s elderly population, many with underlying health conditions, is especially susceptible to more serious cases of Covid-19.
To date, more than 4,000 people in the state have died from the disease.
A Covid-19 study carried out by Wallethub examined data on state vaccination rates, rates of transmission, positive tests, hospital admissions and deaths, and found that West Virginia was one of the least safe states to live in during the pandemic.
The report also showed it has the highest Covid-19 death rate in the country.
In February, West Virginia, long associated with poverty and health problems, surprised health experts across the US by becoming the first state to vaccinate its entire population of nursing home residents and, at one point, by having the second-highest vaccination rate in the country behind Alaska.
West Virginia was also the only state to opt out of the federal government’s vaccination programme, in which major US pharmacy chains Walgreens and CVS helped inoculate residents of long-term care homes.
Instead of running their programme through major pharmacies, West Virginia focused on local businesses, using the deep roots small-town pharmacies have in their communities.
At first, this approach was highly successful. With the help of the West Virginia National Guard, which is in charge of logistics and the distribution of vaccine doses, local pharmacists were able to administer shots quickly, even in areas that are difficult to reach.
But eventually, the state ran out of willing patients.
West Virginia was once the centre of American coal mining and home to millionaires and thriving towns.
But today coal production has slowed to a trickle and the economy is struggling.
People in the state pride themselves on their rural roots and possess a fierce independent streak that often manifests as a deep mistrust of the authorities in Washington.
The state’s Republican governor, Jim Justice, has tried everything short of issuing a vaccine mandate to convince people to be inoculated.
In June, he offered residents the chance to win hunting rifles in exchange for being vaccinated.
Then, in August, Mr Justice launched a vaccine lottery called “Do it for Babydog”, named after his English bulldog, to encourage people to take the shot.
“If you won’t do it for me, if you won’t do it for your family, you’ve got to get vaccinated for Babydog,” he said at the time.
“She wants you vaccinated so badly.”
But those efforts have been mostly in vain and the hope state officials had that a majority of West Virginians would be vaccinated has slowly faded.
Dr Marsh said a huge portion of the state was unlikely to change its mind about taking the shot.
“We know that in our country, people enjoy the right to make decisions about what they want to do and don’t want to do,” he said.
“In the current environment, we respect that right. And even though for us, we know the consequences of not being fully vaccinated are potentially getting severely ill with Covid-19, going to the hospital [and possibly] dying.”
Dr Marsh and his team continue to work tirelessly to offer vaccine doses to as many people as possible.
Dr Krista Capehart, an associate professor at West Virginia University’s school of pharmacy, recalled travelling more than three hours from the university in Morgantown along rugged roads to vaccinate a handful of people at a coal mine.
“When you get into rural areas, they need to have that connection and understand that people do care,” she said.
“They need to have that oneon-one connection. They need their questions answered.”
Dr Capehart said many of the people she met were hesitant about being vaccinated and had been filled with misinformation.
That led them to question whether taking a shot would really protect them she said.
Mr Justice has criticised people who spread conspiracy theories about the vaccines.
“How difficult is this to understand? Why in the world do we have to come up with these crazy ideas – and they’re crazy ideas – that the vaccine has something in it and it’s tracing people wherever they go?” he said at a press conference last month.
But it is not only conspiracy theories that officials have to tackle – it is apathy as well.
When you get into rural communities, people need that connection ... they need their questions answered
DR KRISTA CAPEHART
West Virginia University
“Mostly, it’s just an inconvenience,” said a student at West Virginia University who has not yet been vaccinated.
“I’m not going to go out of my way to go get it.”
Apathy combined with a belief in the need to defend civil liberties has stymied not only West Virginia’s vaccination efforts but those of the country as a whole.
Only 58 per cent of people in the US are vaccinated against Covid-19, which is above the world average but far behind many G20 countries.
Dr Marsh often turns to a parable involving starfish when in need of motivation.
In the story, a young boy on a beach sees dozens of stranded starfish and starts throwing them back into the water.
When an adult tells him to give up, that there is no way he can save them all, the boy says: “You may be right, but for the ones that we do help, it will make a big difference.”