Infectious Diseases specialists discuss impacts of coronavirus on rural communities

Posted at 7:03 PM, Apr 21, 2020
and last updated 2020-04-21 20:03:36-04

OMAHA, Neb. (KMTV) — Rural communities across Nebraska are being hit hard by the coronavirus pandemic.

According to data from the Nebraska Department of Health and Human Services, three of the four counties with the most confirmed cases in the state are located in rural regions, including Hall County, which has more than 530 confirmed cases.

With few infectious diseases and critical care specialists working west of Omaha and Lincoln and limited ICU capabilities, these smaller hospitals in rural regions of the state are starting to reach capacity.

“When you really break it down by county, it’s a different picture that emerges and it’s alarming,” said Dr. Angela Hewlett, a physician with Nebraska Medicine and the medical director of the Nebraska Biocontainment Unit. “They’re close-knit communities, they’re smaller towns. They have frequent gatherings. Whole towns may attend a community gathering in one small town.”

Hewlett said while cases began in Omaha, the epicenter for the virus has shifted to smaller rural counties in Western Nebraska. She said a lot of cases in a particular rural county can be traced back to a birthday party in mid-March. Along with nursing homes and long-term care facilities, Hewlett said she’s seen a rise in confirmed cases in areas near food processing and meat packing plants.

“These places are not places where people can work from home and they can’t telecommute and they need to actually go to work,” Hewlett said. “When you’re living day to day working at a job where you don’t have an ability to stay home it makes it easy for the virus to spread through a community.”

As well Hewlett said testing issues in rural communities are making it tougher for people to know if they have the virus or not.

“In these small communities it’s difficult to obtain the test, the turnaround time is very long, those tests have to be taken via transit to a central lab somewhere and makes it difficult to make decisions on if a person is positive or negative if it takes a long time for the test to come back,” Hewlett said.

“You might think that these rural communities have been spared but they haven’t,” said Dr. Andrew Pavia, the chief of the Division of Pediatric Infectious Diseases at the University of Utah.

He said while some rural counties are showing few confirmed cases people should take these limited numbers with a grain of salt.

“There are areas where few people are getting tested,” Pavia said. “Does that mean there is no disease? Absolutely not, it means we don’t have a good spotlight of what is going on in those cities and we’re missing things.”

In Nebraska, Dr. Hewlett said smaller hospitals with limited ICU capabilities are starting to become full in some cases and those hospitals are needing to transfer patients to larger hospitals to get appropriate care. She said Nebraskans still need to be cautious about spreading the virus.

“We have not reached our peak, we’re not sure what week we’re on but we have not reached out peak,” Hewlett said. “Our curve in Nebraska is sloping upward, albeit gradually but we’re still seeing increasing cases in Nebraska, particularly fueled by these rural counties with their fairly large outbreaks. I’m afraid what we’re going to see is a peak, a down slope and if we go back to business as usual we’re going to see another peak and possibly a lot more cases. If we do it right then we won’t see a huge surge in cases but I agree if we open up and don’t take this seriously and don’t think about the actions then we will see a lot more cases.”

Hewlett expects more rural hotspots across the U.S. over the coming weeks. She said rural hospitals don’t have enough staffing currently and believes enhancing testing capabilities to be able to do large amounts of contact tracing would be huge for these communities.

Watch reporter Phil Bergman’s story in the above video.

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