Coronavirus Threatens Strained Rural Health Care System

By: - March 17, 2020 12:00 am

Competitors lounge near cattle barns at the Rio Grande Valley Livestock Show in Mercedes, Texas, last week. Rural areas face numerous challenges when they encounter a coronavirus outbreak: fewer hospitals, longer distances to care and a higher proportion of vulnerable people. Delcia Lopez/The Monitor via AP

Editor’s note: This story was corrected March 18. Due to a reporting error, an earlier version contained an incorrect statistic on the rural population over the age of 65.

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If you’re exhibiting coronavirus symptoms and meet the criteria, you should get tested.

But if you live in rural Presidio County, on the western end of the Texas-Mexico border, be prepared to travel. County residents who are severely ill are being told to go to Big Bend Regional Center in Alpine, Texas, which is nearly 90 miles away from the city of Presidio. The hospital will stabilize those patients before sending them nearly 200 miles to El Paso, according to a hospital spokeswoman.

Patients in the region seeking test results should be prepared to wait. The 25-bed hospital in Alpine takes samples and sends them to the nearest testing site, also in El Paso. Those tests are reported in a day or two. Three local clinics also have a handful of coronavirus tests, but those are taken by a courier to El Paso on weekdays, and then flown across the state to a lab in Dallas. The turnaround time is three to four days, said Dr. Adrian Billings, with Preventative Care Health Services in Alpine.

“People who live out here in West Texas, we’re used to it,” said Gary Mitschke, emergency management coordinator of Presidio County. “If you don’t have 100 miles — well, you really haven’t gotten anywhere.”

As in the rest of the country, most of Texas’ coronavirus cases have been in its largest cities, including Austin, Dallas, Houston and San Antonio. But the virus is moving toward less populated areas. 

El Paso also is metropolitan, but it’s far west of the coronavirus clusters in the eastern and central parts of the state. On Friday and Sunday, the City of El Paso Department of Public Health reported its first two presumptive positive test results for COVID-19, also the earliest reported cases in West Texas. 

“We’re just as exposed as anybody else in the country as far as I’m concerned,” Mitschke said.

Rural people often travel to urban centers for food, shopping and health care. For example, Harrison County, Kentucky, which saw the state’s earliest cases of coronavirus, has a population of roughly 19,000 people. But it’s less than an hour’s drive from an urban center, Lexington.

Rural areas face numerous challenges should they encounter a coronavirus outbreak. There are fewer hospitals, residents travel longer distances to get medical care and a higher proportion of people are older, poorer and sicker.

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April Simpson

April Simpson reports on rural issues at Stateline. Before joining Pew, Simpson was associate editor of Current, where she covered public broadcasting and nonprofit media.