MARY LOUISE KELLY, HOST:
After months of affecting big cities, COVID-19 is now hitting some rural areas hard. That is the case in Missouri. Experts say there are three key factors interfering with those communities' abilities to fight the virus. From member station KCUR in Missouri, Alex Smith has more.
ALEX SMITH, BYLINE: During the last week, the rates of new COVID-19 cases in Pettis County, located in central Missouri, have been much higher than rates in Kansas City or St. Louis, where the virus has surged for months. The once far-off threat has suddenly become personal for the staff at Bothwell Regional Health Center in Pettis County, including for CEO Lori Wightman.
LORI WIGHTMAN: In the case of smaller communities, you're taking care of neighbors and you're taking care of family members, of friends.
SMITH: Pettis County is one of five largely rural or small town counties in the state with weekly infection rates higher than in urban centers. Wightman says that in many ways, the hospital is in better shape than once feared. Improved treatments have meant fewer deaths and shorter hospitalizations, and the state has shored up supplies of masks and other protective equipment. But Bert Malone, who's on the board of the Missouri Public Health Association, says that while the state has managed to help hospitals, it has dropped the ball elsewhere.
BERT MALONE: The fact of the matter is the hospitals are at the end point of this pandemic. The dollars and the most effective strategies should be put at the front end of preventing disease, preventing individuals so they don't have to go to the hospital.
SMITH: Many experts say the best way to do that is by wearing masks. Missouri has made national news several times this summer with videos of pool parties and other eye-popping violations of health guidelines. But Republican Governor Mike Parson has repeatedly scoffed at a statewide mask mandate, insisting that masks should be a matter of, quote, "personal responsibility." Then there are the ongoing problems of testing and data reporting. A week and a half ago, Missouri appeared to have the second-fastest rate of new infections in the entire country. But state officials claim this was due to a case backlog and say new cases are now closer to national averages. It's the latest in a string of data reporting errors, gaps and corrections by the state. Georgetown University public health researcher Claire Standley says these can mislead the public.
CLAIRE STANDLEY: You know, transmission is being maintained within the community, and it's just our ability to count those cases that is changing.
SMITH: Finally, there's the problem of funding. In March, Congress approved the CARES Act. It authorized emergency funding for local health departments, which would help them increase testing and reporting capacity. But in Missouri, the money went instead to county governments, many of which have still not passed it along to their health departments. As COVID numbers in Pettis County have jumped, the county commission began distributing more emergency funds and is now mandating masks in public. But the county was caught flat-footed and Lori Wightman thinks it didn't have to be this way.
WIGHTMAN: I know that had we had more people wearing masks earlier, we may have avoided having so many people in our community and so many people in the hospital due to this infection.
SMITH: And the messaging remains muddled. While Governor Mike Parson now regularly urges Missourians to wear masks, he's still often seen without one in public himself.
For NPR News, I'm Alex Smith in Missouri.
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