In Nemaha County, a small community in rural Kansas with just over 10,000 people, a single nurse is triaging more than 600 COVID-19 positive cases over the phone because the community hospital where she works has no space left to accept new patients.
In fact, health administrators in the county told The Daily Beast that there’s no room left at the closest regional hospitals, more than an hour away, either. Over the last several weeks the county has experienced a massive COVID outbreak, primarily, doctors there say, because local officials bucked a July order by the governor directing counties to implement mask mandates.
Nemaha did finally implement that mandate Thursday but health administrators say it may be too late, particularly because residents are still resistant to mask and social distancing guidelines. The virus has infected more than 640 people, killed five, and shows no sign of slowing.
“Now we’re trying to send patients to the next higher care facility which can be hours away by car,” said a spokesperson for the Nemaha Community Hospital, one of the two hospitals in the county, adding that if patients are critical enough the hospital transports them via helicopter to those advanced care facilities. “It is very overwhelming for all of us. It’s scary how quickly [the virus] is multiplying.”
If a lack of beds was the only problem, perhaps Nemaha County could navigate through the current crisis. But the county is dealing with several different problems, local officials said. The entire county is running low on nurses and doctors to treat patients because they too have become infected with the virus. The situation has grown so dire that Nemaha Community Hospital is currently developing an overflow ward with dorms for staff who may be infected but are asymptomatic, and have to work in the coronavirus wing.
Over the past three weeks, rural communities across America have been ravaged by the coronavirus like Nemaha, crowding testing centers and overfilling cash-strapped hospitals. In hot-spot counties in Wisconsin, North Dakota, California, and Kansas, health administrators say they have run out of space for seriously ill patients and are experiencing staffing shortages that are beginning to impact the quality of care. In North Dakota, the situation has become so bleak that hospitals are sending COVID-19-positive staff back to the floor—so long as they are asymptomatic—to care for those infected and residing in the facility. A similar situation played out in New York City during its peak in April.
“Our staff are working hours and hours and hours trying to make our patients comfortable. I talked to one of our nurses Monday who said this was the worst she’s ever seen and she’s used to work in a big hospital,” the Nemaha hospital spokesperson said. “Our staff is struggling, but they are doing what they have to to get us through.”
Despite a third wave of the virus spreading rapidly through the country, the Trump administration has been largely absent from efforts to contain the pandemic. And while President-elect Joe Biden’s COVID-19 task force plans to find ways to help states finance their virus response, it cannot implement policy changes until it takes office in January. Till then, states will likely have to fend for themselves.
Since September, Trump health officials working with the White House’s coronavirus task force—including Dr. Anthony Fauci, the nation’s top infectious disease expert—were hinting that the president had essentially given into the idea that there is nothing else his team could do to fight the virus until a viable vaccine becomes available. The task force has stopped meeting regularly, officials say, and what little conversations do take place have focused almost entirely on vaccine development and distribution. That’s put Dr. Deborah Birx, the coordinator of the task force, out on her own, traveling to states across the country to try and find ways to work with local officials in helping them develop tools for mitigating the spread of the virus.
That’s not been sufficient for the states. According to officials working on the logistics end of the administration’s coronavirus response, states have in recent weeks ramped up their outreach to the Department of Health and Human Services (HHS) and the Federal Emergency Response Administration (FEMA) for support. According to a spokesperson with the Department of Health and Human Services, 16 states and Guam have experienced surges in COVID-19 infections and requested federal assistance since Sept. 15. Their needs include medical supplies and personal protective equipment from the strategic national stockpile.
During a press briefing Friday, Vice President Mike Pence told reporters that the federal government was “immediately” supplying hospitals with what they needed on a case-by-case basis. But that is not true, according to officials working on the federal government’s response to the coronavirus.
States are still required to search the commercial market first before receiving help, a spokesperson for the Department of Health and Human Services said. And in times of crisis, health officials in rural communities told The Daily Beast, finding the money to quickly purchase medical supplies on the open market isn’t always feasible. “All requests made by states have been fulfilled and continue to be fulfilled,” an HHS spokesperson said. “If a product is scarce, HHS may then deploy the [stockpile] to fill that gap on a temporary basis until a commercial product is available.”
FEMA is still assisting with the national testing demand, said Janet Montesi, a spokesperson for the department. According to internal FEMA data, about 17,300 National Guard troops were activated to help with doling out and administering testing in states across the country.
But at a local level, it is clear that more help is needed. In Wisconsin, where the coronavirus situation is on the brink of overwhelming even some of the biggest hospitals, Gov. Tony Evers told reporters this week that the Trump administration was not on its way to help. A spokesperson for the state’s Department of Health said hospitals are running low on basic supplies, like gloves.
“We are struggling as a state and we struggle as much or more than other states in the country,” Evers, a Democrat, said. “Just about a week or so ago I had an opportunity to speak to Dr. Birx ... they read what responses are here… can they help? Possibly. But they also report to a president who frankly isn’t consistent on the things that count like masks and making sure you don’t have public gatherings that spread the disease. So, they’re probably not going to play a political role here.”
Without significantly more funding from the federal government, some of which was supposed to come through in another stimulus package, counties are having to rely on their own residents to stop the spread. In communities that have refused to implement mask mandates and where disinformation about the virus runs rampant, that task has become increasingly difficult.
In Modoc County, California, a small, rural county of 10,000 in the northeastern part of the state, officials once marveled at the fact that the community had not recorded a single COVID-19 case. Now, positive case numbers are spiking. Still, local administrators refuse to implement a mask mandate or limit social gatherings, which has overwhelmed the small hospitals available to the community.
In Shawano County, Wisconsin, a community of 40,000 located in the eastern part of the state, the local health department is desperate.
“Whether one ‘believes’ in COVID-19 or not, we do not want to be the cause of someone’s exposure to a devastating illness because we may not know someone else’s health condition,” a recent statement by the county health department said. “We are NOT going to move out of this crisis until each one of us takes on the hard choice to NOT act in risky behavior that exposes us to devastating results.”
And in Nemaha County, health administrators issued a notice to community members pleading with them to take the virus seriously.
“We are feeling the same dread as everyone else. We are just as deeply fatigued from COVID-19 as everyone else,” the memo said. “Until a safe and effective vaccine is approved and available in our area, we have limited tools to stop the spread of COVID-19.”