Rural Life in the time of Covid
I’ve only ever lived in rural areas. As a result, my social media feed is filled with news, requests, and rants from rural areas. I currently live in a rural area. To put it mildly, I really, really care about rural areas. I’m pretty damn proud of my rural roots, rural friends, and rural communities. I’m not so impressed, “these days”, with the xenophobic expressions of my rural cohorts. I’m seeing it everywhere. Coronavirus is a license to say “stay away from my paradise”.
Sure, traveling less is crucial to slowing the spread of this damn thing. But we all need to travel less. It isn’t just “city people” that need to travel less. We all need to travel less. We also need to spread out more. Rural areas are great for that. My lunch-time walk, even with social distancing measures, presents some risk of transmission. The same walk in New York City, with the same measures, would present much, much greater risk of transmission. Sure, it seems as though hospital resources will be stressed. But hospital resources will be stressed everywhere. That isn’t something special to rural areas. If this thing gets as bad as it seems it will get all hospitals in all parts of the US will be used more than they are ready for.
In fact, maybe rural health care is, arguably, better prepared to handle the coronavirus? Let’s look at some numbers. First, over the whole US. It is pretty clear that there are about 330 million people in the US. And there are between 62000 and 200000 ventilators in the whole country. Why the broad range? According to the Society of Critical Care Medicine (SCCM) there are 62000 “full-featured mechanical ventilators”. If you broaden the definition and count of a ventilator to include similar machinery and older models that could be rejuvenated, you get up to 200000. So, that’s a total of one ventilator for every 1650 to 5322 people, depending on how you count.
Now, let’s look at some rural areas. I collected some regional ventilator data from the web. Are these regions counting “full-featured” ventilators or using the broader definition? I don’t know. I have to assume that the publicized quick counts of ventilators are generally employing the narrower, “full-featured” definition of a ventilator. Let’s use the baseline, then, of one full-featured ventilator for every, roughly, 5000 people in the United States.
The state of Idaho, where I live, has one ventilator for every 4330 people. Not awesome, but perhaps better than the national average.
Teton County, Wyoming (yes, an outlier... the richest county in the country. But also one of the vociferous populations of folks demanding that others “stay away”) has one ventilator for every 1700 people, with an order in to almost double the supply of ventilators.
The State of Alaska has one ventilator for every 3750 people.
Mono County, California has one ventilator for every 3500 people.
Of course, these rural areas present logistical difficulties in health care delivery. And there’s room for interpretation in the math, to put it mildly. The above is just basic division. We’re looking at countless individual situations and stories that will transcend basic math. On the other hand, rural areas are great places to disperse at least some of our population. Open spaces are crucial to the mental health of many, many of us. Not all of those that rely, emotionally, on open space, can live in and near open space. In fact, the very nature of open space demands that most of its most passionate constituents and participants live elsewhere. Some of us have the great privilege of living in a rural area. A few more of us have the nearly-as-great privilege of being able to get to those rural areas without dramatically taxing the system. Many, many more require that those open spaces remain open, available, and welcoming. In all circumstances.
How many of us, in one sort of health-care situation or another, have traveled to a more densely populated area for specialized care and opportunity we couldn’t get closer to our rural homes? Yes, the current health care situation is different than that which required an orthopedic surgery or an oncology visit, but is it different enough to demand that every single person who currently lives in a more densely populated area than us has to stay there?
We all need to be doing something different from our norm in this pandemic. Less travel, less socializing. Every one of us. Every one of us will take different risks than we are accustomed to. We’re all doing things differently, by choice, by decree, and as we’re shamed into it. Let’s make another one of those things we do differently be in our treatment of “city people”. We’re all just people. Let’s do less judgement and nagging. Let’s be more understanding and forgiving. Others’ version of “less” will be different than yours. At the very least, I’d ask my rural-area cohorts to consider from whence your “stay at home” messaging and judgement comes? Is it really based on reducing the country (and world’s...) overall risk in this situation, or is it based on protecting the privilege you know you have?
Citations:
All population data from US Census numbers.
https://sccm.org/Blog/March-2020/United-States-Resource-Availability-for-COVID-19
https://www.jhnewsandguide.com/news/health/coronavirus/hospital-purchases-more-ventilators/article_61daec05-d2b5-54bb-8e6b-c8a6de2850d2.html
https://www.idahostatesman.com/news/coronavirus/article241154021.html)
https://www.adn.com/alaska-news/2020/03/28/alaska-has-about-200-ventilators-and-160-icu-beds-statewide-state-says/
https://www.latimes.com/california/story/2020-03-28/mono-county-sheriff-to-city-dwellers-stay-out