LIMA — The novel coronavirus took longer to reach rural communities. But new COVID-19 cases and deaths are now rising faster in rural counties, a concerning trend as Ohio and other states relax their stay-at-home orders and allow some businesses to reopen.
While the number of cases and deaths per 100,000 people is still lower in rural areas than in urban centers, a recent analysis from the Kaiser Family Foundation found that mostly rural counties saw a 125% increase in coronavirus cases and a 169% increase in coronavirus-related deaths in the two weeks prior to April 27, surpassing metro counties.
“I think in some rural communities the message hasn’t been communicated clearly enough that everyone is potentially at risk,” said Dr. Carrie Henning-Smith, a researcher with the University of Minnesota’s School of Public Health.
Rural counties are demographically at higher risk, too. These counties are older, on average, and have higher rates of underlying health conditions, higher rates of unemployment and higher poverty rates when compared to urban areas, Henning-Smith said.
There are other complicating factors: Rural communities tend to have worse broadband and cell service, which Henning-Smith explained makes it harder for people in those areas to go about their daily lives without leaving home.
“It’s a lot harder to be able to order groceries to be delivered to your door,” she said. “You’re still going to have to be going out and interacting with one another.”
Why did it take so long for the coronavirus to make its way to rural America?
“There’s not as much interaction between people from rural areas and people from the city,” said Dr. Tara Smith, an epidemiology professor at Kent State University, who studies infectious diseases and rural communities. “They’re less dense. They’re not generally taking public transportation or other shared spaces in public. There’s just less chance of transmission in many of these places. But what we’re seeing in a lot of these rural areas is that we’re having hotspots.”
Nursing homes and long-term care centers have been one such source of COVID-19 outbreaks in rural areas, in part because those residents were among the first to qualify for coronavirus tests.
An outbreak at the Meadows of Leipsic nursing home and assisted living facilities, for example, account for the majority of the confirmed COVID-19 cases in Putnam County, which as of 2 p.m. Wednesday had recorded 71 cases and 12 deaths. At least 51 of those positives were residents or staff at the Meadows of Leipsic, according to the most recent Ohio Department of Health data released on April 30.
There are other troubling outbreaks in prisons and meat packing facilities, which are also concentrated in rural areas.
And with limited testing — which is even more scarce in rural towns with small hospital systems — Smith worries some communities won’t detect outbreaks right away.
“And then, by the time they’re already big and affecting a large portion of the community,” she said, “that makes it much more difficult to respond.”
Public health observers are also worried about rural hospitals, many of which, Henning-Smith said, operate in the red each year.
Hospitals large and small suffered significant financial losses when elective surgeries were postponed. And, as Henning-Smith noted, many continue to lose money if they have not yet seen an influx of COVID-19 patients.
The U.S. Department of Health and Human Services will distribute $368 million to more than 200 rural hospitals and health centers in Ohio as part of a federal effort to keep those hospitals, many of which were operating thin margins prior to the coronavirus pandemic, from closing.
Reach Mackenzi Klemann at 567-242-0456.