Pluses and minuses for rural areas where coronavirus is concerned

Wednesday, March 25, 2020

While it’s reasonable to assume that people living in rural areas such as Southeastern Montana face a lower risk of being infected with the coronavirus due to the relative ease of social distancing, rural residents should not assume that any part of the United States will be spared.

That was the message Monday from a top Centers for Diseast Control doctor during a CDC webinar aimed specifically at rural health care providers, stakeholders and the media.

Dr. Jay Butler, CDC deputy director of infectious diseases, addressed a variety of issues surrounding coronavirus and Covid-19 from social distancing, to prevention and testing and, of course, hand hygiene.

Butler said it’s going to take everyone in a community working together to stop the spread of the virus, focusing on the importance of social distancing.

“Social distancing is very important,” he said. “Stand together, but at least six feet apart.”

He said communities can stand together by protecting critical infrastructure, such as the health system.

One way the public can help achieve that goal is by calling before going to the hospital or the health care provider. He noted that symptoms can be diagnosed on the phone and that for those not in the most as-risk groups, isolating at home is as effective as going to the hospital.

He said it has to be recognized that a small number of people will be infrected who require critical care -- the elderly and people with several pre-existing conditions such as respiratory ailments, lupus, cancer and diabetes. These are the priority cases that will need the limited number of hospital beds available.

He noted the coronavirus is a “truly a learning curve” for the CDC and that researchers are learning more daily

“Sometimes despite the best science, what happens in nature can outsmart us,” he said, likening the situation to a tornado or hurricane in that a community can make all the plans ahead of time it wants, but it’s not going to stop it from hitting.

He, of course, mentioned hand-washing, along with social distancing, several times during the webinar as the most effective defense against the virus. He said there is little evidence that wearing a mask gives one any greater protection from being infected than proper hand hygiene.

He also mentioned that a few drugs “have shown promise” in treating Covid-19, all of the evidence so far is anecdotal.

“Currently there are no proven medications that will treat Covid-19 and have documented improvements in outcomes,” he said.

He noted the same thing about reports that people infected with Covid-19 experience changes in their sense of smell or taste.

When asked whether rural communities are at less risk than urban ones, Butler said it depends more on the local environment than a person’s county environment.

“If a county has two people per square mile, that’s a good start,” he said. “But if you are in a house with 20 people, your risk is as high as someone living in an urban environment.”

He said rural areas have particular challenges in addition to their inherent advantages.

Among the challenges are a lack of widespread broadband or even basic internet access which make working from home or even keeping abreast of the latest health guidelines difficult, as well as distance to hospitals and obtaining transportation for the elderly.

Despite that, he said, many ranch and farm activities should not be adversely impacted.

“I was working on a farm as an undergraduate student,” he said. “That is the kind of activity that should be able to continue because it’s not that hard to social distance compared to working in an office.”

He advised farmworkers to avoid a lot of interpersonal contact when they come back in off the field and “Do what you can to make hand hygene possible -- preferably water and soap.”