COVID-19 swallowed the countryside and small towns of America after hitting a big city in the spring

Nick brown

(Reuters)-Dr. Drew Miller knew he had to move his patient.

The vital signs of a 30-year-old COVID-19 victim crashed, and Kearny County Hospital in the countryside of Lakin, Kansas, was not equipped to handle the case. Kearney’s Chief Medical Officer, Miller, who is also the county’s health officer, called on a larger hospital for an ICU bed. He said no one was found due to the surge in cases of coronavirus throughout Kansas.

The next day, the young man was dying by the time the bed opened elsewhere. Miller and his staff desperately performed chest compressions to save him for 45 minutes.

For some reason, Miller said the patient had regained his pulse and was sent by ambulance to a larger facility about 25 miles away. Miller then prayed with his family. The family knew “very well” from Løkin, a town of only a few thousand people.

“It’s a real miracle he survived,” Miller said.

After hitting a big city in the United States in the spring, COVID-19 now seems to swallow the countryside and small towns of the United States and permeate every corner of the country. According to Reuters interviews with more than 12 healthcare providers and public health authorities in the heart of the country, many hospitals have beds, equipment, and most importantly, clinical staff, including specialists and nurses. There is a big shortage.

COVID-19 cases and hospitalizations are on the rise nationwide. However, the Midwest, which includes 12 states between Ohio and Dakotas, is particularly brutal. According to the COVID Tracking Project, a volunteer-run data provider, reported case rates are more than double that of any other region in the United States. From mid-June to mid-November, the number of cases reported in the Midwest increased more than 20-fold.

According to a follow-up project, North Dakota reported an average of 1,769 new cases per million inhabitants during the week leading up to November 19. South Dakota recorded about 1,500 per million, Wisconsin and Nebraska recorded about 1,200, and Kansas recorded about 1,000. Even in New York’s worst week of April-business closed and panic struck the masses-the state never had an average of more than 500 new cases per million. California never exceeded 253.

Midwestern hospital officials told Reuters that they had reached or were nearly full. Most people are trying to increase availability by diversion of wings, packing multiple patients in one room, or asking staff to work long hours or shift frequently.

Facilities like Kearney, known as “Critical Access” hospitals, were not created for this purpose. Often sparsely funded, they primarily provide basic or emergency care to residents who live far away from larger medical centers. Now, “we must plan to be able to take care of the incoming people,” said Miller, who specializes in family medicine.

With the proliferation of cases in many conservative states and counties, healthcare professionals convince patients and local leaders that the disease should be taken seriously and that the Democratic Party is not a permanent hoax. He states that he often faces challenges just by letting him do it.

Such a viewpoint flows from above. President Donald Trump has often held shoulder-to-shoulder rallies in the Midwest and elsewhere, treating masks as a matter of personal choice. Trump wasn’t reelected, but as the crisis escalated, there were few signs of change in his coronavirus strategy, leaving him with a term of about two months.

The White House press did not respond to requests for comment.

Some healthcare professionals and hospital staff find it difficult to align laissez-faire policies with the illnesses and sufferings they see.

Dr. Kelly Cocut, an infectious disease doctor at the University of Nebraska Medical Center, said: “There is a break in the community of meeting people at bars and restaurants and planning Thanksgiving dinners. As a healthcare professional, she said,” We feel a kind of disappointment. ” ..

Overall, COVID-19 has killed more than 256,000 people in the United States. As doctors learn more about the disease, viral mortality will decline and vaccines developed by Moderna Inc, Pfizer Inc and others may hit the market early next year. Smaller hospitals, on the other hand, use the same drugs as facilities in big cities, such as remdesivir and dexamethasone, but they do not have the same access to ICU equipment and expertise.

Doctors in the area are not expecting immediate relief due to the cold temperatures, sending people indoors, and ongoing vacation trips.

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“I don’t think the worst is here yet,” Miller said.

Friends and neighbors

Hospital leaders described overwork, sadness, and demoralization of staff struggling to take into account death.

According to health officials, the biggest problem in many hospitals is the lack of staff, not beds. Dr. Anthony Hericks, Chief of Emergency and Critical Care at Avera Health in Sioux Falls, South Dakota, said: ..

Melisa Hazel, a critical care nurse at the Hutchinson Community Medical Center in Hutchinson, Kansas, said that nurses need to observe COVID-19 patients more closely than others because of the potential for rapid decline. Said there is. She recently said she had recovered from COVID-19 herself and returned to work as soon as she was convinced that the virus would not spread.

“I took 12 days off,” she said. “Am I mentally and physically ready to get back to work? No, but my teammates needed me.”

Remote hospitals do not have full staff at the best time. As the number of patients soars, they hire travel nurses. It’s hard to find what’s available right now.

Aya Health, a nurse dispatching company based in San Diego, California, was recruiting about 14,000 jobs in the spring, said April Hansen, executive vice president. That number has now doubled, and wage rates are skyrocketing with demand, she said.

Mary Helland, Chief Nursing Officer at Common Spirit Health in North Dakota, said she had requested a travel nurse from 11 critical access hospitals overseeing in North Dakota and Minnesota. But “larger hospitals have run out of them all,” she said.

At the 190-bed Hatchinson Regional, Chief Nursing Officer Amanda Hallett began a floor shift long after graduating from her desk job.

Physical and mental fatigue is constant and even more difficult if the patient is a close friend or colleague, Hullet said.

Hullet recalled the recent deaths of local couples Bill and Judy Mason, just weeks away from COVID-19. Judy had been teaching dance in town for decades, Hallett said, and her students included some of the hospital’s employees.

Holly Thomas, 37, who is married to the couple’s grandchildren, said Judy was the “glue” that holds the family together.

“I sat vaguely from March to August, but I didn’t see much,” said Thomas, referring to the Midwestern COVID-19. Currently, she hears about two deaths a day. “A high school PE teacher and his wife also died within 12 hours of each other,” she said.

Hazel, a nurse in the Hatchinson area, encountered a patient who was a former bowling companion. “He’s just great,” she said. “Great heart, always willing to sit down and share one or two stories.”

He is currently on a ventilator and is not doing well. “In the next week or two, some difficult decisions will be made,” she said.

‘Fed up’

Healthcare workers told Reuters that denials of the disease were irritatingly common among civil servants, community members, and even patients.

A patient at SSM Health in Janesville, Wisconsin refused to believe that COVID-19 was a serious threat, said Dr. Allison Schwartz, an infectious disease specialist in the state. When he died, “the family didn’t believe that COVID would kill people, so they didn’t want to admit that this patient died of COVID,” she said.

Some Midwestern state and local jurisdictions were reluctant to require masks or social distance.

Republican Nebraska Governor Pete Ricketts even said he wouldn’t allow the municipality to impose mask obligations.

Ricketts’ office declined to comment, but the governor said at a press conference on November 13 that he “opposed a broad mission in favor of educating people about how to use masks.”

“Masks work, but it’s just one tool,” said Ricketts, urging people to focus on keeping distance and avoiding large gatherings.

South Dakota Governor Kristi Noem refused to require masks to be worn, did not impose restrictions on businesses or meetings, and said such issues were “individual responsibility.” In July, she hosted an Independence Day celebration on Mount Trump. Rushmore where the crowd was nearby and many attendees were maskless.

Doctors say trying to change such behavior can feel like a desperate task. “Everyone [is] “We continue their lives,” Schwartz said, but “we feel like we’re drowning.”

Nick Brown reported from New York. Callaghan O’Hare contributed reports from Lakin and Hutchinson, Kansas. Edited by Julie Marquis.


Source: Reuters

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