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While much attention has been focused on metro areas, semi-rural and rural parts of America face challenges from the cornoavirus known as COVID-19  [SARS-CoV2] too.

While a great deal of the coverage of the SARS-CoV2 and COVID-19 pandemic in the U.S. focuses on urban areas and the states with larger cities, semi-rural and rural parts of America are not immune to the virus’s spread. Semi-rural and rural parts of the U.S. are not only facing challenges from COVID-19( SARS-CoV2 ) just as the more populous parts of the country are; they face some unique challenges from the virus and its spread.

The most pronounced increases in cases of COVID-19 are all in states that are more semi-rural and rural, who have governors who have resisted calls to issue statewide shelter at home orders. This includes a 53 percent increase in Oklahoma, a 60 percent increase in Arkansas, a 74 percent increase in Nebraska, an 82 percent increase in Iowa, and a 205 percent increase in South Dakota.

Here’s to Good Health in 2020 displayed on HRRMC Sign (Photo by Taylor Sumners)

The challenges facing semi-rural and rural areas run the gamut from economic issues, to access to the necessary healthcare to deal with the type of medical emergencies resulting from COVID-19 infections. While there was reporting about the temporary closing of the Smithfield pork processing plant in Sioux Falls, because of the spike in COVID-19 cases at the plant specifically and in South Dakota in general, similar problems exist throughout the meat processing and production supply chain.

The Tyson Foods chicken processing plant in Blackhawk County, Iowa is also experiencing a COVID-19 outbreak among its workforce and is under pressure from local health officials to temporarily close until it can get it under control. Throughout the U.S., meat processing facilities have closed down because of COVID-19 outbreaks among their workers.

The economic effects of these closures ripples in all directions: affecting consumers far from the places where cattle, poultry, and pigs are raised, who will find increased prices and far fewer choices in the grocery store. When those ranchers and farmers have less money to spend in their local economies, this negatively impact ranchers and farmers of these products, as well as the communities in which they live. Of course, the economies of the communities where the processing plants are located will suffer for the same reasons: fewer people working, resulting in more people cutting back on spending in the local economy.

It is not just cattle ranchers and pork and poultry farmers who are being affected. Restaurants in more urban and suburban areas are closed, or doing more limited take out and delivery-only business; a significant market for farm and ranch products. As a result they are dumping products like milk; sending cattle, hogs, and chickens to slaughter they ordinarily wouldn’t, dumping eggs, and plowing over fruits and vegetables growing in the fields.

This isn’t because there is not still a need for these products in the U.S.; Americans still need to eat in mid April, just like they did in mid January. The problem: the supply chains for grocery stores and for the restaurant industries are not the same, leading to a significant increase in food waste by farmers, ranchers, and other food producers who have suddenly found their markets closing down. At the same time, the amount of Americans either furloughed or unemployed that now have to turn to food banks have increased exponentially.

It is not that America does not have or cannot produce enough food for its citizens. Rather it is a logistical problem created by different supply chains, creating surpluses in one part of the food market, shortages in another; all exacerbated by increases in the numbers of infections at key locations along the food production supply chain.

This logistics problem also presents another major problem for the semi-rural and rural parts of America: access to the healthcare facilities, equipment, and technologies that are necessary to combat COVID-19 as it moves from the more populous urban and suburban parts of the U.S. to the less populated semi-rural and rural areas. Since 2010, for a variety of reasons, 119 rural hospitals have closed across the U.S., despite nearly 20 percent of all Americans being dependent on a rural hospital for care

 The recent legislation to provide stimulus to Americans, as well as shore up businesses impacted by SARS-CoV2/COVID-19 prohibited government owned hospitals and healthcare facilities from accessing these funds. Unfortunately nearly a third of all rural hospitals and over 15 percent of rural health clinics are government owned. While both Democratic and Republican members of the House and the Senate have asked the Trump administration for a waiver, so far none has been granted.

This means that as COVID-19 infections continue to spike in the semi-rural and rural parts of the U.S., financially squeezed hospitals and community health care facilities will face additional financial constraints in their abilities to provide care for their communities. Without adequate funding, rural hospitals and health clinics won’t be able to afford the equipment and materials needed to properly treat the patients from their communities or keep their doctors, nurses, physician assistants, nursing assistants, respiratory therapists and technicians, and their maintenance and environmental services staffs safe.

All of this is wrapped within a final set of challenges, which are also financial. States, whether on the coasts or in the middle of the U.S., whether having large urban and suburban populations or primarily semi-rural and rural ones, are not allowed to run budget deficits. They must balance their budgets.

Right now the more rural and semi-rural states are dependent on financial transfers via the Federal government of funds from Federal tax receipts from the more prosperous states with larger urban and suburban populations. Federal tax revenues from New York and California alone are subsidizing a significant portion of the rest of the U.S.

New York and California, and the eight other states whose citizens contribute more in Federal taxes than they receive back, face severe economic shocks from having to increase spending to combat COVID-19 face combined declines in revenue created as a result of the necessary shelter at home orders. While these orders bent the curve of the pandemic’s spread and protected Americans, it is necessitates that the Federal government step in and increase support directly to states.

All states are now in the same boat – the ten that contribute more than they receive, and Colorado is in that ten — and the remaining 40 who do not. They all need financial support from the administration that can be pushed to municipalities that are feeling the economic impact of combating the SARS-CoV2 and COVID-19. Health services have to be funded, as do emergency services and teachers and a dozen other things.

The devastation that COVID-19 is inflicting on urban and suburban parts of the U.S. will not be confined to those areas. The semi-rural and rural areas will be affected too. The unique ways of life – political, social, economic – in those semi-rural and rural areas present both similar and different challenges as those being experienced in the more populous parts of the United States. No part of the U.S. is immune to COVID-19 and no part is going to emerge from this pandemic unscathed.