Rural Healthcare Systems Stretched To Limit Due To COVID-19 Medical services in small Northwest towns are stretched to the limit with shortages of qualified workers and PPE, CARES Act funds running out and hospitals at or near capacity.

Rural Health Systems Challenged By COVID-19 Surge

  • Download
  • <iframe src="" width="100%" height="290" frameborder="0" scrolling="no" title="NPR embedded audio player">
  • Transcript


When COVID-19 hits rural communities, there's little backup in their health care systems. Nursing staffs are strained and doctors are often few and far between. About 1,000 people live in the town of Tonasket in north central Washington state, and at least 16 people there have died since Thanksgiving. The Northwest News Network's Anna King reports.

ANNA KING, BYLINE: Debbie Roberts wishes her stepbrother had just slid away from his advanced Parkinson's.

DEBBIE ROBERTS: If only he hadn't contracted this COVID and left this world in such agony.

KING: He died November 29, part of an outbreak at a nursing facility in Tonasket.

ROBERTS: We sort of talk to him, you know, among ourselves. We say, sorry, Ken, we're so sorry that you had to go this way.

KING: Roberts doesn't blame the nursing home, but more than a dozen people there are dead and dozens more sickened, including nearly half the staff. Rural America is home to few doctors, few ICU beds and not enough replacement staff when health care workers get sick.

DOUGLAS WILSON: That's a difference between life and death sometimes.

KING: That's Dr. Douglas Wilson, the incoming CEO with Confluence Health. It's a rural health care system in Washington state. He says COVID-19 patients are crowding out victims of car accidents and heart attacks.

WILSON: You know, you hate to put someone in a helicopter or an ambulance and fly them over the mountains in the winter when they would've done better had they been able to receive care here locally without traveling.

CARRIE HENNING-SMITH: Rural residents, on average, are older than urban residents.

KING: That's Carrie Henning-Smith with the University of Minnesota Rural Health Research Center.

HENNING-SMITH: Rural residents have more underlying health conditions and rural residents are less likely to have health insurance and reliable access to health care.

KING: Henning-Smith says once COVID-19 gets into a rural area, the effects are dramatic. And experts say without supercold storage, rural areas may wait longer to get the much-anticipated vaccines. One of the hardest hit rural spots in Washington state is Grant County, three hours east of Seattle. So far this year, at least 65 people there have died from COVID-19, more than half in just the past six weeks.

THERESA ADKINSON: I'm done with COVID. I am burned out. My staff are exhausted.

KING: Theresa Adkinson is the public health administrator for Grant County. There are so many sick, her office has largely stopped contact tracing. She's disheartened when she puts out press releases with high death counts and then sees lifelong friends posting about unmasked gatherings on Facebook.

ADKINSON: The vaccine is coming. We can see the finish line. It's just it's a ways out there.

KING: When COVID-19 hit head nurse Rhonda Piner's workplace in Tonasket, she got it, too. The day after Thanksgiving...

RHONDA PINER: I'd been a nurse for 25 years and - but I knew that I could no longer take care of myself, and so I called 911.

KING: Piner was hospitalized for six days. She says the prospect of returning to work is daunting.

PINER: I started crying, I'm gone tell you, because I'm sad to go back and find out who didn't make it and who did.

KING: At the nursing home where Piner works, more than a third of the residents have died. For NPR News, I'm Anna King in Richland, Wash.


Copyright © 2020 NPR. All rights reserved. Visit our website terms of use and permissions pages at for further information.

NPR transcripts are created on a rush deadline by an NPR contractor. 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.