I've been thinking of rural America and the hospitals that serve them recently.
Rural areas, which tend to have older and more at-risk populations, have special challenges when it comes to testing, access to healthcare, shortages of providers, nurses, RTs, vents, supplies like the n95s. They rely on being able to transfer pts that are more complicated, will be in the hospital for any length of time, may require procedures or equipment above a certain level.
Hospital administrators within their systems have been preparing and know that geograhic distances is no assurance they will escape the pandemic. Rural hospitals have been closing in many communities and some have been on the verge of it prior to this. Few have ICU beds. They too are no longer doing what elective procedures they usually perform - a revenue stream. Some are in states that never expanded Medicaid which provides some reimbursement and will leave states footing the bill. You can bet they have had discussions with regional hospitals in towns of 25,000 or more and know the impact a surge in tiertiary hospitals will impact all. Many residents are uninsured but may have chronic diseases that will complicate their care. With staff shortages, the impact when some get Covid 19 and those exposed who need to self-quaranteen will be significant.
grin:
