COVID-19 hurts rural areas, too, even if it’s not obvious

Don’t underestimate how quickly the new coronavirus moves. Start staying at home now.

Follow all of PopSci’s COVID-19 coverage here, including tips on cleaning groceries, ways to tell if your symptoms are just allergies, and a tutorial on making your own mask.

This post has been updated.

For the past month, New York City has been the epicenter of the nation’s COVID-19 pandemic. As of mid-April, the city had recorded more than 142,000 cases—exceeding any place else in the nation—and nearly 10,000 deaths. Hospitals across the boroughs and surrounding counties are overwhelmed, and the outbreak isn’t predicted to ease for at least several more weeks.

New York City isn’t the only community that’s reeling from the arrival of COVID-19. Hundreds of people have died across Washington State’s King County alone, and New Jersey, Louisiana, Georgia, and other states are now seeing similarly high numbers of fatalities. At least 42 governors have issued stay-at-home orders (though a few are looking to rescind them in coming days despite warnings from local leaders and health care officials).

Still, there are many communities around the country that haven’t seen the spread of COVID-19 just yet. So what should you do if you’re not in a hot zone for the virus?

“Stay home! Even if you think it is not in your area, take serious precautions. Go out when you absolutely have to. Try to do errands once a week instead of a little every day,” Charlotte Baker, an epidemiologist at Virginia Tech in Blacksburg, advised in an email to Popular Science. “Staying home now will help reduce how the outbreak affects your area. It really works but everyone has to do their part.”

As long as people continue to mingle in stores, restaurants, and parks (and yes, that includes protests), the number of new cases will continue to rise in all areas, Baker said. Canceling events and keeping your distance from others won’t completely eliminate transmission of COVID-19, but these steps will help prevent huge numbers of people from getting sick all at once and leaving hospitals without enough beds or ventilators for those who are critically ill.

Currently, the Centers for Disease Control and Prevention (CDC) advises against gatherings of 10 or more people anywhere in the US. This social-distancing practice is crucial because people with COVID-19 can be contagious before they realize they’re sick. It’s best to stay at least 6 feet away from people who aren’t in your household when you can. If you’re older than 60 or have other circumstances that make you more likely to get seriously ill if you catch COVID-19, you should limit your contact with other people as much as possible. The CDC is also recommending that everyone wear cloth masks when venturing outside.

Beyond that, try not to touch your face, wash your hands often and thoroughly, and regularly clean surfaces in your home with soap and water or disinfectant wipes or sprays. Have groceries and supplies delivered if you can. Make sure you have extra food and at least a month’s supply of prescription medications in case you become sick or have to self-quarantine for several weeks.

You can also look out for your neighbors by picking up groceries for people who are at higher risk for COVID-19 or by donating blood, which is in short supply because of the pandemic.

If you feel unwell, call your doctor. If the symptoms aren’t severe and you can rest and take over-the-counter medications at home, avoid the hospital, says Emily Gurley, an epidemiologist at the Johns Hopkins Bloomberg School of Public Health in Baltimore. Because diagnostic tests for COVID-19 are still limited in many areas, especially more rural ones, it’s not always easy to find out if you have COVID-19 or a different respiratory ailment. When in doubt, Gurley says, assume that you have COVID-19 and keep everybody you live with at home.

It’s also important to have a plan for what you’ll do if you do catch COVID-19. “Do you have someone who could drop off groceries for you? Do you know who would take care of you if you were sick? Is there someone you can count on?” Gurley says. “Thinking through what you would do if you were in that scenario is important as a part of preparedness.”

These steps will be easier for some people to follow than for others. Not everyone has transportation, access to buses, taxis, or delivery services, or money for extra food and medicine. For people in rural areas, grocery stores, pharmacies, and clinics might not be close by.

“We don’t need a pandemic to tell us that there are rural communities that are very underserved when it comes to medical care and access to medical care,” Gurley says. “But the pandemic will expose that even more.”

Communities that have less health care infrastructure to begin with will be particularly vulnerable to COVID-19. “This means that there will be an overall larger impact on small towns and rural areas as well as underserved populations in more densely populated areas,” Baker wrote. “We will need to make testing readily available in these communities, increase the number of clinicians, and increase the ability of these areas to access daily necessities.”

Because the coronavirus that causes COVID-19 is new, it’s unclear when the majority of the population will gain immunity to it. It will take longer to reach some areas than others, but eventually Gurley says there’s no reason to think that some communities in the US will evade outbreaks. “The United States isn’t just one place; it’s many places that are connected,” she says. This means that outbreaks will peak at different times across the country.

Hopefully, Gurley says, we will learn how better to combat COVID-19 in places that are already hotspots and apply these lessons to other parts of the country. “We’re all vulnerable to what’s happening in New York,” she says. “Our fates are linked, so it makes sense for us to act like they are.”

COVID-19 moves quickly—at one point in the March, the number of new cases in New York City was doubling every three days. But there’s a lag between when somebody becomes infected and when their case is reported: It takes awhile for people to catch the virus, develop symptoms, seek medical care, get tested for COVID-19, and finally receive a diagnosis.

“By the time people are really hearing about it in their area, it’s everywhere,” Gurley says. “It’s best to take precautions now to limit exposure and also to be ready to stay home.”

Waiting for the novel coronavirus to arrive in your neighborhood and then coping with an outbreak is stressful and frightening. So be gentle with yourself and take whatever steps you can to look after your own mental well being.

“Don’t force yourself to be more productive or beat yourself up for not accomplishing what you feel you would have ordinarily done,” Baker wrote. “Enjoy time with family, use technology to stay connected with other people, and enjoy the fresh air (6 feet away from others!) This is going to be here for a while—it is a marathon, not a sprint.”