[ad_1]
What your doctor is reading on Medscape.com:
MAY 02, 2020 — On March 14, the Saturday before school closed for the year, more than 400 people attended a quinceañera in rural Doniphan, Nebraska — population 829.
Two of the attendees later tested positive for COVID-19. And now, 7 weeks later, Hall County, home to Doniphan, leads the state in COVID-19 incidence. It has over 1000 cases, more than double that of urban Douglas County, where Omaha is located.
Meanwhile, nearby Nuckolls County — along with 33 other rural counties in the state — doesn’t have a single case.
Such wide variation from county to county suggests that rural hospitals may need to prepare differently than their big-city counterparts. While cities have been gearing up for or are already in the midst of a patient surge, some rural areas are experiencing micro-outbreaks — such as the one in Hall County — while others anticipate a slower, more sustained outbreaks that could last for months.
Many rural hospitals already suffer from strained finances, leaving them understaffed or on the brink of shuttering. Now these stretched-thin hospitals face the added burden of not knowing which scenario to prepare for.
Medical care in rural America for decades has been challenged by a population that is older, poorer, and sicker than its urban counterparts. There are fewer ICU beds per capita, fewer options for backup staffing, and less access to specialists (outside of Omaha, there are only two infectious disease doctors in the entire state of Nebraska). It all adds up to make the rural areas vulnerable to the pandemic and its course unpredictable, said Angela Hewlett, MD, MS, an infectious disease specialist at the University of Nebraska Medical Center and the medical director for the state’s Biocontainment Unit.
Nebraska is 34th in the country in the number of COVID-19 cases, which — at first glance — seems to imply the state is in decent shape. “But break it down by county, and it’s a completely different picture,” Hewlett said. “It’s really alarming what we’re seeing in individual counties.”
The epidemiology of COVID-19 in Nebraska is similar to that of rural landscapes across the country. Lightly populated counties account for both the lowest and highest per-capita incidence of COVID-19 in the United States. (Lincoln County, Arkansas, tops the list with 6258 cases per 100,000 people. Dozens of counties sit at the bottom, with zero confirmed cases.)
