Rural hospitals in US hit by pandemic

Elmhurst Hospital in Queens, New York City, made headlines nationwide with stories of numerous deaths and photographs of bodies being placed in refrigerated trucks.

In March and April, "everyone was watching in horror what was happening in New York City and New Orleans, but that never seemed to arrive in rural America", said Brock Slabach, senior vice-president of the National Rural Health Association, according to the Fierce Healthcare website. "Over the summer, we thought perhaps rural areas were exempt from the impact of COVID-19."

With some exceptions, they were. In summer, the disease spread to suburban communities and ravaged the Sun Belt, which stretches across the south of the country from Florida to California. Rural areas again appeared to be free from the disease.

This is no longer the case.

The pandemic raging across the country is overwhelming hospitals of all sizes. The already-frayed healthcare safety net in rural areas is under attack from a "fall wave" of COVID-19 cases that has gone from bad to worse.

Nationwide, healthcare experts expect the latest wave to last until at least next month, surpassing the two previous ones in terms of the number of cases, hospitalizations and deaths.

Of the first 100,000 COVID-19 deaths in the US, about one-fifth occurred outside of urban areas. Nearly half of the second 100,000 deaths were among non-urban residents, according to an analysis by National Public Radio.

Slabach said the nation is now seeing higher mortality numbers in rural areas as the proportion of deaths in mid-size cities and rural communities rises.

Rural populations are often older, sicker and poorer than those in urban areas and have reduced access to physical and mental healthcare. This likely means that more rural residents infected with COVID-19 during this wave of cases will end up in hospitals.