Rural America's Hospitals are Not Prepared to Protect Older Adults From a Surge in COVID-19 Cases

Natalie M Davoodi, Margaret Healy, Elizabeth M Goldberg, Natalie M Davoodi, Margaret Healy, Elizabeth M Goldberg

Abstract

Rural communities with predominantly older adult populations could be especially vulnerable to poor outcomes from COVID-19 due to lacking intensive care unit (ICU) capacity. Our objective is to describe the scope of the problem by summarizing population totals of older adults in rural America and their community's ICU bed availability. We performed a review of peer-reviewed literature, in addition to hand searching non-peer-reviewed and governmental/non-governmental agency reports, using the Kaiser Health News data report to assess the number of ICU beds in 10 predominantly rural states with the highest older adult populations. We found that while 19% of the U.S. population lives in rural counties, these counties contain only 1% of the ICU beds in the United States. Counties particularly at risk for inadequate ICU capacity include Crittenden, Arkansas; Cass, Minnesota; and Sagadahoc, Maine. Solutions include building new delivery systems, reopening previously closed rural hospitals, and calling on local businesses to create medical supplies. In summary, the 10 million older adults in rural communities in the United States may face challenges with obtaining critical care treatment due to the increased need of ICU beds during the COVID-19 pandemic.

Keywords: COVID-19; intensive care unit availability; older adults; rural populations.

Conflict of interest statement

Declaration of Conflicting Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

© The Author(s) 2020.

Figures

Figure 1.
Figure 1.
Flow diagram of peer-reviewed article selection process. Note. ICU = intensive care unit.
Figure 2.
Figure 2.
Estimated total number of ICU beds in predominantly rural states with the largest proportion of OA citizens. Note. ICU = intensive care unit; OA = older adults.
Figure 3.
Figure 3.
Estimated number of older adults living in counties with no ICU beds. Note. ICU = intensive care unit.
Figure 4.
Figure 4.
Estimated number of counties in predominantly rural states without ICU beds. Note. ICU = intensive care unit.

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Source: PubMed

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