Thread by @ProfYolonda

A brief thread about how the #COVIDー19 crisis in my small hometown of Albany, GA (Dougherty County) exposes some of the challenges unique to healthcare in rural places, but also serves as a harbinger of things to come in larger places. 1/14

Albany is a hot spot. Two and a half weeks ago there were zero cases. Now Albany has the largest number of cases per capita in the state of Georgia. Eleven people are dead. The ICU is FULL (more on that later). Let that sink in. 2.5 weeks from zero to devastation. 2/14

Here is a helpful interactive map of COVID-19 cases in Georgia. You see the dark mass of counties comprising the Atlanta metro area. Then you see one lone dark county in south GA. That's Albany. Someone came into town for a funeral. Now here we are.
albanyherald.com/local/georgia-… 3/14

Dougherty County has been doing daily briefings at noon. Here is yesterday's:
facebook.com/dougherty.ga.u… 4/14

One challenge has been to stop people from having church. Some of you are snickering at "those-dumb-hicks- down-south-who-worship-sky-daddy-and-therefore-deserve-whatever-they-get" Fuck you. I'm not talking to you. Feel free to exist this thread now. 5/14

But for those of us who think seriously about #publichealth and #bioethics, it is often difficult to balance respect for the cultural practices that form the fabric of who people are with impressing upon them the reality that those cultural practices are killing them. 6/14

(I had this fight with my own mother a couple of weeks ago. She insisted that they had hand sanitizer at church & that they wouldn't hug. Then told me that she was going to "socially distance" herself from me & not take my calls. Did she go to church that Sunday? Yes. Sigh.) 7/14

In addition to the deep commitment to church attendance, rural communities imagine themselves to be insular (and therefore at lower risk) in ways that big cities are not. While this is, in *some* sense true, it's also what makes the virus so deadly. 8/14

Exposure at one funeral home allowed this virus to spread like wildfire through my hometown of 70,000. Also, the surrounding communities are getting hit because people go to Albany to go to the grocery store and run other errands. 9/14

According to yesterday's briefing, the ICU is officially full. Another unit has been turned into a makeshift ICU for coronavirus pts. The anesthesia recovery unit (where you go after surgery to wake up) is now the ICU for pts who do not have coronavirus. That's only 10 beds 10/14

As the world is rightfully focused on coronavirus, it is important to remember that people will still have heart attacks, strokes, and other health issues that will require intensive care. In Albany, there will soon be nowhere to put those people. 11/14

There will be nowhere for people in the small surrounding towns to go when their numbers begin to surge (and they likely will). Albany already has patients in hotels. The National Guard is on the way. 12/14

The public health official from yesterday's briefing was literally begging people not to take up motorcycle racing and tree climbing while home quarantined. Why? Because there are no spare personnel to deal with your broken leg. 13/14

This is certainly a crisis in rural healthcare, as rural hospitals have fewer resources to begin with. However, I think we're soon going to see the desperation that we're already seeing in places like Albany in the cities. 14/14