Rural Hospitals Brace For Coronavirus Small-town hospitals are under-equipped to deal with the coronavirus, and administrators warn it's a misperception that people in isolated rural areas are safer from exposure.

Rural Hospitals Brace For Coronavirus

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Rural America - wide, open spaces, sunshine and the wind off the fields. Could people living there be at less risk for contracting the coronavirus? No. Health officials say that's not possible in today's global society, and small towns are beginning to report cases. NPR's Kirk Siegler went to a small Idaho hospital close to the Washington border.

KIRK SIEGLER, BYLINE: Here in Grangeville, Idaho, population 3,000, the Syringa Hospital has just 15 beds, an emergency room and a clinic. As is common in rural medicine, the chief medical officer here, Dr. Matthew Told, is also a family practice OB. And today, he's the on-call ER doc. There is no ICU.

MATTHEW TOLD: We don't have ventilatory services. We don't have respiratory therapy.

SIEGLER: So when they do get a critically ill patient or trauma victims, it's standard protocol to stabilize and transfer them to a large regional hospital in western Montana or Spokane, Wash. But what if ICUs there become overwhelmed with coronavirus patients?

TOLD: The biggest challenge is, you know, being - living so close to a state where there's so many cases that are there, such as Washington, and having that really just across the border.

SIEGLER: Told knows that Syringa Hospital could soon be completely overwhelmed and not able to effectively treat anyone, corona patient or not. This is the story in many communities right now, but it could have an even more dire effect in isolated rural towns like this that lack infrastructure and trained staff, especially if they get sick and can't come to work. Syringa is one of Grangeville's largest employers. So the triage plan for now is to likely block off the ER from the rest of the hospital via a plastic wall. That would at least give them two more isolation beds. Michelle Schaeffer is the Syringa clinic director. She says the single biggest concern right now is that they only have about a month's supply left of masks.

MICHELLE SCHAEFFER: It doesn't help that, you know, we go to - what is it? - an hour and a half to Lewiston to our nearest Walmart, and there's not even toilet paper on the shelves because people are panicking.

SIEGLER: So they're pushing their most effective tool in the community, prevention.

SCHAEFFER: And really make sure that we're educating them on the best way to prevent infection so that it never actually gets into the walls of this hospital.

SIEGLER: Hospital staff armed with pamphlets and prevention talking points are visiting local businesses, nursing homes and schools, the center of small town life.

NATHAN WINDER: There's a new virus you hear about. Maybe it'll come to here someday. What is it?

SIEGLER: Physician assistant Nathan Winder, who sits on Syringa's infection prevention committee, is at Grangeville Elementary, talking to this attentive class of fourth graders.

WINDER: When you cough, you cover it.

SIEGLER: Cough into your elbows. Sing the entire "Happy Birthday" song when you wash your hands, he says, a similar strategy when there's a bad flu outbreak.

WINDER: The kids already know a lot. You know, they're excited. You can tell they want to do the right thing. They want to not spread the germs. They don't want to get sick. They've all been sick.

SIEGLER: But hospital officials say this may be the easiest demographic to convince that there's a serious health crisis looming. Like in a lot of rural America, Grangeville's population skews older. You also find a lot of mistrust toward institutions and the government in rural Idaho, where there's already lower-than-average vaccination rates. People in Grangeville told me that conspiracy theories and misinformation are spreading like wildfire on social media. And some folks just aren't that worried.

JENNIFER ROGERS: To me, it feels political.

SIEGLER: Outside Cloninger's Supermarket, Jennifer Rogers sees corona as just another flu with its inconvenient symptoms.

ROGERS: I mean, if it were close to home and I knew somebody and I could see their reactions and it was super bad, then it would obviously heighten my awareness.

SIEGLER: But for now, Rogers says she isn't doing anything out of the ordinary to prepare.

Kirk Siegler, NPR News, Grangeville, Idaho.

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