|Reed Anfinson with a copy of his Swift County Monitor-News (Associated Press photo by David Goldman)|
The headline in the Swift County Monitor-News was perhaps alarming, but nothing unusual in a global pandemic: “Covid-19 cases straining rural clinics, hospitals, staff,” over a story in which health officials urged residents of the western Minnesota county, pop. 9,838, to protect themselves by getting vaccinated.
"But ask around Benson, stroll its three-block business district, and some would tell a different story,"reports
Tim Sullivan of The Associated Press. The 136-year-old weekly "is not telling the truth," they say. "The vaccine is untested, they say, dangerous. And some will go further: People, they’ll tell you, are being killed by Covid-19 vaccinations."
"One little town. Three thousand people. Two starkly different realities," Sullivan writes. "It’s another measure of how, in an America increasingly split by warring visions of itself, division doesn’t just play out on cable television, or in mayhem at the U.S. Capitol. It has seeped into the American fabric, all the way to Benson’s 12th Street, where two neighbors -- each in his own well-kept, century-old home -- can live in different worlds."
Sullivan continues, "In one house is Reed Anfinson, publisher, editor, photographer and reporter for the Monitor-News. Most weeks, he writes every story on the paper’s front page. He wrote that story on clinics struggling with Covid-19. He’s not the most popular man in the county. Lots of people disagree with his politics. He deals with the occasional veiled threat. Sometimes, he grudgingly worries about his safety. While his editorials lean left, he works hard to report the news straight. But in an America of competing visions, some here say he has taken sides."
One of Anfinson's neighbors (they still watch each other's homes when one's away) Lutheran Church pastor Jason Wolter, "who reads widely and measures his words carefully. He also suspects Democrats are using the coronavirus pandemic as a political tool, doubts President Joe Biden was legitimately elected and is certain that Covid-19 vaccines kill people. He hasn’t seen the death certificates and hasn’t contacted health authorities, but he’s sure the vaccine deaths occurred: 'I just know that I’m doing their funerals.' He’s also certain that information 'will never make it into the newspaper.'"
Anfinson, 67, told Sullivan, “The easy part is speaking truth to power. The hard part is speaking truth to your community. That can cost you advertisers. That can cost you subscribers.” The paper's circulation is 2,000. He told Sullivan that he won’t consider following the example of some other rural publishers who have cut back on opinion pages or even eliminated them.
Anfinson "mourns how some people see him as an enemy," Sullivan reports. "His newspaper should bind people together, he says. Instead, America and Benson are growing angrier. Contentious midterm elections loom."
“It’s kind of sad,” he told Sullivan. “But it would be foolish of me not to be aware of (my safety) with the sentiments out there.” Asked if he carries a weapon, he said he doesn't: “But I know where one is if I need it.”
The numbers are in, and they’re not good.
|Chart from ShopMasks.com; click on it to elnarge.|
"With another coronavirus variant racing across the U.S., once again health authorities are urging people to mask up indoors. Yes, you’ve heard it all before," Maria Godoy reports for NPR. "But given how contagious Omicron is, experts say, it’s seriously time to upgrade to an N95 or similar high-filtration respirator when you’re in public indoor spaces.
“Cloth masks are not going to cut it with omicron,”Linsey Marr
, a researcher at Virginia Tech who studies how viruses transmit in the air, told NPR.
Omicron "spreads at least three times faster than Delta," Godoy notes. "One person is infecting at least three others at a time on average, based on data from other countries."Robert Wachter
, chair of the medicine at the University of California, San Francisco, told Godoy, “The kind of encounter that you could have had with prior versions of the virus that would have left you uninfected, there’s now a good chance you will get infected from it.”
Early research at the University of Hong Kong shows "Omicronmultiplies 70 times faster
inside human respiratory tract tissue than the delta variant does," NPR reports. "That study also found that Omicron reaches higher levels in respiratory tract tissue 48 hours after infection, compared with Delta."
Marr said, “That would suggest to me that maybe it reaches higher levels and then we spew out more [virus particles] if we’re infected,” Also, Omicron may be so contagious that it takes fewer viral particles to create an infection.
Also, "Virus particles from an infectious person can linger in the air indoors for minutes or even hours after they leave a room in some situations, saysDr. Abraar Karan
, an infectious disease physician at Stanford University," Godoy reports. Karan told her, “I think that people need to realize that transmission here can happen even when you’re not near somebody.”
Godoy says, "Given all this, you want a mask that means business when it comes to blocking viral particles. Unlike cloth masks, N95, KN95 andKF94
respirators are all made out of material with an electrostatic charge." That “pulls these particles in as they’re floating around and prevents you from inhaling those particles,” Karan told her. “And that really is key.”
Surgical masks also have an electrostatic charge, but they tend to fit loosely, "A snug fit — with no gaps around nose, cheeks or chin — 'really makes a big difference,' says Marr, who has studied mask efficacy," Godoy reports.
"KN95s tend to be a bit more comfortable than N95s, but counterfeits continue to be a problem. For safer shopping, check out a site likeProject N95
, a nonprofit that helps consumers find legitimate personal protective equipment. Or check the CDC’s site for advice onhow to spot a counterfeit
and a list oftrusted sources for surgical N95s
. For maximum protection, make sure your N95 fits snugly as well, creating a seal around your mouth and nose. The CDC explainswhat makes a good fit
and how to test thatyours is sealing well.
Rural Virginia couple Everett and Kristin Jiles got Covid-19 in July, but only she was vaccinated. After he had a much harder time recovering, the conservative Christian couple became crusaders for vaccination. Here, they talk about their story. (Assn. of American Medical Colleges video)
"Many people in rural and conservative areas remain frustratingly resistant to vaccination, challenging public health officials to come up with more convincing — and sensitive — approaches to promoting greater vaccine uptake," Beth Howardreports
for the Association of American Medical Colleges. "It’s not enough to refute misinformation, experts say. To reach the vaccine-hesitant, public-health officials urge a combination of approaches, from connecting with local physicians to having respectful conversations."
- Just provide the facts. Rural Americans resist mandates because they want to make their own decisions. So providing unbiased, basic information that will help them make an informed decision is the way to go.
- Leave politics at the door. The coronavirus has been deeply politicized, so it's important to avoid saying anything even remotely political in discussion vaccination. One expert told Howard that, if the subject of politics comes up, the best way to respond is something along the lines of "This virus does not care who you are or what you believe." That removes the discussion from politics and enables you to address the other person's concerns.
- Team up with community influencers. Rural Americans trust local health-care professionals much more than outsiders, so they're more likely to listen to fact-based vaccine recommendations from a community doctor, nurse, pharmacist or community health worker.
- Don't refute false claims about the vaccines. By bringing up misinformation, even if you do so to disprove it, you end up reinforcing the belief in the person's mind. So don't repeat falsehoods when providing vaccine information. "For instance, if someone says that vaccines give you Covid-19, you don’t have to say they don’t give you Covid-19," Howard reports. "Instead, provide an answer that addresses the vaccine’s overall safety — why and how they’re safe."
- Treat people with care and respect. Regardless of what someone believes, take their concerns seriously and treat them with respect. Don't talk down to people or make them feel judged or shamed.
- Be prepared to play the long game. It will likely take more than one conversation to change someone's mind about vaccination. When you're wrapping up a discussion about vaccination, "give them a call to action, such as offering additional resources to learn about the efficacy of the vaccine and inviting them to come back and talk about it more so that you can answer any other questions," Howard reports.
On Monday, Dec. 6, The Rural Blog excerpted an NPR story headlined, "A county's vote for Trump is predictive of its Covid-19 vaccination rate, and more generally of its death rate
." It was accompanied by two plotter charts on which the vaccination and death rate of each county were on the vertical axis and its percentage of vote for Trump on the horizontal axis. We used one county as an example, to show how local news media could give their audiences a sense of their place in the phenomenon.
|Screenshot of interactive plotter graphs shows how a higher vote for Donald Trump in 2020 correlates with a lower Covid-19 vaccination rate (left) and a higher Covid-19 death rate. In this example, Jackson County, Kentucky, which went 89% for Trump, follows trendlines created by the averages. For a larger image, click on it; for the interactive database, click here.|
"Since May 2021, people living in counties that voted heavily for Donald Trump during the last presidential election have been nearly three times as likely to die from Covid-19 as those who live in areas that went for now-President Biden," Daniel Wood and Geoff Brumfiel report for NPR.
"The trend was robust, even when controlling for age, which is the primary demographic risk," NPR reports. "The data also reveal a major contributing factor to the death-rate difference: The higher the vote share for Trump, the lower the vaccination rate. The analysis only looked at the geographic location of Covid-19 deaths. The exact political views of each person taken by the disease remains unknowable. But the strength of the association, combined with polling information about vaccination, strongly suggests that Republicans are being disproportionately affected."
"It was not always this way," NPR reports. "Earlier in the pandemic, many different groups expressed hesitancy toward getting vaccinated. African Americans, younger Americans and rural Americans all had significant portions of their demographic that resisted vaccination. But over time, the vaccination rates in those demographics have risen, while the rate of Republican vaccination . . . has flatlined at just 59%, according to the latest numbers from Kaiser . . . 91% of Democrats are vaccinated."
|New coronavirus infections, in ranges by county, Oct. 17-23|
Map by The Daily Yonder; click the image to enlarge it or click here for the interactive version.
New coronavirus infections in rural counties continued declining during the week of Oct. 17-23, but Covid-19 deaths rose nearly 20 percent. The rural new-infection rate was still 78% higher than the metro rate, and the weekly death rate was 120% higher. "Rural counties reported nearly 30% of the Covid-related deaths in the United States, even though they constitute only 14% of the U.S. population," Tim Murphy and Tim Maremareport
for The Daily Yonder.
Rural counties saw 2,980 new Covid-19-related deaths, compared to metro counties' 8,302, Murphy and Marema report. The five states with the highest numbers of rural new infection were, in descending order, Ohio, Michigan, Wisconsin, Pennsylvania, and Kentucky. The five states with the highest rural new infection rates were, in descending order, Alaska, Wyoming, Montana, North Dakota, and Idaho.
Click here for more charts, regional analysis, and county-level interactive maps from the Yonder.
Here's a roundup of recent news stories about the pandemic and vaccination efforts:
Thousands of workers are opting to get fired rather than get vaccinated.Read more here
|A nurse in a Louisiana Covid ward (AP photo by Gary Hebert)|
Requiring all health-care workers to be vaccinated against the coronavirus could worsen chronic staffing shortages at rural hospitals, because rural areas have low vaccination rates and many health-care workers have yet to be vaccinated.
Brock Slabach, chief operations officer for the National Rural Health Association, told Wright, “I've talked with administrators of hospitals that have estimated anywhere from 3 percent to as much as 20 percent of their workforce may have to quit their jobs if they're required to have the vaccine as a condition of their employment. In a rural hospital, that could be two, maybe three nurses, which could cripple their ability to meet the demands of patient care.”
The Centers for Medicare and Medicaid Services hasn’t said when workers will have to meet the requirement, and there are other reasons for uncertainty. "At least 22 states plus the District of Columbia announced that state health care workers—or, in some cases, all health care workers—would need to be vaccinated or regularly tested,according to
the nonprofit National Academy for State Health Policy," Wright notes. "But six states—Arkansas, Georgia, Indiana, Montana, Tennessee and Texas—have approved laws or have executive orders from their governors prohibiting vaccine mandates as a condition for employment. Hospital leaders say the conflicting guidance makes it difficult to know how they should proceed, though experts assert that federal lawwill supersede
any conflicting state law or executive order."
The uncertainty adds to the stress of the pandemic, now in its 20th month. Some hospitals have "cut back, delayed or eliminated services such as elective surgeries, labor and delivery, and other inpatient care," Wright notes. "Nurses and other health care employees have worked double shifts, and many rural hospitals have had to create makeshift intensive-care units."
Public-health agencies, especially in rural areas, have been chronically underfunded for years. A new data analysis reveals just how underfunded and understaffed such agencies are: State and local health departments nationwide need to add 80,000 full-time employees to reach adequate staffing levels, according to the analysis conducted by the nonprofit de Beaumont Foundation and the Public Health National Center for Innovations. That would be an increase of nearly 80 percent.
"Adding those employees would allow health departments nationwide to better deliver services like immunizations and preventive health measures—but not to prepare for or respond to emergencies, including outbreaks and pandemics," Kate Queramreports
for Route Fifty. "The analysis does not recommend hiring specific types of employees, nor does it estimate the cost of adding 80,000 positions—a scope that’s narrow by design, said Brian Castrucci, president and CEO of the de Beaumont Foundation, which advocates for public health. It’s meant simply to provide a snapshot of staffing levels at state and local health departments, similar to thehealth professional shortage areas
identified by the federal Health Resources and Services Administration."
|Pastor Lewis (Photo by Jessica Tezak for Kaiser Health News)|
In rural Eastern Kentucky, keeping hospitals from being overwhelmed by Covid-19, the flu and other illnesses this winter may depend on rural churches helping vaccination campaigns, Sarah Varneyreports
for Kaiser Health News.
Varney writes mainly from "Leslie County, in the foothills of the rugged Pine Mountain ridge that anchors the state's eastern coalfield," where "public health workers are trying to outsmart the fantastical tales spread on Facebook about the Covid-19 vaccines, while also helping residents overcome the everyday hurdles of financial hardship and isolation."
The region matches what national polls show tend to be the most adamant anti-vaccine part of the U.S. population, citing "tends to be disproportionately white, rural, evangelical Christian and politically conservative," The New York Timesreports
"Local health agencies have been eager to enroll churches in the all-hands-on-deck vaccination effort," Varney reports. "Some church leaders have refrained from encouraging vaccination, afraid of offending congregants in a state where mistrust of government intrusion runs deep." But not Billy Joe Lewis, pastor of the Full Gospel Church of Jesus Christ on Cutshin Creek, which drains much of the county.
"We've still got to use common sense," Lewis told Varney. "Anything that can ward off suffering and death, I think, is a wonderful thing."
He has seen both. "In recent weeks, Lewis held a funeral service for a 53-year-old unvaccinated former coal miner, suspended Sunday services after more members fell ill and, with a heavy heart, canceled Homecoming — a cherished yearly gathering of area churches that marks the fall foliage with a celebration of the gospel and shared faith," Varney writes.
Another big obstacle to vaccination is "the specter of coercion" in a region "where government directives have been met with derision," Varney reports, quoting Louisa nursing-home owner David McKenzie: "We do not like to be shoved. We resent it, and we shove back."
"They're fearful of 'The Man'," McKenzie told Varney. "The Man could be your employer, it could be the government, it could be a newspaper reporter." And there's another kind of fear, Varney reports, paraphrasing and quoting McKenzie: "People who boasted about refusing the vaccines cannot change their minds, or 'They'll look like they're weak, or they caved to The Man'."
|Stateline chart, based on Centers for Disease Control and Prevention data|
Some states with large rural populations got off to a fast start getting their residents vaccinated, but recently "have hit a wall," reports Stateline, a service of the Pew Charitable Trusts.
"Those less populous states outhustled bigger ones using innovative distribution schemes such as flying vaccines on small airplanes to remote areas, tapping into existing rural health systems and eschewing the county-by-county model that slowed larger states’ distribution," Elaine Povichwrites
., noting Alaska and West Virginia. "The plummet is a combination of the unsustainability of early distribution methods and less demand for vaccines among the remaining, largely rural population, experts say."
Jennifer Tolbert, state health reform director for the Kaiser Family Foundation, told Povich, “More recently, what you are coming up against are ideological issues in more conservative states. Vaccines are available, but absent mandates and requirements for people to get vaccinated, if there is hesitation or reluctance in large sectors of the population, the vaccines are going to plateau.”
William Galston, a senior governance-studies fellow at the Brookings Institution, a nonpartisan think tank, "noted that white people without a college degree, who generally make up more of the vaccine-resistant U.S. population, are a higher share of the rural population." He told Povich, “I won’t say demography is destiny, but when you are looking at vaccines, it’s way up there.”
|University of Iowa College of Public Health graph, adapted by The Rural Blog|
Rural deaths from Covid-19 have spiked to the point that the latest rural death rate is twice that of the overall rate in metropolitan areas,according to a report
from the Rural Policy Research Institute.
Fred Ullrich and Keith Mueller of the College of Public Health at the University of Iowa tracked Covid-19 mortality rates from the beginning of the pandemic and found that counties outside metro areas began showing higher rates in June, with a wider separation beginning in August.
Over the course of the pandemic, the non-metro mortality rate, 231 deaths per 100,000 residents, has been only moderately higher than the metro rate, 195 per 100,000, Ullrich and Miller report.
The researchers also tracked the rates in micropolitan areas, which are outside metros but have cities with populations between 10,000 and 50,000. Their death rates were usually about the same as those in rural areas until last month, when the rural rate clearly exceeded it.
Ullrich and Mueller's report also tracks the rate of new cases since the start of the pandemic. It shows that on Sept. 15, the seven-day average of new cases in metro areas was 43.3 per 100,000 residents, and in non-metro areas (rural and micropolitan) it was 66.8 per 100,000.
The overall non-metro vaccination rate is 41.4 percent, while the metro rate is 53.3%.
By Al Cross
Director, Institute for Rural Journalism and Community Issues, University of Kentucky
Millions of Americans say they have decided not to get vaccinated to protect themselves, their families and their neighbors from the coronavirus, but polling and anecdotal evidence show that some will change their minds. News media have a role to play in that, especially in rural America, where vaccination rates are lower than the rest of the nation, sometimes dangerously lower.
Few vaccine-hesitant or -resistant people are likely to be persuaded by a news story or editorial urging vaccination, but it's important to keep delivering facts about the vaccines, because social media are awash with misinformation about them. And there's another way to promote the shots: lead by example.
That's what Alan Gibson, editor and publisher of the Clinton County News in Albany, Kentucky, did this week. On the back page of the newspaper is a "house ad" telling readers that the paper's entire staff of five is vaccinated and urging readers to do likewise.
Gibson told me he got the idea from the Kentucky Chamber of Commerce's "Covid Stops Here
" campaign, which provides signs that businesses can download and print to display their level of vaccination, and lets them post their logos to do likewise.
Gibson knew his staff was fully vaccinated. "I thought, we should promote this," he said. Why? "We're one of the hardest-hit counties in the nation but we're one of the slowest to get vaccinated." And he thought it would be better to persuade by example than to lecture: "Do as I do, you know? I'm tired of arguing with people, because the arguments aren’t valid." He said it's worth the effort "if just one or two people look at it and say, 'I need to go ahead and do this.'"
|Clinton County (Wikipedia map)|
The White House will tell federal agencies today to begin preparing to shut down, as prospects for an agreement in Congress to keep funding the government remain cloudy, The Washington Postreports
. A shutdown would have an impact on rural America, from Agriculture Department programs to national parks and most other federal functions, including response to the pandemic.
"Administration officials stress the request is in line with traditional procedures seven days ahead of a shutdown and not a commentary on the likelihood of a congressional deal," the Post reports. "Democrats and Republicans have made clear they intend to fund the government before its funding expires on Sept. 30, but time is running out and lawmakers are aiming to resolve an enormous set of tasks to in a matter of weeks."
Bill Hoagland, a senior vice president at the Bipartisan Policy Center and former Republican staff director for the Senate Budget Committee, warned that parts of the Centers for Disease Control and Prevention and the National Institutes of Health would close in a shutdown, the Post reports: "Hoagland said a very brief shutdown may occur but said he doubted it would go on for 'any length of time'." But he also said, “This would be the first shutdown during a declaration of national emergency. In the midst of an ongoing pandemic and non-resolved issues related to the delta virus, to have a shutdown of some of the major federal agencies would add unbelievable complications to our ability to recover.”
Rural residents who watched television news from stations in the top 25 TV markets last year were more likely to follow precautions against catching the coronavirus,a study
|Unvaccinated respondents were polled between June 9 and July 6, 2021. Covid States Project chart; click the image to enlarge it.|
A new report from The Covid States Project examines reasons why people do or don't get coronavirus vaccinations, with a heavy emphasis on why unvaccinated people remain so.
- 67% of respondents said they had already had at least one vaccine dose, 15% said they were willing to get vaccinated, and 18% said they weren't willing to get vaccinated.
- Lack of trust in institutions that oversee and vouch for vaccines' safety underlies many concerns about coronavirus vaccines.
- Trust in institutions is strongly associated with vaccination at the individual and state levels.
- Overall, 45% said in June that they trust the news media to do the right thing to best handle the current coronavirus outbreak. Only social-media companies, at 33%, scored lower. Hospitals and doctors were the most-trusted segment, at 92%. The pollsters did not ask respondents to specify what they meant by "news media" or to differentiate among different news sources.
- 13% of vaccinated respondents said they trusted the news media "a lot" and 38% said "some".
- 6% of unvaccinated respondents said they trusted the news media "a lot" and 24% said "some".
- From April to June, trust levels for all institutions and people declined modestly.
"President Biden announced sweeping new coronavirus vaccine mandates Thursday designed to affect tens of millions of Americans, ordering all businesses with more than 100 employees to require their workers to be immunized or face weekly testing," The Washington Postreports
. "Biden also said that he would require most health-care facilities that accept Medicare or Medicaid funding to vaccinate their employees, which the White House believes will cover 50,000 locations." That includes outpatient facilities like dialysis clinics and home health agencies.
The announcement drew immediate criticism from many, including some Republican governors, The Associated Press reports. Wyoming Gov. Mark Gordon has asked his attorney general to fight the mandate when it is put into effect, and Missouri Gov. Mike Parson is considering a special legislative session to challenge the mandate. Biden called such governors "cavalier" with the health of children and of their communities for resisting the mandates.
|Pew Research Center chart; click on it to enlarge.|
Social media is a notorious source of misinformation about the pandemic and vaccines. That adds significance to a new Pew Research Center survey showing that nearly 40 percent of Americans say social media is an important source for coronavirus vaccine news. Pew conducted the survey from July 26 to Aug. 8. Here's some of what they found:
- Women and younger Americans are more likely than men and older Americans to say they get coronavirus vaccine news and information on social media; younger Americans and women are more likely to be on social media in the first place.
- About half of the respondents said they get news and information about vaccines from social media: 30% said they get "some" and 18% said they get "a lot."
- The other 51% say they've gotten little or no vaccine news or information from social media.
- Though half the respondents get at least some vaccine news from social media, only a few (6%) believe it's the best way.
- Another 33% said it's an important way, 29% said it's not an important way, and 31% said they don't get any vaccine news on social media.
- Respondents who say social media is an important source of vaccine information are more likely to regularly rely on social media for news in general.
- Only 4% of respondents said they regularly get general news from Snapchat, and 11% said the same about Instagram. But 85% of people who regularly get news from those platforms say they get a lot or some information about the vaccine there too.
- 31% of respondents said they regularly get general news from Facebook, and 82% of that group say they're getting vaccine news there too.
|Cartoon by Nick Anderson|
But the science is inconclusive at best, and leading scientific bodies have said so. The studies ivermectin fans often cite are either far too limited in scale to draw conclusions (which the studies' authors acknowledged), or say ivermectin only shows a therapeutic effect at toxic doses, or are ethically suspect. One study was yanked from a peer-reviewed journal almost immediately because the paper contained unsubstantiated claims and promoted the authors' own ivermectin treatment.
In some cases, courts have forced hospitals to allow Covid-19 patients receive ivermectin. Why not just let them take it? It's not necessarily safe, for one thing: Some people are experiencing violent diarrhea and other side effects from taking it, especially those using the over-the-counter version meant for animals. And putting one's faith in ivermectin may dissuade people from seeking other experimental but approved treatments for Covid-19, such as monoclonal antibodies.
UPDATE: Greg Sargent of The Washington Post explains "How right-wing media and social isolation lead people to eat horse paste," which tastes awful.
|House (Berea College photo)|
"I was taught to sacrifice my own comfort for the good of others, whether it be by volunteering my seat to elders in a crowded waiting room, letting a pregnant woman go in front of me in the grocery line, or giving half of my sandwich to a hungry classmate," House writes. "Sacrificing for the common good was something most of us were taught when I was growing up. Just a few decades later, I’m seeing people in my hometown, and all over the country, thinking only of themselves. They’re not just unwilling to make sacrifices for others during a pandemic; they’re angry about being asked to."
Why are people in your state hesitant about, or resistant to, getting vaccinated for the coronavirus? A