An Uncertain Future for Rural Health Care

Even before the pandemic, hospitals in rural areas already faced a mounting crisis.

In Georgia, seven rural hospitals have ceased providing inpatient care or closed outright within the last 10 years, according to the Cecil G. Sheps Center for Health Services Research. A major factor in their closures may have been the state’s refusal to expand Medicaid, as hospitals frequently are required to absorb costs from providing care to uninsured patients. The list of defunct hospitals includes Calhoun Memorial Hospital, Charlton Memorial Hospital, Chestatee Regional Hospital, Hart County Hospital, Lower Oconee Community Hospital, North Georgia Medical Center, and Stewart-Webster Hospital.

As COVID-19 spreads through rural Georgia, hospitals that have been under financial strain suddenly are faced with an influx of patients requiring very intensive care. Meanwhile, a dearth of rural hospitals has forced some COVID patients to travel to the nearest city in order to get medical help.

The Phoebe Putney Health System in Albany, Georgia, runs the only major hospitals in Dougherty and surrounding counties. While this has put strain on the hospital system, it has had the advantage of support through equipment donations from the state and other sources.

Albany Mayor Bo Dorough spoke with Georgia Voice about the effect of the pandemic on the Phoebe Putney Health System. He said the support the local hospital system received because it was on the front line of the pandemic made all the difference in acquiring the resources needed for COVID-19 care.

“Having been hammered so early on, we were able to access ventilators. [Phoebe Putney Memorial] Hospital was in a position where there was concern that if the admittance of patients in respiratory distress continued at the same rate they would be without sufficient ventilators. But then the state, on or by March 22, delivered 20 ventilators. That was like the cavalry coming in,” the mayor said.

On May 1, when Georgia Voice last interviewed Mayor Dorough, Phoebe Putney had at least 200 ventilators, of which just less than 50 were currently in use. The hospital system had weathered the worst of the surge and most of the COVID patients had been discharged. Nonetheless, there are some concerns that have persisted.

Despite the large number of ventilators compared to the number of patients who need them, it seems not all ventilator-type devices are identical. According to Dorough, “[Phoebe Putney] has explained that there are five different types of ventilator and some have apparently not enough capacity for people who are in extreme respiratory distress, though I do not profess to know the specifics of that.”

While the Phoebe Putney Health System appears to have weathered the storm, it is difficult to tell how other rural hospitals will fare. COVID-19 cases in rural Georgia have so far been centered in and around Albany, but as time has passed, the concentration of cases seems to be spreading in a wave away from the South Georgia city. Mayor Dorough worries that the reopening of the state will result in a new surge of cases in less prepared areas. If that were to happen, there may not be enough resources to keep rural hospitals afloat, both in terms of lifesaving supplies, and financially.

According to the Georgia Department of Public Health, the number of new COVID-19 cases in Georgia is declining; however, because of the time it takes to get test results, new COVID cases over the past two weeks have been underreported. The state’s trend toward recovery could be an illusion caused by faulty data.

Even if the number of cases in Georgia is declining, the relaxation of social distancing could quickly result in a resurgence of the pandemic. However, we will not know if that happens until roughly three weeks afterward. Not only does it take two weeks to get in all the test results for a given day, the tests cannot detect the virus in a person who has been recently infected. Social distancing is still the safest bet.

For this article, Georgia Voice contacted South Georgia Pride to find out more about the effect of the pandemic on the rural LGBTQ community. As of the time of writing, an interview could not be conducted. South Georgia Pride has, however, put out this statement on its website:

“Due to the rapidly developing situation with COVID-19, our home page will be dedicated to providing information and resources for the communities we serve. Please submit any information or resources to contact@southgapride.com.”