Rural counties least impacted by coronavirus

AP/Houston Chronicle:

As the coronavirus rages across the United States, mainly in large urban areas, more than a third of U.S. counties have yet to report a single positive test result for COVID-19 infections, an analysis by The Associated Press shows.

Data compiled by Johns Hopkins University shows that 1,297 counties have no confirmed cases of COVID-19 out of 3,142 counties nationwide. The number of counties without a positive coronavirus case has declined rapidly, dropping from over half as the AP was preparing to publish. Of the counties without positive tests, 85% are in rural areas — from predominantly white communities in Appalachia and the Great Plains to majority Hispanic and Native American stretches of the American Southwest — that generally have less everyday contact between people that can help transmit the virus.

At the same time, counties with zero positive tests for COVID-19 have a higher median age and higher proportion of people older than 60 — the most vulnerable to severe effects of the virus — and far fewer intensive care beds should they fall sick. Median household income is lower, too, potentially limiting health care options.

The demographics of these counties hold major implications as the Trump administration develops guidelines to rate counties by risk of the virus spreading, empowering local officials to revise social distancing orders that have sent much of the U.S. economy into free fall. President Donald Trump has targeted a return to a semblance of normalcy for the economy by Easter Sunday, April 12.

Experts in infectious disease see an opportunity in slowing the spread of coronavirus in remote areas of the country that benefit from “natural” social distancing and isolation, if initial cases are detected and quarantined aggressively. That can buy rural health care networks time to provide robust care and reduce mortality.

But they also worry that sporadic testing for coronavirus could be masking outbreaks that -- left unattended -- might overwhelm rural health networks.
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Testing is not now available in many of these remote areas.  People who need testing are likely to have to go to larger urban centers for testing exposing them to potential infection.