SCOTT SIMON, HOST:
The U.S. is entering into what many believe is the pandemic's fall surge - at least 83,000 infections confirmed on Friday alone. Some of the worst outbreaks are in the Midwest, with rural communities being hit especially hard. Reporter Will Stone's been following the path of the pandemic. Will, thanks for being with us today.
WILL STONE, BYLINE: Sure thing, Scott.
SIMON: Of course, at the start of the pandemic, big cities were more seriously affected, which makes some sense when you consider urban population density. What we're looking at now are very different kinds of communities that are being struck. What do you see?
STONE: Cases have just exploded in the past month in rural America. They're now at record levels, if you look at the number of new infections and hospitalizations. And what's striking is that cases started to pick up in early September nationwide across the board - urban, suburban, rural. But the growth in rural counties has completely outpaced what you see in the cities. It's really accelerated. And in the most rural counties, the rate of infections per capita is much higher than what we see in the big urban centers now. It's about double. And this makes sense because the Midwest, the Great Plains, parts of the West - these are more rural states, and this is where the pandemic has a foothold.
But it's not only cases. This is what Brock Slabach with the National Rural Health Association told me.
BROCK SLABACH: We're seeing the mortality rates much higher than urban. And, of course, we know that rural populations tend to be older, sicker and poorer.
STONE: Which means they're more likely to get seriously ill if they catch the virus.
SIMON: Will, do we know why cases in rural states are surging?
STONE: I've been trying to get at this question in my reporting, and there's no one reason. To an extent, public health experts expected the pandemic to shift from the cities to more rural communities. We saw this trend with HIV, for example. And once the coronavirus gets to these rural areas, it can be really hard to slow it down because they don't have the resources like big cities.
I've also had people tell me there's been a sense of complacency, a feeling that this was an urban problem, almost a myth that being more spread out means you're not at risk.
And there's clearly a political element here. Rural America skews conservative. And people who work in health care in small towns in states like the Dakotas, they tell me that not everyone thinks the pandemic is that serious. And just this week, I heard the governor of Ohio call out rural areas in his state for not wearing face masks as much.
SIMON: How are states and how are hospitals trying to cope with the situation?
STONE: Well, hospitals are scrambling to find room. Listen to what Dr. Joshua Kern said recently. He's with St. Luke's Hospital in Twin Falls, Idaho.
JOSHUA KERN: I think we're all alarmed and, frankly, kind of scared about what is to come. We're being overwhelmed with patients. And frankly, there's nowhere to send them. Most of the hospitals in this area are experiencing similar issues. There's not really a cavalry to come. We're it.
STONE: This past week actually had the highest number of COVID hospitalizations that we've seen in the last two months. So in Wisconsin, they've set up a field hospital. In Utah, some of the big hospitals in Salt Lake have maxed out their ICU capacity. And this puts a huge strain on the entire region because the smaller rural hospitals don't have the staff or beds, so they count on transferring patients to the cities. But that's getting a lot harder since everyone is increasingly busy. And it looks like the trends are moving in the wrong direction.
SIMON: Reporter Will Stone, who's tracking the path of the coronavirus, which now is gripping the Midwest. Will, thanks so much.
STONE: Thank you.
NPR transcripts are created on a rush deadline by Verb8tm, Inc., an NPR contractor, and produced using a proprietary transcription process developed with NPR. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.