By Betsy Sugar ’21, Staff Writer

Cartoon by Richard Farrell ’22

The current global pandemic has upended everyday life for many, but states have responded at disparate rates and with unique measures. Most notably, city and state legislators in regions with large rural populations enacted guidelines more slowly, according to a New York Times article outlining stay-at-home orders by state. This trend is particularly apparent in the South, and the end result could produce lasting repercussions.

As respiratory droplets transmit SARS-CoV-2, the virus that causes COVID-19, the most effective method to prevent transmission is to maintain distance from others and wash hands frequently. Social distancing calls for people to maintain a six-foot space between individuals. Densely populated cities, like New York, face a heightened challenge in enforcing adequate social distancing and have consequently experienced the pandemic’s effects more intensely. 

In contrast, sparsely populated regions such as the South have responded more slowly. One reason is the geographic isolation that characterizes more rural communities. Rebekah Bass ‘21, who lives in Boiling Springs, North Carolina, said, “I think that living in a rural community in some ways is an advantage. We have the advantage of space, which is what we want during this time of social distancing.” However, she noted that this space comes at a price. “[T]he burdens of having to provide your own transportation to get to health care providers will only become more of a life or death concern as there are more confirmed cases in my community.”

According to the Center for Disease Control, those most at risk of COVID-19 are older adults and individuals with preexisting conditions. An April 2nd article in The Atlantic noted, “southern states fill out the entirety of the top 10 states in percentage of population diagnosed with hypertension by a doctor.” The article also states that southerners are “more likely to suffer from chronic diseases than other Americans,” such as lung disease, heart disease, and obesity. The article posits this as a potential explanation for why younger people in the South face greater death risk from COVID-19 than in other regions of the country. 

While many rural southerners hope their geographic distance could protect them, this isolation could lead to health care challenges due to minimal infrastructure. For instance, rural areas are less likely to have well-equipped hospitals nearby with a sufficient number of ventilators. The Washington Post calculated that “nearly half of the [U.S.] adult population lives in regions where the demand would exceed the supply” if residents do not adhere to strict social distancing. Of that half, most live in “micro-geographies” in rural areas without a large number of ventilator-supported ICU beds. 

Sadie Blackshear ‘23, resident of Red Oak, North Carolina, a town with a population of about 3,500, shared her outlook on her community’s readiness in the face of the pandemic. “The closest hospital is Nash UNC Health Care in Rocky Mount; it’s about a 15-minute drive away. The next nearest hospitals are 30-60+ minutes away.” Nash UNC Health Care began to “offer a mask to each of its employees (but not patients) to wear if they would like, but each employee gets only one and must keep up with it. The main issue they’re facing at the moment is [a] lack of access to hand sanitizer and wipes.”

Sommer Holmes ‘21 lives in Ayden, North Carolina, a town with a population of less than 5,000. She expressed concern about her local hospital’s preparation, stating, “I highly doubt they are equipped because they are small, outdated, and lacking full-time doctors.” Rural hospitals have been struggling in recent years in the US, well before the onslaught of the recent pandemic. CNN reported that “170 rural hospitals in 36 states have closed since 2005. More than half were in southern states.” 

While those living in rural areas experience the pandemic distinctly from those in densely populated cities, Sociology professor, Dr. Alessandra Bazo Vienrich anticipates disparity between the experiences of those within rural communities themselves; minorities and people of color are at particular risk in the face of this pandemic. 

Dr. Bazo Vienrich, who teaches SOC 264: Latinxs in the South, unpacked the higher risks facing the southern Latinx population amidst the pandemic. “One [reason] stems from the fact that many Latinxs work in industries that are considered essential. This maintains [their] employ[ment] during the pandemic but also puts them at risk of contracting COVID-19.” Dr. Bazo Vienrich also cited language barriers, exacerbated in more rural hospitals, and the additional risks undocumented workers face. “In regards to healthcare, many low-income Latinxs, or those who are undocumented, do not get health insurance through their employers. Not having health insurance may prevent those who are symptomatic from seeking out medical help.”

Not only are language barriers a potential risk in regards to healthcare, but Latinx children also face unique challenges with the shift to remote education. “Latinx children whose parents are not bilingual and who are not old enough to supervise their own online learning are going to be disproportionately affected by the lack of support at home,” Dr. Bazo Vienrich noted.

Indeed, many rural schools face greater challenges in maintaining education in the face of online learning. Blackshear herself has faced Internet connection difficulties, as “being out in the country means the only option for the Internet is DSL, and scarce cell service renders hotspots useless, so connectivity issues become prominent.” DSL, or Digital Subscriber Line, is a form of internet service that delivers Internet through phone lines and tends to be slower and less reliable. Without stable WiFi, students and teachers in rural areas struggle to finish the school year. While COVID-19 has affected the entire country, the rural South faces unique challenges. As the New York Times indicated in an article on April 15th, the South is beginning to see per capita cases of COVID-19 similar to those in New York and New Jersey. From poorer health infrastructure to a population at a higher risk of contracting severe cases of COVID-19, the rural South faces disparate long-term impacts from this pandemic.