Rural Midwest hospitals struggling to handle coronavirus surge

WESSINGTON SPRINGS, S.D.— Rural Jerauld County in South Dakota didn’t see a single case of the coronavirus for more than two months stretching from June to August. But in the last two weeks, its rate of new cases per person soared to one of the highest in the nation.

“All of a sudden it hit, and, as it does, it just exploded,” said Dr. Tom Dean, one of just three doctors who work in the county.

As the brunt of the virus has blown into the Upper Midwest and northern Plains, the severity of outbreaks in rural communities has come into focus. Doctors and health officials in small towns worry that infections may overwhelm communities with limited medical resources. And many say they are still running up against attitudes on wearing masks that have hardened along political lines and a false notion that rural areas are immune to widespread infections.

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

It ripped through the nursing home in Wessington Springs where both his parents lived, killing his father. The community’s six deaths may appear minimal compared with thousands who have died in cities, but they have propelled the county of about 2,000 people to a death rate roughly four times higher than the nationwide rate.

Rural counties across Wisconsin, North Dakota, South Dakota and Montana sit among the top in the nation for new cases per capita in the last two weeks, according to Johns Hopkins University researchers. Overall, the nation topped 8 million confirmed coronavirus cases in the university’s count on Friday.

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

As cases surge, hospitals in rural communities are having trouble finding beds. A recent request to transfer a “not desperately ill, but pretty sick’’ COVID-19 patient was denied for several days until the patient’s condition had worsened, Dean said.

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

Even as outbreaks threaten to spiral out of control, doctors and health officials said they are struggling to convince people of the seriousness of the pandemic.

In swaths of the country decorated by flags supporting President Donald Trump, people took their cues on wearing masks from his often-cavalier attitude toward the virus. Dean draws a direct connection between Trump’s approach and the lack of precautions in his town of 956 people.

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