How Behaviors Impact Coronavirus Spread & Confirmed Case Reporting

Part 1 – Introduction to Issues

This is a pretty loaded topic. Breaking this one up into several parts. In this post I’m addressing limitations to medical accessibility, such as uninsured rates, caregiving, and religious exemption from government advised or required disease control practices, such as social distancing. Let’s talk about human behavior and how that may impact the vulnerability of your location in the United States to coronavirus.

Accessibility, Uninsured Rates, and Alternative Medicine

Source: https://www.census.gov/data-tools/demo/sahie/#/?s_searchtype=s&s_agecat=1&s_statefips= You can play with this viewer too! Go play with census data and learn about the United States.

There are many reasons Americans are uninsured. Being uninsured will ultimately lead to limited access to healthcare. Due to decisions that were made regarding how to implement mandated healthcare, the poor were punished for not being able to afford exorbitantly priced healthcare. I don’t care who you blame for it not working. Point is, it didn’t, and now we’re sunk. You may notice a similarity between the map above and the maps in my previous post on the closure of rural hospitals and poverty. Texas and Oklahoma are currently set up to be the two of the hardest hit states by coronavirus because these are uninsured populations that feel they cannot seek already-limited healthcare (because hospitals closed). This means that they turn to alternative medicine at home and don’t call a doctor due to the cost. Alternative medicine, though potentially complementary (waiting on research), doesn’t involve providing ventilators to people drowning from their own viral lung inflammation. Alternative medicine doesn’t necessarily involve reporting confirmed cases to the state, either.

Luckily, telemedicine is slowly stepping up the game at reducing costs and improving accessibility, but until we have Point of Care testing that allows for mass screening that could be distributed to a population via the health department – good luck. The FDA still strictly prohibits self administered tests. This is one of the major outstanding limitations preventing telemedicine from serving our most underserved and vulnerable populations in the United States during this pandemic.

Religious Exemption

Source: http://childrenshealthcare.org/?page_id=24

Religious exemptions for medical care are a real thing. I know there are people reading this that are going to think, “but no one in their right mind is thinking that now!”

Oh honey, I wish I could say that was so. Let me first introduce you to What’s The Harm. Even without coronavirus, people are and will be dying due to lack of access to medical care in part because their families opt out via religious exemptions. When this is combined with alternative methods gone wrong and cultural factors, the vulnerability of this population is amplified by pre-existing public health issues.

Part of the states’ Stay At Home orders have meant the discontinuation of standard church gatherings and not everyone is taking it so well. Across the United States, churches are challenging these orders by stating that they are restricting freedom of religion. The continued in-person gatherings of worship services and other church functions result in COVID-19 outbreaks within communities. The Palmer Grove Baptist Church in Burke County, Georgia is one example from today, 31 March 2020. Another example: a choir practice when there were no positive cases reported in the county lead to an outbreak due to asymptomatic transmission. In Arkansas, California, Florida, Louisiana, Oklahoma, South Carolina, Tennessee, Texas, Washington, and Wisconsin, churches have risked or spread COVID-19 to members through gatherings or other church related events. As long as church closures are seen as a threat, these communities will be at higher risk for impacts from COVID-19.

I’ll be making a separate post dedicated to addressing the religious exemption issue in a culturally sensitive manner. Stay tuned for part 3.

Home Care For The Sick

One of the most wonderful things about America is that we are a country of caregivers. By acting as a caregivers we enter others’ homes or share homes with them to ensure their wellbeing. Remember that map from this other post on poverty and rural hospital closures?

When we care for the sick at home, a variety of other factors come into play that may delay or prevent access to medical intervention or reporting. Cultural norms around illness, including distrust of the medical system, preference for home care, and family caregiving will play their roles in the spread of COVID-19.

Source: https://www.cdc.gov/aging/caregiving/caregiver-brief.html

This means that children and older family members that do have symptoms may not have access to medical intervention, documentation, advice, or have sufficient care or separation from family members. While these deep-rooted beliefs come from a nurturing and caring place of love, it is important that cases at least be documented. These practices currently put families and communities at high risk of having the virus spread within them. While we do have recommendations for caregivers and home care instructions for coronavirus patients, they are not practical options, nor sufficient for the average family in America.

Home Burials

Source: https://www.romemonuments.com/home-burials – great website. Highly recommend reading more there!

In Part 2 – Home Burials and Funeral Industry

Thank you to anyone reading these commentaries and predictions. Without you I would be shouting into a void.

Poverty And Coronavirus: How Bad Could It Get?

Source: https://www.census.gov/library/visualizations/interactive/2014-2018-poverty-rate-by-county.html#

Let’s talk about poverty and how it plays a role in pandemics (specifically covid-19 and the current state of things in the US).

First, to get this out of the way ,

Poverty does not mean someone is…
dirty
diseased
uneducated
deserving of their position
being punished
has made mistakes
is suffering consequences
or any of that B.S.

Now that that’s out of the way. Let’s move on.

Source: It’s a zoomed in version of the map above, y’all. I’m from the Chesapeake Bay and you can see West Virginia, Tennessee, and Kentucky at high risk just by consideration of poverty.

Impoverished areas tend to have worse health care with low availability than areas of higher average income. And it has only gotten worse over the past 4 years. This means that in these areas everyone is of a much higher risk category when it comes to having community impact from covid-19. There are a couple factors playing into this, but let’s start with the accessibility question.

Closure of Rural Hospitals

Rural hospitals often serve impoverished areas. Because healthcare in the United States is privatized it is not secure. Based on whether or not a larger medical network parent hospital corporation thinks a hospital is profitable, a hospital can be closed down. This is not a new problem. It’s been going on for the past decade, quietly, while everyone else focused on all of the other aspects of healthcare. Except for rural communities where we banded together and started figuring out Ag worker clinics and other ways to cover vitals needs. But guess what: that can’t do crap against the coronavirus.

Since coronavirus entered the United States, West Virginia saw the closure of Fairmont Regional Medical Center at the hands of California owned Alecto Healthcare Services. Other hospitals across the United States are closing and laying off workers to reduce costs and shift resources within these greater hospital networks, like Alecto Healthcare Services. This reduces the resources available to impoverished or communities that might not make these networks as much money. Another example is Missoula, Montana where Western Montana Clinic laid employees ahead coronavirus in a similar way.

Source: https://www.bloomberg.com/news/articles/2020-01-09/hospital-bankruptcies-leave-sick-and-injured-nowhere-to-go

Bloomberg reported back in January that hospital closures were becoming a concern prior to the coronavirus hitting the United States media’s attention. The article references hospital networks taking these actions as a means of weeding out “weaker facilities”.

“Some of the more recent closings are the result of large health systems weeding out weaker facilities. That’s the case with hospitals run by Community Health Systems Inc. and its spin-off, Quorum Health Corp.

All of the areas where these hospitals once were are at much higher risk of having their remaining healthcare systems overwhelmed.

Source: https://www.bloomberg.com/news/articles/2020-01-09/hospital-bankruptcies-leave-sick-and-injured-nowhere-to-go

Under the Trump economy, hospitals have suffered immensely as measured by the Polsinelli TrBK Health Care Services Distress Index (tracks bankruptcy filings in health-care). Not only has this president set our healthcare system up to fail during his entire time in office, he is now trying to deny all responsibility. I don’t identify with a political party in the United States, but seriously.

Essential Employees

Essential employees include delivery drivers, manufacturing employees, gas station workers, grocery store check out clerks, health care workers, government workers, and all of these low-paid minimum wage jobs. Who makes minimum wage?

Source: https://policy-practice.oxfamamerica.org/work/poverty-in-the-us/us-minimum-wage-map/ Darker areas of map represents the concentration of workers being paid under $10.10/hr.

Many of the essential employees that are still going to work are the same ones making minimum wage. They are also the ones living in low income areas where healthcare is suboptimal, easily overwhelmed, and is far away. Assuming they can afford it at all.

Notice something that will make your heart break? Where did all of the hospitals close?

Update: as of 31 March 2020

Source: https://coronavirus.1point3acres.com/en (8:49 PM MST) – Where’s all of Oklahoma’s testing?

I’m not a religious person, but I ask if you read this to pray for those communities. This is where flattening the curve is both most important and least likely to happen. For further reading on how the US is doing with that check out this post here.

Happy to update this and answer questions, plus dress this up with additional research.

Thank you for reading – without you these would just be shouts into the ether.

New Short Story: The Disappearance of Lula Mae Darling

Image: Thomas Fields of Unspash https://unsplash.com/photos/CHmJOPQ77gU

Hey all! As many of you know, or if you haven’t guessed already based on my author bio, I’m from Middle of Nowhere Atlantic Coastal Region of the Southern United States. I’m married to a New Englander or ,”Yankee”. I grew up surrounded by unique stereotypes, and I love exploring the roles of stereotypes in American culture. If you like this kind of story, please let me know and I will write more like it.

Without saying anything more, I hope you enjoy my story “The Disappearance Of Lula Mae Darling” published today on Coffee House Writers!