Coronavirus overwhelms small rural hospitals where tired doctors treat family and friends



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As Dr Shane Wilson tours the tiny 25-bed hospital in northeast Missouri, many of his movements are familiar in the coronavirus era. Masks and gloves. Zippered plastic walls between hallways. Hand sanitizer as it enters and leaves every room.

But one thing is radically different. Born and raised in the city of just 1,800 people, Wilson knows most of his patients by first name.

He visits a woman who was a gymnastics teacher at her school and later remembers laughing a day when she caught him smoking at school and made him pick up cigarette butts with a friend as punishment. Another man was in the middle of his soybean harvest when he got sick and couldn’t finish.

In November, Wilson treated his own father, who along with his wife worked in the same hospital. Wilson, 74, has recovered from the virus.

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The coronavirus pandemic largely hit urban areas first, but the fall wave is also devastating rural America. The United States now averages over 170,000 new cases every day, and it’s wreaking havoc from the largest hospitals to the smallest, like Scotland County Hospital.

The tragedy is smaller here, more intimate. Everyone knows everyone.

Memphis, Missouri, with a population of 1,800, is the largest city for miles upon miles amidst the cornfields of the northeastern corner of Missouri. Agriculture accounts for most of the jobs in the region. The area is so remote that the nearest red light, McDonald’s and Walmart are all within an hour’s drive, the hospital’s public relations manager Alisa Kigar said.

People come to the hospital from six surrounding counties, usually for treatment of things like farm and sports injuries, chest pain, and the flu. Usually there is plenty of room.

Dr Shane Wilson, left, sits on a bed as he talks with COVID-19 patient JoBeth Harvey, who was once a gym teacher at his school.

Dr Shane Wilson, left, sits on a bed as he talks with COVID-19 patient JoBeth Harvey, who was once a gym teacher at his school.
(AP Photo / Jeff Roberson)

Not now. The small hospital with around six doctors and 75 nurses out of 142 full-time employees is in crisis. The region is seeing a sharp increase in COVID-19 cases and all available beds are generally occupied.

Doctors at Scotland County Hospital are already making difficult, often heartbreaking decisions about who to admit. Wilson said some moderately ill people were sent home with oxygen and said, “If things get worse, come back, but we don’t have a place to put you and we don’t have a place to. transfer you.

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Meanwhile, the staff shortage is so severe that the hospital has appealed for anyone with healthcare experience, including retirees, to come to work. Several have responded and are already on staff, including a woman who works as a licensed practical nurse while studying to become a registered nurse.

The hospital’s chief nursing officer, Elizabeth Guffey, said nurses were working up to 24 extra hours a week. Guffey sometimes sleeps in an office rather than coming home between shifts.

“We’re in peak capacity almost 100% of the time,” Guffey said. “Everything is therefore on the bridge.”

It is especially difficult to see friends and relatives battling the disease when a large majority of the community still does not take it seriously, she said.

“We spend our time indoors taking care of these very sick people and then we go outside and hear people tell us that the disease is a hoax or that it doesn’t really exist,” said Guffey.

Glen Cowell wasn’t so sure about the virus until he brought him to his knees.

At 68, Cowell still works on his 500-acre farm near Memphis and is healthy enough to not take pills a day. He started to feel bad around November 11, tested positive four days later, and then gradually became sicker. On November 18, an ambulance took him to the emergency room. He was treated and returned home.

“They only had one bed and I didn’t feel sick enough to take someone else’s bed,” Cowell said.

But soon the breathing became difficult and nausea set in. Worse yet, his temperature reached 104 degrees. Another ambulance trip was followed by a long hospital stay.

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He doesn’t know where he caught the virus, but admits he wasn’t too careful.

“I’m as independent as a pig on ice,” Cowell said. “I was quite ambivalent about it. If Dollar General said I had to wear a mask, I wore a mask. If I crossed the street to Farm & Home, I wasn’t wearing a mask. I really wasn’t aware that it could grab you and not let go.

Brock Slabach, senior vice president of the National Rural Health Association, based in suburban Kansas City, said it takes “space, people and stuff” to run a rural hospital. “If you don’t have any of these three, you’re really crippled,” he said, noting that many hospitals are facing shortages in all three areas.

Wilson spent hours on the phone one day, trying to find a larger hospital capable of providing the critical care that could save a man in his fifties who was seriously ill with the virus.

By the time the University of Iowa hospital agreed to take him away, it was clear he couldn’t survive the 120 mile journey.

“I don’t know bringing him to Iowa City would have made a difference,” Wilson said. “Sometimes people are sick enough not to survive, and that’s the reality of what we have to face. But it’s still damn frustrating to be sitting here with your hands tied.

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