Although COVID-19 is an equal opportunity pathogen, there is a stark contrast in perception of and response to the threat of this highly infectious virus across areas of the United States. We see major metropolitan, densely populated cities decreeing shelter-in-place-type orders. Meanwhile, we hear of rural America questioning social distancing measures. We even see the President of the United States trying to balance an effective response while also appealing to the “less-concerned” America, tweeting:
Small cities, towns, and rural areas are not immune to COVID-19. The Governor of Louisiana, recently said,
“We have the fastest growth rate of confirmed cases in the world in the first 13 days right here in Louisiana”
Louisiana Governor John Bel Edwards
The national battle against the spread of COVID-19 could be won or lost in small cities and small towns across the country. Unchecked by social distancing, this virus will continue to infect without prejudice. But rural Americans may be at higher risk of more severe disease and worse outcomes. That is because rural communities are more often older, more likely to be obese, more likely to smoke, and more likely to be of overall poorer health. These communities also have fewer (and far between) healthcare facilities.
Whether you are a town of 1000 or a city of 10 million, no-one is immune to COVID-19 or from its rapid spread. Smaller communities may, in fact, be at higher risk of overwhelming their local healthcare systems. The result of which could be a higher fatality rate than the major metropolitan areas with the lion’s share of cases.