Coronavirus Is Coming for Rural America
(Bloomberg Opinion) -- The course of the Covid-19 pandemic in rural Mower County, Minnesota, is hand-written across six easel-sized sheets of paper affixed to the wall of the local Emergency Operations Center. Six cases and no deaths were recorded on March 22, the first entry. Pam Kellogg, Mower County's community health division manager, points to the fourth sheet, covering much of May. “It was the third week when things really hit us.” On May 31, Mower reported 64 new cases, for a total of 318 out of a population of about 40,000. By mid-June, it had the second-highest case incidence in Minnesota, and by the end of the month it had nearly 1,000 infections.
Mower’s experience is increasingly common. Of the 10 U.S. counties with the highest number of recent Covid-19 cases per resident, nine are nonmetropolitan areas with populations under 50,000. There are several factors behind that surge, including the prevalence of older populations, meat-processing plants and communal living among immigrant labor forces. But what it adds up to is a quietly growing crisis. For many of these rural communities, confronting the coronavirus pandemic will require a lot more than issuing stay-at-home orders — and there won’t be much help from Washington or anywhere else.
Austin, the Mower County seat, is located 100 miles south of the Twin Cities. Like many small towns, its economy revolves around agriculture, the local hospital and the government. The biggest employer, Hormel Foods Co., maker of products like SPAM and Skippy Peanut Butter, is headquartered across the highway from a Mayo Clinic facility.
Collaborative efforts between Hormel and Mayo were common even before the pandemic. But in mid-March, when Austin reported its first cases, their partnership turned out to be essential as it became clear that government support and reliable information were in short supply. Mayo provided guidance on protective measures in Hormel’s workplace, for instance, and even found the company a batch of no-touch thermometers. With the food industry becoming a hub for rural Covid outbreaks nationwide, that help proved critical.
In fact, while the outbreak was centered on Mower’s food-production industry, workplaces themselves didn’t seem to be the cause. “A lot of times that’s not where they’re getting it from because we’re all wearing our PPE when we’re at work,” explains Kellogg, from behind a face mask, in a Mower County Government Center conference room. “It’s outside of work that people tend to get relaxed and not go through the same safety measures.”
Increasingly, data seems to back up that assessment. In the early spring, Mayo started offering drive-thru Covid testing at its facility in Austin, using kits that it developed in-house, and partnered with Hormel and another local food business, Quality Pork Processors Inc., to offer screening in their facilities. What those tests revealed, when followed up with contact tracing, was that the hubs of transmission were mostly outside the workplace — situations like carpools, for instance, where masks and other precautions aren't generally observed.
Perhaps the biggest risk, says Kellogg, is the communal housing that immigrant food laborers have flocked to in rural areas across the U.S. over the past few decades. Research suggests that crowded households — not necessarily dense cities — are often the culprit in spreading the virus. And when colleagues or family members live in tight quarters, transmission is easier, social distancing is harder and effective quarantine may be impossible.
By early June, as cases surged, Mower was under pressure from state officials “do something,” Kellogg recalls. Shutting down food-processing plants, which would devastate the region’s already hard-hit farmers, wasn’t an option. Likewise, stay-at-home orders, social distancing and mask-wearing — though critical components of any Covid-19 response — wouldn’t be sufficient to stop the spread in communal housing.
Instead, Mower would need to rely on the kind of local networks that so often hold rural communities together. County officials worked with Hormel, QPP and Mayo to quickly set up a targeted screening program for employees and their families. The state conducted a weekend-long mass-testing event that drew 2,000 locals. That was supplemented with county-funded hotel stays for sick and vulnerable people who couldn't isolate at home. To feed them, and keep them from venturing out to grocery stores, the county started delivering meals from the local jail. When cased spiked, and resources were severely stretched, officials reached out to the Salvation Army to create food boxes — with supplies donated by Hormel, among others — to deliver to families in quarantine. Meanwhile, Hormel committed to buying 300 meals a day from local restaurants and arranged for volunteer “SPAMbassadors,” connected to the local SPAM Museum, to deliver them to seniors.
Some of these efforts sound suspiciously heartwarming, as if lifted from Bedford Falls in “It’s a Wonderful Life.” But the data shows they’re having a real-world effect. Over the past week, Mower’s daily case count has dropped to single digits, and both county officials and Mayo staffers are cautiously optimistic that the worst is over.
There are lessons to be learned here. At a time when social services and rural health care are unusually stressed, and the federal response is often in chaos, community-based solutions to Covid outbreaks are going to be increasingly important. Mower is perhaps luckier than many of its counterparts, with a major corporation and a well-regarded health clinic in town. But the partnerships that guided this diverse rural community through its worst public-health crisis in a century should nonetheless offer an example for other small towns. For better or worse, they’ll need to rely on themselves.
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
Adam Minter is a Bloomberg Opinion columnist. He is the author of “Junkyard Planet: Travels in the Billion-Dollar Trash Trade” and "Secondhand: Travels in the New Global Garage Sale."
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