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Rural hospitals are buckling under the weight of increasing COVID-19 cases

by Valerie Dimond, Contributing Reporter | August 05, 2020
Risk Management Telemedicine
Since the outset of the pandemic, rural areas have seemed somewhat insulated from COVID-19 as cases surged in densely populated areas like New York City. Not anymore. As novel coronavirus cases across the U.S. edge closer to 5 million, rural areas are now experiencing similar rates of spread — but they also face a serious dearth of medical resources to handle it.

Rural hospitals are disappearing. The Centers for Disease Control and Prevention (CDC) says 170 hospitals have closed since 2005 with 700 more currently at risk of closure. When rural residents do get sick, many must travel long distances to reach hospitals and other healthcare facilities. Among rural hospitals that do exist, most lack the critical care equipment and staff to treat COVID-19 patients. These facilities have a severely limited number of hospital beds, ICU beds, or ventilators. Some have no ICUs at all.

In many cases, the only way to give patients the care they need is to transfer them to a hospital that can — and that is not easy.

Evans Memorial Hospital in southeast Georgia, for example, recently had to search long and hard to find another hospital that would accept the transfer of a very sick COVID-19 patient, reported Georgia Health News. With no ICU or critical care beds, they reached out to 14 other hospitals before finally finding one that would accept the patient, only it was two states and 500 miles away in Bowling Green, Kentucky.

The Georgian county population is about 10,000, and saw an increase in cases from 79 two weeks ago to more than 200 today. “We are seeing quite a spike, through the ED [emergency department] and for those who are being admitted," said Evans Memorial Hospital CEO Bill Lee.

About 46 million people live in rural areas across the country, and they may also be at higher risk of severe illness from COVID-19 because they tend to be older and have underlying chronic illnesses and disability, according to the CDC.

Yesterday, President Trump signed an executive order to improve rural health and telehealth access which includes upgrades to infrastructure, steps to improve the health of rural Americans, reducing some regulatory burdens and other developments but not much to attenuate the existing shortage of critical care facilities and clinical staff. Although the president did note the scarcity while signing the order at the White House, he pointed to reimbursement hurdles, stating that they have led to reduced patient volume and hospital closures.

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