Summer sunset with a red barn in rural Montana and Rocky Mountains
Credit: iStock

Most of the reporting on coronavirus has focused on its spread in major urban areas, especially New York City. But I was spurred into looking at what is happening in rural America by the fact that the “hot spot” in my home state of Minnesota is not the Twin Cities metro area. The disease has taken hold in the city of Fairmont, which is located in Martin County—an agricultural community in the southwestern part of the state.

While the number of cases and deaths related to coronavirus in Martin County is fairly low (34 cases and 4 deaths), it dwarfs those in the metro counties on a per capita basis. For example, per 100,000 people, Martin County’s numbers represent 170 cases and 20 deaths, compared to 17 cases and 0.7 deaths per 100,000 in Hennepin County, which includes Minneapolis.

No one knows why this virus has taken hold in Martin County, but that hasn’t stopped speculation. Here is what Tim Langer, public health sanitarian with Martin County Human Services, ventured.

“My personal opinion is there are some folks listening to some media outlets that were not taking this seriously. That can be a factor, too. It’s hard to prove that. I don’t want to get political. But there were outlets saying it’s a hoax, it’s no worse than a cold, and those are things people listen to.”

Martin County, Minnesota isn’t the only rural area that is facing a coronavirus outbreak. In hotspots like Blaine County, Idaho and Eagle County, Colorado, the explanation is clear: rich ski towns have some of the highest infection rates in the country. But what explains the fact that Greer County, Oklahoma is the hot spot of that state, with an infection rate of 520 and death rate of 50 per 100,000?

In terms of what can happen in rural areas, it is the relatively small town of Albany, Georgia that should provide a warning to the rest of the country. It is now facing the fourth-worst outbreak per capita in the United States. Located three hours from Atlanta and 40 miles from the nearest interstate in the southwestern part of Georgia, the town of 75,000 has a per capita infection rate of 659.

The outbreak in Albany is now spreading to the surrounding areas. For example, this is what is happening in nearby Early County.

In the tiny county of Early in southwest Georgia, five people have died. And the mayor and the police chief of the county seat, Blakely, are among the county’s 92 confirmed cases. It has been a shock for the rural county of fewer than 11,000 people.

Some of the issues faced by these communities are similar to those we hear about in urban areas. For example, Montana Senator Jon Tester recently said that his predominantly rural state needs hundreds of thousands of masks, visors and gowns. But with the closure of so many rural hospitals, this story from West Virginia might not be uncommon.

On March 23, emergency medics were called to take an 88-year-old woman with the coronavirus to the hospital, Mr. Angelucci said. Instead of making a quick drive to Fairmont Regional, about two minutes away, Mr. Angelucci said that the medics had to drive to the next-nearest hospital, about 25 minutes away. A few days later, she became West Virginia’s first reported coronavirus death.

Stories like these aren’t getting much attention in mainstream media, partly because the numbers aren’t as overwhelming as they are in urban areas and partly because most news outlets are located in places like New York. But it is also because, for too long, all of us have assumed that this was an “urban pandemic.” Unfortunately, that excluded a lot of people in some of the rural communities that have been hardest hit.

“Being from a small town, you think it’s not going to touch us,” Blakely’s assistant police chief, Tonya Tinsley, said. “We are so small and tucked away. You have a perception that it’s in bigger cities.”

That is all gone now.

In many of these rural areas, the outbreak began in places where people in small towns tend to congregate: churches, nursing homes, and—in the case of southwestern Georgia—a funeral home in Albany. So regardless of how dispersed the population is naturally, social distancing is still important.

Nancy LeTourneau

Follow Nancy on Twitter @Smartypants60.