Thursday, June 11, 2020

Rural hospitals ramping services back up — but carefully

In the midst of the pandemic, hospitals nationwide (including rural ones) have shut down elective procedures to limit the spread of the coronavirus, preserve personal protective equipment and keep from being overwhelmed by a surge of covid-19 patients. But as states have loosened restrictions, rural hospitals are trying to navigate the challenges of reopening while observing new pandemic safety protocols—often with less money and fewer resources than larger hospitals.

"Across the country, rural areas are on the forefront of the political and economic movement to reopen, but these areas are not immune to their own struggles with the virus," Laura Benshoff reports for Philadelphia NPR affiliate WHYY.

"For rural hospitals in particular, managing the process of reopening is both fraught and necessary. In the early days of the pandemic, hospitals braced for a surge in infections that could risk overwhelming their services. For rural Wisconsin, that surge didn't come," but it still could, Rob Mentzer reports for Wisconsin Public Radio. "The new normal at these hospitals includes coronavirus testing for all patients ahead of even routine, unrelated procedures, because some carriers of covid-19 are asymptomatic. Hospitals physically separate the areas where covid patients are treated from those where they conduct routine testing, surgeries or other procedures. And everyone, patient or staff, is required to wear a mask."

A second wave of coronavirus cases could overwhelm rural hospitals; that's in danger of happening in Chambersburg, pop. 50,000, in Pennsylvania. Days after Gov. Tom Wolf announced he would ease restrictions on gatherings in Franklin County, covid-19 cases filled the intensive care unit at WellSpan Chambersburg Hospital, Benshoff reports. A physician told Benshoff that the ICU has been operating at near capacity for weeks, and a few more cases would "tip the balance" and overwhelm the hospital.

"As public officials across the country decide whether to ease social distancing restrictions, economic devastation is weighed against the likelihood of loss of life," Benshoff reports. "In Franklin County, momentum has tipped toward reopening but public opinion on the ground falls far short of consensus and some local doctors question the decision."

Rural hospitals and communities are facing the same quandary in Washington state. Gov. Jay Inslee allowed medical providers to do elective and non-urgent procedures on May 18, as long as they use personal protective equipment and other safety and sanitation procedures to limit the spread of the virus, Arielle Dreher reports for The Spokesman-Review in Spokane.

"Hospital officials hope the change will not only help them provide better care, but also help them stabilize their institutions," Drehere reports. "The drop in patients, combined with the costs of trying to acquire PPE, prepare for covid-19 patients and purchase testing materials, led to financial decline, at times swiftly, for rural hospitals.

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