Friday, March 27, 2020

Rural coronavirus cases increase 28 percent in the past day

"About a third of the nation’s rural counties have reported a case of coronavirus as of Thursday, March 26. Those cases have resulted in 32 deaths, an increase of 11 from Wednesday," The Daily Yonder reports. "The number of covid-19 cases in rural America grew by 613 yesterday, bringing the total number of cases reported in rural counties to 2,773."

See The Daily Yonder story for a county-level map of cases.

Last coal unit at iconic Paradise plant shuts down; U.S. coal production and employment keep going down

The Paradise Fossil Plant was the Tennessee Valley Authority's only coal-fired plant with cooling towers, typically used at nuclear power plants, because its coal burners were so big. (Associated Press photo by Dylan Lovan)
Despite Republican lawmakers' "best efforts to make good on Trump’s campaign promise to save the beleaguered coal industry, including an eleventh-hour pressure campaign, the Tennessee Valley Authority power plant at Paradise burned its last load of coal last month," Dylan Lovan reports for The Associated Press. "The plant’s closure — in a county that once mined more coal than any other in the nation — is emblematic of the industry’s decades-long decline due to tougher environmental regulations, a major push toward renewable energy and a rise in the extraction of natural gas. The shuttering of businesses nationwide and a reduced need for energy amid the global coronavirus pandemic threatens to deal coal yet another devastating blow."

The plant once had the world's largest coal-fired burners and was fed by a mine with "the world's largest shovel," as noted in the 1971 song "Paradise" by John Prine, whose father came from the long-deserted Muhlenberg County town that gave the plant its name.

The closure of the Paradise Fossil Plant now and the Navajo Generating Station in November are reminders that coal-fired power plants are an increasingly endangered species in the U.S., and that the mining jobs that fuel such plants are headed in the same direction. The overall economy added more than 6.4 million jobs in the past three years. But, though there was a small uptick in the number of coal mining jobs in the U.S. after Trump's election, the latest jobs reports show that there are nearly 1,000 fewer coal miners working compared to three years ago, Chuck Jones reports for Forbes.

"With the fuel unable to compete in most places with natural gas, nuclear, and renewables, the mining and burning of coal is increasingly toxic economically as well as environmentally. Coal mines are becoming 'stranded assets' — unlikely ever to pay off the costs of their development. The risks for financiers are becoming too great," Fred Pearce reports for Yale Environment 360. "Twelve years ago, 45 percent of U.S. electricity was generated by burning coal. The figure is now 24 percent and falling fast."

The waning usage of coal worldwide is making a measurable difference on the environment: according to a recent report by climate think-tank Ember, global carbon emissions from electricity generation fell by 2 percent last year, the biggest drop in nearly 30 years, mostly because of milder winters and less reliance on coal-generated power worldwide (though China has increased its reliance on coal-fired power plants), Jillian Ambrose and Simon Goodley report for The Guardian.

Rural workforce, supply chains are tricky during pandemic

Though metropolitan areas are seeing more coronavirus cases so far, rural areas are still getting hit with supply-chain and workforce issues.

It's planting season, and many farmers relying on foreign labor have been facing a looming shortage since the U.S. closed its consulates in Mexico on March 18. Consulates process migrant farmworker visas. However, after appeals from farm groups and ag-state lawmakers, the U.S. Department of Agriculture "announced late Thursday that the State Department and the Department of Homeland Security have agreed to waive in-person interview requirements for H-2A and H-2B visa applicants," Liz Crampton reports for Politico's Morning Agriculture. "Demand for H-2A visas, reserved for agricultural labor, jumped 11 percent last year; H-2B visas, for non-agricultural temporary workers, is capped by Congress at 66,000."

The nation's food supply is fine thus far, but Gary Schnitkey, an agricultural economics professor at the University of Illinois, noted in a recent webinar that changing supply-chain logistics will be an issue. Transportation and food industries will have to adjust to shifting food from restaurants to grocery stores, since so many more people are eating at home these days, Jonathan Hettinger reports for the Midwest Center for Investigative Reporting.

To hurry delivery of supplies, the Trump administration has suspended a rule that required commercial truck drivers to get a sleep break after 14 hours of work, Sky Chadde reports for the Midwest Center.

Quick hits: Pandemic hits when Appalachia is already struggling; lawmakers must acknowledge rural realities

Here's a roundup of stories with rural resonance; if you do or see similar work that should be shared on The Rural Blog, email us at heather.chapman@uky.edu.

The coronavirus pandemic couldn't have come at a worse time for Appalachia. Read more here.

Lawmakers must acknowledge the differing needs and resources of rural areas in responding to the pandemic, according to one op-ed. Read more here.

On being black, rural and Southern during the pandemic: Read more here.

What it's like to not have running water during a pandemic: Read more here.

Rural America can play a big role in helping the nation recover from the pandemic by expanding biomanufacturing, Tom Vilsack and Ro Khanna write in an op-ed for the Des Moines Register. Vilsack is the former Agriculture Secretary and governor of Iowa. Khanna represents Silicon Valley in the House and has made headlines for his efforts to bring tech jobs to rural areas.

CDC webinar advises rural stakeholders on pandemic response; USDA launches rural response page

The U.S. Department of Agriculture's Rural Development agency has launched a rural response page for the pandemic. Click here for more information. The Centers for Disease Control and Prevention will host a webinar of interest to rural stakeholders today at 2 p.m. ET. The webinar will address higher-risk populations and people with underlying medical conditions. Click here for more information.

The CDC held a webinar on March 23 to inform and advise rural health-care providers and other stakeholders on responding to the coronavirus pandemic. The webinar featured Dr. Jay Butler, deputy director for Infectious Diseases at the CDC, and Health and Human Services Deputy Secretary Eric Hargan. Here are a few highlights from the webinar:
  • Lab tests aren't seeing the virus sticking around long on paper or cardboard. So be cautious about handling mail, but not over-worried.
  • Spring planting should not be affected by the pandemic.
  • Rural areas, especially medical providers, are seeing shortages of supplies. The Federal Emergency Management Agency is working with HHS to look at alternative supply chains to increase distribution of supplies to rural areas (such as personal protective equipment). Butler mentioned distributing supplies from the federal government's Strategic National Stockpile, but was not specific. He also did not answer a question The Rural Blog submitted about how rural providers can purchase supplies when they're frequently at the end of supply chains and the federal government is a major competitor. 
  • It's difficult to say whether rural areas are more or less at risk for the coronavirus. That depends not just on your population density, but on your household density, Butler said. In general, the spread in rural areas will be slower, but "we shouldn't assume that any part of the country will be spared."
  • Butler addressed conjecture that the pandemic will peter out during the summer. Though viruses like the flu do see fewer cases in warm weather, it's impossible to say what will happen, he said.
  • Rural health-care providers should exercise good judgment in deciding whether to keep well-child and other elective appointments and procedures. It depends on how much the virus is present in the community, though the CDC broadly recommends deferring non-essential appointments.
  • Butler acknowledged that rural hospital closures make it harder for rural residents to access care. He said that, even if a local hospital is closed, local leaders could reopen it with a volunteer staff to handle moderately ill patients. But rural hospitals should ensure that there is a plan to transport severe patients to larger hospitals.
  • Rural areas should set up isolation and quarantine areas, but the CDC doesn't recommend using large enclosed areas like school gyms. Since the virus is airborne, more caregivers will likely be infected.
  • Almost all hospitals have done some pandemic planning, but Butler encourages them to revisit those plans and do tabletop exercises to consider different scenarios, such as health care workers suddenly unable to come in to work because of childcare issues.
  • Butler recommended that churches avoid large gatherings.
  • When asked how rural providers can get testing kits, Butler said the term "kits" is inaccurate, and that it can't be done just anywhere. The testing is mainly available only in larger hospitals and state labs, though they're hoping for rapid tests that can be done by local doctors. Doctors can work with state or private labs to get specimens tested quickly, Butler said. Butler acknowledges that there is a testing backlog, but said he has been told that that backlog should be cleared "fairly soon." That projection is at odds with reports that widespread testing will not likely be available soon. 

Thursday, March 26, 2020

Weekly paper, radio station team up for first time to remind Wyoming county that local business sustains community

Editorial in The Douglas Budget and the Glenrock Independent, Converse County, Wyoming:
   In an unprecedented move, The Douglas Budget and Glenrock Independent newspapers are working side-by-side with KKTY Radio and numerous other business and civic leaders in a media blitz to remind Converse County residents that it’s up to them to help their communities’ small businesses survive the failing economy.
Screenshot of online ad; sponsor names roll through box
   “There’s a massive reduction of income taking place. Revenue streams are drying up quickly. Now is the time to support each other. We need our neighbors, sports teams, non-profits, our community – to support the businesses who have supported them for so long,” Douglas Budget Publisher Matt Adelman said.
   Businesses are working to roll out the “Shop Local” campaign across all media in the upcoming 30 days, including messages in print and websites/online, through social media and across all of KKTY owner Dennis Switzer’s radio stations and signals.
   “Without the support of citizens in our communities, there will be no revenue, no money available to help as we have done in the past. If you know someone who owns a business or works for a small business, you really should consider buying locally and supporting the businesses here or six month to a year from now, they won’t be here. Help them. Help the community. Help your fellow citizens,” Adelman implored.
   Switzer, who owns several radio stations in Douglas, including KKTS and KKTY, said radio stations and newspapers are generally competitors for local ad dollars, but at this point in time it is necessary to work together to try to help the town’s small businesses survive.
   “The economy is in crisis. Our health is in crisis. This is a time where we hang together, we build our community together. Local media does a wonderful job of serving their communities. We live here, we eat here, we go to church here, we do business here.
   “In normal times, we are a vital business community. In crisis, we have to work together to keep what’s important to us,” he stated.
   Switzer and Adelman want people to consider shopping locally whenever possible.
“That’s almost a worthless phrase these days. Everyone says it. I’ve sold advertising in Douglas for 25 years, mostly to locally owned ‘Mom and Pop’ businesses. If you’ve lived here long, you most likely know mom and pop. As our economy struggles, in part from the coronavirus, those businesses will struggle. They’ve been struggling already because of Amazon and online shopping. A lot of those ‘Mom and Pop’ businesses are up against the wall. We need to remember – it is vital to support them,” Switzer stressed.
Converse County (Wikipedia map)
   “These are the businesses who have supported sports boosters, nonprofits like the animal shelter and Boys & Girls Club, and been there when others in our communities have been in need or want, often without a second thought and without any reason but it was the right thing to do,” Adelman noted. “Now, they need everyone to return that kindness by shopping in their businesses, even as they struggle to get supplies in or run out of key items quickly. Because if we don’t support them now, in their time of extreme need, they most certainly will not be here in the future to continue to support others in our communities.”
   Both businessmen expressed high levels of gratitude to the large number of business, civic and community leaders who have stepped up this week to support the Shop Local-Shop Life message. A full list of those can be found on the ad in this issue, as well as on websites for douglas-budget.com, glenrockind.com and kktyonline.com and during the radio ads which will begin airing this week.
   Any business wishing to participate in the “Shop Local” campaign can pick up posters and flyers to display in their location’s windows or hand out to customers. All are free of charge. For more information, to add your name to the list of supporters or to pick up a poster, contact the Budget at (307)358-2965.

Trump administration shielded Walmart from criminal prosecution over opioid prescriptions, investigation finds

A ProPublica investigation has found that top Department of Justice officials shielded Walmart from criminal prosecution in 2018 for allowing suspicious opioid prescriptions to be filled over the objections of thousands of Walmart pharmacists. This happened as the Trump administration told the public it would crack down on those responsible for the opioid epidemic, Jesse Eisinger and James Bandler report. Their blockbuster report is based on Walmart internal emails and documents, legal correspondence, and interviews with nine people familiar with the investigation.

Joe Brown, U.S. attorney for the Eastern District of Texas, and a team of employees including Heather Rattan, who has spent most of her career prosecuting drug cartels, began investigating Walmart in 2016. According to the evidence they gathered, Walmart pharmacists in Texas and other states reported hundreds of thousands of suspicious or inappropriate opioid prescriptions to their supervisors. They knew these opioids were being prescribed by "pill mill" doctors, and begged the corporate office to allow them to refuse to honor such prescriptions. Some of the doctors had been banned from sending prescriptions to all of Walmart's major competitors.

Walmart corporate officials didn't take broad action in response to these claims at the time, even though some customers who got those prescriptions died from overdose. The company said it could not cut off a doctor entirely, and that each prescription must be evaluated individually, the Texas prosecutors found. Some doctors were only banned after prosecutors began investigating Walmart, Eisinger and Bandler report. But pharmacists in some states had limited power to block individual doctors because of protective measures by state boards of pharmacy and medical boards.

The company appeared primarily concerned with the profitability of such opioid prescriptions: "An opioid compliance manager told an executive in an email, gathered during the inquiry and viewed by ProPublica, that Walmart’s focus should be on 'driving sales'," Eisinger and Bandler report.

It wasn't the first time Walmart had gotten in trouble for failing to vet opioid prescriptions; in 2011 the company entered into a secret settlement with the Drug Enforcement Administration in a similar case and promised to make greater efforts to curb improper filling of opioid prescriptions, admitting no wrongdoing. That settlement has not been previously reported. "Walmart had repeatedly run afoul of the Controlled Substances Act," Eisinger and Bandler report. " The company had received more than 50 'Letters of Admonition' from the DEA for its prescribing practices from 2000 to 2018, according to records obtained by ProPublica."

In 2018, Rattan, the federal prosecutor in East Texas, told Walmart she was going to indict it for violating the act, an unheard-of step against a Fortune 500 company, for failing to properly track and report suspicious opioid prescriptions.   Walmart had admitted to mistakes and appeared open to a civil settlement, but stopped cooperating with prosecutors in mid-2018. Through law firm Jones Day, which has deep ties throughout the government, Walmart "added a Trumpian tactic: At a moment when the president had established a habit of attacking the investigators in his own government, the company followed a similarly aggressive approach," Eisinger and Bandler report. "Walmart lawyers complained to Washington about the Texas prosecutors, accusing them of seeking to 'embarrass' the company while using the threat of criminal charges to extort a larger civil fine. Criminal and civil investigations can run in parallel, but it’s an ethical violation for prosecutors to use the threat of criminal penalties to generate a higher civil settlement."

A Walmart lawyer also said in a letter to a Justice Department official that criminally convicting Walmart could harm millions of senior citizens and low-income people who rely on federal programs for food and medicine, since a convicted corporation might be barred from participating in such programs. As prosecutors continued their chase, "Walmart exercised its PR and political muscle," Eisinger and Bandler report: In May 2018, the company announced it would limit first-time opioid prescriptions to no more than a seven-day supply.

Walmart got high-ranking Justice employees to intervene, and the department informed Walmart that it would decline to prosecute. The prosecutors didn't give up, and in October 2018 got a sympathetic ear from acting DEA Director Uttam Dhillon. They all headed to Main Justice to meet with Deputy Attorney General Rod Rosenstein. He refused to revive the criminal case, and suggested prosecution of individual employees. But Justice blocked that too, and Trump appointees in the department consistently sided with Walmart when the team filed a civil case, Eisinger and Bandler report. One of the Texas prosecutors resigned in protest in October 2019.

Small newspapers in Canada, U.K. suspend printing; some in U.S. may due to pandemic-driven loss of ad revenue

We noted in an item earlier this week that loss of ad revenue has hurt small newspapers in Michigan. Many rural newspapers in the U.S. are considering temporarily suspending their print editions, says Al Cross, director of the Institute for Rural Journalism and Community Issues, which publishes The Rural Blog. New stories from Canada and the United Kingdom show that the phenomenon is even more widespread than that. 

"Halifax-based SaltWire Network announced Tuesday afternoon it's temporarily laying off 40 percent of its Atlantic Canadian workforce, suspending production of all weekly newspapers across Newfoundland and Labrador and Nova Scotia, and producing only four daily publications: the St. John's Telegram, the Halifax Chronicle Herald, the Cape Breton Post and Prince Edward Island's Guardian," the Canadian Broadcasting Corporation reports. "The company intends for the layoffs and suspension of publications to continue for the next 12 weeks."

JPI Media, which owns dozens of newspapers in England, "told staff on Wednesday that all of its free newspapers delivered door-to-door would temporarily stop printing due to the logistical challenges of arranging delivery, alongside the catastrophic collapse in the local advertising market," Jim Waterson reports for The Guardian. "JPI Media said it intended to retain journalists at the non-printing outlets to run websites. But the decision to cease printing raises questions about how long this can sustained, given that sources have suggested digital advertising revenue was already minimal at many of these outlets. Instead they relied heavily on income from print advertising, which has been cut heavily as small businesses cut spending." The British government "has made clear that it considers reporters and print newspaper distribution staff as key workers during the crisis, due to the importance of getting accurate information to people’s homes," Waterson reports.

USDA Rural Development announces pandemic relief measures for housing, utilities and businesses

Responding to the coronavirus pandemic, the U.S. Department of Agriculture's Rural Development office has announced a series of measures meant to bring immediate help to rural residents struggling to afford housing, rural landlords who own affordable housing, rural utilities, and rural small business owners, retroactively effective to March 19. Read more here.

7 more states get Medicaid waivers for pandemic; hospitals, caught in lull between elective surgery and crisis, need aid

On Wednesday the Centers for Medicare and Medicaid Services approved waivers in seven more states in an effort to help them fight the coronavirus pandemic. "Indiana, Iowa, Kansas, Kentucky, Missouri, Oregon and Rhode Island scored the new Section 1135 Medicaid waivers. So far, the CMS has approved 23 of these waivers with an average turnaround of less than seven days between a state submitting its plan and getting the green light," Erica Teichert reports for Modern Healthcare.

The waivers apply to Medicare, Medicaid and the Children's Health Insurance Program. "Under the waivers, states can temporarily suspend prior authorization requirements, extend existing authorizations for services through the end of the public health emergency, suspend some nursing home pre-admission reviews, ease reimbursement for care delivered in alternative settings due to facility evacuations, and relax provider enrollment requirements to allow states to more quickly enroll out-of-state or other new providers to expand access to care," Modern Healthcare reports. The waivers are retroactive to March 1 and will end when the health emergency is declared over.

Rural hospitals could benefit, especially since many were in poor financial health before the pandemic. Right now, rural hospitals are facing a one-two punch: not enough money to prepare for pandemic patients, and not much money coming in since elective procedures have been ordered canceled in many states. "The lull threatens to bankrupt them," Richard Read reports for the Los Angeles Times. Today, one of Kentucky's largest rural hospitals furloughed 300 of its 1,200 employees as its awaits the surge of covid-19 patients without revenue form elective procedures.

Wednesday, March 25, 2020

Some conservative radio talkers downplayed covid-19 threat and criticized efforts to blunt its spread, ProPublica reports

President Trump and Mark Levin in the Oval Office on Oct. 8
(Photo by Leah Millis, Reuters)
Several conservative radio talk-show hosts, "including at least four of the 12 most listened to as measured by Talkers," an industry magazine, "have downplayed the threat of the coronavirus and criticized efforts to blunt its spread," Jack Gillum and Derek Willis report for ProPublica.

The reporters researched archives of TVEyes.com and Cortico, a noprofit that says it works with the MIT Media Lab "to foster constructive public conversation in communities and the media that improves our understanding of one another."

Even after President Trump declared March 13 that the coronavirus and its covid-19 disease constituted a national emergency, "Some hosts groused that aggressive measures to contain the disease were a political ploy to undercut the president or ram through unpopular Democratic legislation," ProPublica reports. Polling before Trump's declaration showed considerably less concern among Republicans about the virus than among Democrats; that gap has since narrowed.

Several hosts, including the nationally syndicated Mark Levin, compared covid-19 to seasonal flu, even though it has a higher mortality rate, a much higher hospitalization rate, and a much longer incubation period, allowing people who don't have symptoms to spread the virus unwittingly. "Also, unlike the flu, covid-19 has no vaccine or approved treatment," the reporters note. "Although the hosts conceded that some level of concern about covid-19 is justified, their skepticism could deter their audiences from self-quarantining, social distancing and other behavioral changes that health officials say are necessary."

Dollar General, Walmart and CVS hiring big in pandemic

Amid layoffs and shutdowns nationwide, many people are struggling with how to pay the bills. Here's something that may help a little in rural areas: Dollar General, CVS, and Walmart, which all have substantial presences in rural America, are on hiring sprees to help meet demand for their goods.

Dollar General Corp., which has a massive rural presence, is hiring up to 50,000 new employees for its more than 16,000 stores by the end of April. Most of the positions are expected to be temporary, but some may become permanent, Mike Snider reports for USA Today. The chain also says it plans to invest about $35 million in employee bonuses.

CVS Health announced Monday that it plans to hire 50,000 full-time, part-time and temporary employees in the coming weeks to deal with the surge in business. Walmart says it's hiring more than 150,000 new workers, Andrew Soergel reports for U.S. News & World Report. Walmart is offering bonuses between $150 and $300 for part-time and full-time employees.

EPA doesn't appeal court decision limiting small-refinery biofuel waivers, handing a win to corn and ethanol interests

"The Trump administration has decided not to appeal a court ruling that would sharply reduce its use of waivers exempting refineries from the nation’s biofuels regulation, cheering the corn lobby but drawing anger from oil refiners," Stephanie Kelly reports for Reuters. The Environmental Protection Agency had to appeal by yesterday, and no such filing was entered.

"EPA had been expected to apply the decision nationwide and drastically cut the number of exemptions it issues," Ryan McCrimmon reports for Politico's Morning Agriculture. "But the president faced heavy pressure from Republicans and Attorney General William Barr not to do so. That prompted Trump to instead request an extension until March 24 on whether to appeal the ruling." In the end, the administration apparently decided not to appeal, even after more than a dozen Republican senators from oil-producing states published an open letter to the president warning that allowing the ruling to stand would financially endanger small refineries.

"The decision appears to end a years-long battle between the rival oil and corn industries," two important Trump constituencies, Kelly reports. "Refiners argue the waivers are crucial to keeping small refining facilities in business, but agriculture representatives say they have been overused and hurt farmers by eroding demand for corn-based ethanol."

The battle centers over the Renewable Fuels Standard, which requires refiners to blend increasing amounts of ethanol into their gasoline each year. Small refiners that would be financially hurt by adhering to the blending standards can seek waivers, but corn interests have accused the Trump administration of improperly using the waivers as a way to get around the RFS, Kelly reports.

EPA appears to be complying with the court ruling. In late February, it had scaled back its granting of waivers, McCrimmon notes.

March survey of rural bankers shows largest one-month drop in economic confidence since poll began 14 years ago

Creighton Univ. chart compares current month to last month and a year ago; click here to download it and Table 2 (below)
More than six in 10 rural bankers surveyed for the latest Rural Mainstreet Index say they expect a recession because of the coronavirus pandemic, marking the largest one-month decline in the confidence index since the survey began in January 2006, and its lowest point since October 2016. About 32 percent of bankers surveyed said they expect little economic impact from the virus.

The index, compiled by Creighton University economist Ernie Goss, is a monthly survey of bankers "in approximately 200 rural communities with an average population of 1,300" in 10 states where agriculture and energy are critical to the economy: Colorado, Illinois, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota and Wyoming.

The overall index for March fell from 51.6 for February to 35.5 in March. Anything below 50 is "growth negative." This marks the first month below neutral after six months straight above 50, Goss reports. The only three measures on the index above 50 were loan volume, checking deposits, and home sales (see Table 1, above).

The survey says it is "an early snapshot of the economy of rural, agriculturally and energy-dependent portions of the nation." This edition is more like time-lapse photography, because the situation changed rapidly in March. "Over the last two weeks, the coronavirus has resulted in almost one-half, or 47.6%, of bankers surveyed reporting a decline in client or customer visits," Goss writes. Also, 14.3% of banks reported an increase in staff absences due to the virus.
Creighton University chart; click here to download it and Table 1.

Coronavirus highlights digital divide in rural, urban areas

The coronavirus pandemic has highlighted the rural-urban digital divide, as rural workers and students across the nation struggle to work and learn from home with only patchy broadband access; many must rely on wireless as their only source of internet.

"The Pew Research Center reported that in 2019, about 73 percent of American adults had a home broadband connection," Ivan Pereira reports for ABC News. "However, about 63% of rural Americans have broadband internet access, which is 12 percentage points below urban Americans and 16 percentage points below suburban Americans, according to a survey released last year by Pew." The Pew data is based on surveys; the official numbers have been criticized for overstating how many rural Americans have access to rural broadband.

Tim Marema, editor of The Daily Yonder, told ABC that the problem results from years of failure to invest in rural broadband infrastructure construction, and the gap can't be quickly closed in response to the pandemic. Pereira reports, "While the Federal Communications Commission and internet providers have put in temporary fixes, such as removing data caps, increasing cellphone tower range and free access to low-income users, Marema and other activists say those solutions won’t go far enough in the next few weeks."

Moreover, some internet-provider solutions are difficult for some to access. Comcast, which has a larger rural reach than most internet providers, announced recently that it would offer two months of free service for its lowest-tier internet plan, but "Enrollment in Internet Essentials remains relatively low, in part because its eligibility requirements disqualify many poor applicants. For example, anyone who has been a Comcast customer in the previous 90 days, or who has unpaid bills with the telecom company, is ineligible," Nicole Aschoff writes for the left-leaning publication Jacobin.

In many rural areas, the lack of broadband means the "homework gap" is widening among rural K-12 students, and becoming a new problem for college students returning home to rural areas to finish out the semester, Shane Fowler writes for the Lexington Herald-Leader in Kentucky. Fowler is a student at Harvard Law School who is back home in Cynthiana, but is frustrated that it's difficult to access class lectures delivered via teleconferencing software.

Confirmed rural covid-19 infection and death rate much lower than metro rate; map shows county-level data

Daily Yonder map; click the image to enlarge it, or click here for the interactive version.
It is difficult to assess the spread of the coronavirus; testing has been restricted, and not all cases are reported. Figuring out rural vs. urban rates of infection is problematic, too, since not every case has been traced to a specific county. But new county-level data shows that rural infection rates remain lower than metropolitan rates, Tim Marema and Bill Bishop report for The Daily Yonder.

As of March 23, there were 41,096 confirmed covid-19 cases nationwide, and only 1,313, or 3 percent, were in a rural or non-metropolitan area, according to county-level data from USAFacts.org, Marema and Bishop report. Deaths from covid-19 have the same ratio: 15 non-metro counties have reported a covid-19 death, just under 3% of deaths nationwide.

Marema and Bishop stress that the numbers aren't written in stone, citing variations in testing procedures and reporting criteria. They also note that many cases will not likely be reported since those with mild cases are being urged to stay home and not get tested.

Tuesday, March 24, 2020

Local papers render public service with coronavirus coverage; here are some resources that may help

Local and rural newspapers all over the nation are producing outstanding coverage of the coronavirus pandemic under stressful conditions.

In one example, The Pilot, a twice-weekly paper in Southern Pines, N.C., has created a frequently updated special section on its website. The paper's last edition had 24 pages instead of the usual 40 due to a drop in advertising, but it has put all its online coronavirus coverage outside the paywall and is publishing new updates frequently, Publisher David Woronoff writes in an editorial. Many other newspapers are doing likewise.

Woronoff tells his readers that this is an expensive decision, and asks them to consider subscribing so the paper can continue serving the community. The Pilot was named the country's best community newspaper for three consecutive years (2015-17) by the National Newspaper Association.

Here are some resources to help local papers cover the pandemic:
  • America's Newspapers and Editor & Publisher have launched an online source for the latest covid-19 information called Media Virus Watch.
  • Green Shoot Media has created a free covid-19 special section for newspapers. It covers a broad range of topics, including health tips and how readers can support local businesses.
  • The Pennsylvania News Media Association has created a series of free public-service ads that newspapers can print.
  • The Rural Health Information Hub has a toolkit with links to resources that may help you in covering the pandemic.

Bipartisan legislation seeks rural hospital relief; Medicaid waivers greenlit in 11 more states to combat coronavirus

Late Monday the Centers for Medicare and Medicaid Services approved waivers in 11 more states to improve the response to the coronavirus pandemic. The newly approved states are Alabama, Arizona, California, Illinois, Louisiana, Mississippi, New Hampshire, New Jersey, New Mexico, North Carolina, and Virginia. Florida and Washington state received the waivers last week, John Commins reports for HealthLeadersMedia. The waivers relax or remove certain requirements for Medicare, Medicaid and the Children's Health Insurance Program.

"Under the waivers, states can temporarily suspend prior authorization requirements, extend existing authorizations for services through the end of the public health emergency, suspend some nursing home pre-admission reviews, ease reimbursement for care delivered in alternative settings due to facility evacuations, and relax provider enrollment requirements to allow states to more quickly enroll out-of-state or other new providers to expand access to care," Modern Healthcare reports. The waivers are retroactive to March 1 and will end when the health emergency is declared over.

The move could help rural hospitals and health care providers struggling to cope with or prepare for the pandemic, many of which are already vulnerable to closure. Research has shown that Medicaid expansion helps rural hospitals. "Some rural communities have large senior populations and only one small hospital serving several towns. And no ventilators, the critical lifeline for patients who can’t breathe on their own," The Kansas City Star reports.

Many hospitals are canceling elective surgeries to prepare for the surge of covid-19 patients, but that means hospitals already on the edge financially are losing out on income, Edgar Walters reports for The Texas Tribune. "Meanwhile, the institutions also find themselves needing to pay higher prices for personal protective equipment such as face masks and other gear that's in short supply," Lauren Weber reports for Kaiser Health News. Last Thursday the American Hospital Association asked Congress for $100 billion for all hospitals to help with coronavirus-related expenses, citing rural hospitals' financial strain.

On Monday, a group of representatives and senators introduced coordinated bills aimed at providing financial relief for rural hospitals and other rural medical providers. The House version was sponsored by Reps. Terri Sewell, D-Ala.; Phil Roe, R-Tenn.; and Kim Schrier, D-Wash. The Senate version was introduced by Sens. Michael Bennett, D-Colo.; John Barrasso, R-Wyo.; and Doug Jones D-Ala. Barrasso, Roe, and Schrier are physicians. The bipartisan sponsorship could help parts of the bill get included in the big rescue package being finalized by House and Senate leaders. It would:
  • Provide a one-time grant to rural hospitals of $1,000 per patient day for three months.
  • Provide a one-time grant equaling the total reimbursement received for three months of services to make up for the loss of revenue.
  • Increase Medicare reimbursement 20 percent for any patient in a rural hospital using the swing bed program, to encourage larger, overcrowded hospitals to free up capacity.
  • Offer a one-time grant for all providers and ambulatory surgery centers equal to their total payroll from Jan. 1 to April 1, 2019.
  • Authorize the Small Business Administration to provide low-interest loans to physicians and other rural health care providers that would not begin accruing interest until two years after the pandemic has ended.

Environmental Journalists award entries now due April 8

The deadline to enter the 2020 Society of Environmental Journalists awards contest has been extended until April 8.

Journalists may enter the contest multiple times, but each story may only be entered once. Stories must have been published between March 1, 2019 and Feb. 29, 2020. Books must have been published in 2019. Entry fees range from $15 to $110. Click here for more information or to apply.

Several winners in the 2019 contest had rural resonance; click here to read more about them.

Virginia and West Virginia trying to expand black walnut syrup industry; could provide off-season income for farmers

Highland County, Va.
(Wikipedia map)
A bottle of maple syrup is a common sight on breakfast tables all over the nation. How about black walnut syrup, though?

Researchers in Virginia and West Virginia are hoping to expand the growing industry and introduce a locally known product to a larger audience, Casey Febris reports for The Roanoke Times.

Currently, there's only one commercial black-walnut syrup operation in Virginia. It's in Highland County, which is already known regionally for its maple syrup. Walnut syrup is made about the same way as maple syrup, by tapping the trees and boiling the sap. But because walnut sap contains pectin (the substance that makes jelly gel) the filtering process is more difficult. Black walnut trees yield far less sap than maple trees too, so the finished product is more expensive, Febris reports. Since it's such a rare product right now, a gallon of it can go for upwards of $400 online.

"Mike Rechlin, maple commodity specialist for Future Generations University in West Virginia, likes to refer to walnut syrup as an 'untapped resource.' There’s still much to learn about walnut syrup and the most efficient ways to produce it, but he believes it could be a boon for farmers," Febris reports. "Rechlin is researching ways to increase walnut sap production to make it more economically viable. He’s also looking to make it easier to produce, like finding a work-around for the pectin problem." Rechlin often works with Tom Hammett, a Virginia Tech professor who is researching the viability of different kinds of tree sap as syrup sources. Syrup production could provide off-season income for farmers who grow other crops, they say.

Rechlin said that many who have tried walnut syrup say they like it better than maple syrup, and notes that it could be used in specialty high-end foods and cocktails. "I will say that Virginia and West Virginia could be the Vermont of walnut syrup," Rechlin told Febris.

Wild horses and burros in West outrun the federal program that is trying, and failing, to reduce their numbers

Mustangs rounded up in the fall of 2019 near Challis, Idaho. The mares were treated with fertility control drugs and released. (New York Times photo by Hilary Swift)
The Bureau of Land Management has been trying to reduce the number of wild horses and burros on public lands in the West by rounding them up, but there are two problems with that approach: "It hasn’t been able to round up nearly enough horses to limit the wild population. And it doesn’t know what to do with the ones it has managed to capture," Dave Philipps reports for The New York Times.

Once the government captures the horses, it has to feed and care for them. "The costs and frictions of having so many animals on the government’s hands — 49,000 at last count — have pushed the whole wild horse program toward collapse," Philipps reports. "The rented pastures and feed lots where they are kept now devour more than two-thirds of the program’s budget, leaving little money for anything else, including looking for ways to get the bureau out of its current fix."

The bureau has reduced roundups in recent years because of the cost, but that gave the horses and burros more room to expand. Though 7,300 horses were captured in 1029, an estimated 17,000 foals were born. "There are now about 100,000 wild horses and burros on public lands — more than at any time since the days of the Old West. The government reckons the land can sustain only about 27,000," Philipps reports. "Bureau officials warn that the mustang herds are a looming catastrophe for the land, and there is no cheap or obvious solution. Capturing all the excess horses and caring for them in storage for the rest of their lives could cost up to $3 billion. Doing nothing may prove costly, too."

However, wild-horse welfare groups say there is no overpopulation, and that the government is lowballing its estimate of how many horses the land can support because it's serving the interests of cattle ranchers, Philipps reports.

In the 1980s, the BLM said it addressed the problem by rounding up horses and finding them adoptive homes, but news media discovered that most of the adopted horses were actually being slaughtered at a profit for BLM employees. Modern-day legislative support for slaughtering horses has been "widely unpopular," Philipps reports. Many have suggested that the agency would be more successful by focusing more on administering birth control drugs instead of doing the roundups.

The BLM says it can create a sustainable program if Congress gives it more money. Congress has approved such funding three times in the past 30 years, but ballooning costs and animal-welfare lawsuits have made such approval complicated. "The bureau is in talks to open two huge feedlots to hold thousands of horses. But it is unclear if Congress is willing to spend billions to store unwanted horses, especially if an economic downturn drains public funds," Philipps reports.

Monday, March 23, 2020

Is your local hospital ready for the coronavirus? If it's rural, probably not. Here are possible scenarios for your area.

Projections of how hospitals would cope with different covid-19
scenarios. Click on the image to enlarge it. (ProPublica map)
"Though the U.S. health care system is projected to be overwhelmed by an influx of patients infected with the novel coronavirus, the pressure on hospitals will vary dramatically across the country. That’s according to new data released by the Harvard Global Health Institute, which for the first time gives a sense of which regions will be particularly stressed and should be preparing most aggressively right now," ProPublica reports.

ProPublica presents nine scenarios that show how hospitals across the nation would cope if the infection "curve" presented differently. For example, in the mildest scenario, if 20 percent of adults were infected over 18 months, hospitals could generally handle it. In the worst-case scenario, in which 60% of the population is infected over six months, virtually all hospitals in the nation would be overwhelmed. You can enter your ZIP code into a search bar in the ProPublica story to receive a custom chart and numbers for your hospital referral region; boundaries for those can be found in the Dartmouth Atlas of Health Care.

Rural hospital systems may have a greater ability to deal with more patients since there are fewer potential patients to begin with, the research suggests. But rural hospitals may have less experienced staff and less equipment to care for complex cases. That's the case with rural hospitals in Kentucky, hospital and public-health officials told Bill Estep and Will Wright of the Lexington Herald-Leader.

Lack of rural concern about pandemic a result of politicizing it and maybe calling news media the enemy of the people

Conservative Americans and those in rural areas tend to take the coronavirus pandemic less seriously. "Government responses have followed these same tracks," Ron Brownstein writes for The Atlantic. "With a few prominent exceptions, especially Ohio, states with Republican governors have been slower, or less likely, than those run by Democrats to impose restrictions on their residents."

In West Virginia, (and Kentucky too) the general lack of concern has alarmed health officials who wanted the pandemic taken more seriously. "Many residents accused the state’s Republican governor, Jim Justice, of overreacting when he closed the schools," Todd Frankel reports for The Washington Post.

Grant County (Wikipedia)
That perception was supported by West Virginia's lack of confirmed cases: it was the last state to have a confirmed case of covid-19, but that may have partly been because the state had little ability to test for it, Mallory Simon reports for CNN.

In Grant County, an Eastern Panhandle county that voted overwhelmingly for President Trump, local health officials were appalled that locals weren't taking warnings seriously. "The price of politicizing the pandemic was coming due," Frankel reports.

But the refusal to take covid-19 seriously is also the price of calling the news media "the enemy of the people," said Al Cross, director of the Institute for Rural Journalism and Community Issues, which publishes The Rural Blog.

Some good advice: Remember 'The peace of wild things' as a pandemic transforms our daily lives

Spring Beauty flowers in Renkl's yard.
(NYT photo by William DeShazer)
Because of the coronavirus pandemic, the world looks a lot different than it did a month ago for most Americans: social distancing, layoffs, constant news updates about the newly infected and government measures. But our world is changing in a much older way, and taking the time to revel in it can help us stay calm, Tennessee writer Margaret Renkl writes in The New York Times.

Spring has arrived. "Out in the woods, the trout lilies are opening near toadshade and bloodroot and mayapple, all of them reaching up from the cold soil to bloom in the brief sunlight of early spring, before the trees leaf out and the forest overstory draws in all the available light," Renkly writes. "Pull up a weed from the wet soil of the water-drenched garden and smell the rich life the earthworm has left behind. Just a whiff of it will likely flood you with a feeling of well-being. The scent of freshly turned soil works on the human brain the same way antidepressants do."

Being out in nature comforts Renkl, reminding her that her own worries exist in the "larger context" of nature's rhythms. "I can scroll and worry indoors, or I can step outside and remember how it feels to be part of something larger, something timeless, a world that reaches beyond me and includes me too. The spring ephemerals have only the smallest window for blooming, and so they bloom when the sunlight reaches them. Once the forest becomes enveloped in green and the sunlight closes off again, they will wait for another year. Sunlight always returns the next year."

The op-ed reminds us of Kentucky farmer and poet Wendell Berry's timeless poem, "The Peace of Wild Things," in which Berry writes that being in nature eases his worries:
I come into the peace of wild things
who do not tax their lives with forethought
of grief. I come into the presence of still water.
And I feel above me the day-blind stars
waiting with their light. For a time
I rest in the grace of the world, and am free.

How to celebrate National Ag Day at home tomorrow

National Agriculture Day is tomorrow, but official events in Washington, D.C., and in many states have been canceled because of the coronavirus pandemic. Emma Wilson at Successful Farming has some suggestions for how you can observe the holiday at home:
  • Make a farm-to-table meal with your family.
  • Research agricultural issues affecting your region.
  • Share what agriculture means to you in a photo on social media – whether it’s the ingredients for your dinner, a rural field, or livestock. Use the hashtag #FoodforLife.
  • Have a scavenger hunt in your kitchen.
  • Read agriculture books.
The day, part of National Agriculture Week, was organized by the nonprofit Agriculture Council of America. This year's theme is "Food Brings Everyone to the Table." Click here for logos, a media toolkit, and more ideas for promoting the day.

Covid-19 hurts small businesses nationwide, including small newspapers in Michigan and likely elsewhere

Businesses nationwide are in dire financial straits because of the coronavirus. Because cash-strapped businesses are spending less on advertising, that's hurting newspapers that rely on advertising revenue. In Michigan, "C&G Newspapers, a chain of 19 weeklies in Oakland and Macomb counties — where virus cases are growing rapidly — announced Saturday it is temporarily suspending print newspaper publication," reports Bridge, a nonprofit Michigan news publication.

The chain said it hopes to resume business with local advertisers soon and plans to resume print publication in two to four weeks. "The C&G announcement came hours after a Michigan Press Association bulletin described newspapers statewide as facing 'immense pressure' from lost advertising during the crisis," Bridge reports.

MPA encouraged newspapers to hang in there, and said the industry may seek government economic relief soon. The organization "said it had 'grave concerns' that disruption of newspaper delivery could threaten newspapers' long-term fight to maintain printed public notices from government bodies – an important source of revenue and transparent government," Bridge reports.

Al Cross, director of the Institute for Rural Journalism and Community Issues, which publishes The Rural Blog, commented on the notion of government relief for newspapers. "Over the weekend I got a call from an independent weekly newspaper that is facing another cut in pages due to the lack of ads, and wondering if it should solicit support from local governments to keep going," Cross said. "I said that is a slippery slope, but if the governments buy a reasonable amount of advertising to amplify valuable public-service messages, and the editorial department stays clear of the discussions, maintaining an arm’s-length relationship, I would find that acceptable on a temporary basis. And the newspaper should be transparent about it, telling readers that their tax dollars are being used to support it."