COVID-19 pandemic hampers already-strained rural health care system

Rural hospitals across the country are in a difficult spot right now. COVID-19 is hitting them harder than many metropolitan hospitals as they deal with issues of lower staffing.

According to the National Center for Biotechnology Information, about 20% of our nation’s population lives in rural areas, yet less than 9% of our nation’s physicians practice there.

Add on the fact that according to CDC data, COVID is killing rural Americans at a rate 3.5 times higher than those living in metropolitan areas, and this issue is affecting staff and patient care.

“I’m very worried about rural health care because rural health care is teetering on the brink right now,” said Dr. Kurt Papenfus, an ER doctor at Keefe Memorial Hospital in rural Cheyenne Wells, Colorado. “There’s a darkness in this illness that I can’t say I’ve said about any other illness.

In late October, Dr. Papenfus contracted COVID-19 as he was traveling back from the Northeast to visit his daughter.

“I was very cognizant and was wearing a mask at all times, social distancing, and washing my hands,” Papenfus said. “But I remember having this thought on the train that this is a super-spreader event.”

When he got home, Papenfus got tested and was confirmed positive for COVID-19. The diagnosis put Keefe Memorial in a tailspin as he served as the only ER doctor in the small 25-bed hospital.

“We are a trauma level four hospital so keeping that physician on staff 24/7 is what we are required to do,” said Stella Worley, Keefe Memorial’s CEO. “And it is getting to be more of a challenge to have hired physicians out here in rural [America].”

Within minutes of learning of Dr. Papenfus’ COVID-positive diagnosis, Worley was on the phone with several different hospitals working to find a replacement. Within a few hours, they had settled on a former ER doctor who moved to another hospital in Texas a few months prior.

After she agreed, Keefe Memorial paid the doctor to drive 10 hours from Texas to Colorado and fill in immediately as Papenfus recovered at home for the next two weeks.

“Worst-case scenario is you would have to divert patients if there’s no one in the door to care,” said Worley.

Populations in rural America tend to be older, poorer, and less insured than the nation at large, according to the National Conference of State Legislatures.

Since 2010, hospital closures in rural America have been growing as there have been 118, including 17 last year.

The closures only exacerbate a growing lack of health care coverage in rural America, said Dr. Dan Derksen, a rural health care expert and family physician

“Once a critical access hospital (25 beds with a 24/7 emergency department and at least 35 miles from another facility) closes, they almost never come back,” he said.