Our country’s rural communities may be lulled into a false sense of security because of sparse populations and lower numbers of COVID-19 cases thus far when compared with other parts of the United States.

But it remains a growing threat to communities across our country, large and small, urban and rural. Pandemics are democratizing events. No one is immune. Ultimately, this virus will not discriminate against geography.

Although density of population and transmission are linked, and the virus may be slower to reach our rural cities and towns, populations in these areas are increasingly vulnerable.

Public health experts agree: It is not a matter of “if” but “when” the pandemic reaches these communities.

Indeed, this first wave is now blazing its trail globally, including with new clusters beginning to emerge and exacting a growing toll on Middle America. Smaller towns are becoming new hot spots with sharp increases in the number of cases.

It is estimated that at least 25% of people carrying the virus are without symptoms and passing it on to others widely and unsuspectingly. The situation for communities that believe they are unaffected can turn on a dime. Unfortunately, by the time residents can detect the virus it has already greatly compromised the health of the community.

This past week, two counties in rural Georgia moved overnight from being virtually virus-free to having the state’s highest per capita rates of transmission. Steep increases continue in Missouri as well, with more than 60% of counties reporting cases of COVID-19. The state currently has nearly more than 2,000 cases and dozens of deaths.

Populations in rural areas tend to be at higher risk for severity of illness from the virus because of age and underlying medical conditions. Our country’s elderly continue to be hardest hit by the disease, accounting for 80% of fatal cases in the United States. Residents in these communities also typically have poorer access to transportation and medical care. At the same time, many rural areas lack the capacity to handle those who do get sick. A number of rural critical access hospitals and health care facilities have been shuttered, and those that remain open are often cash-strapped, understaffed and underprepared.

The Spanish Flu pandemic of 1918 offers a cautionary tale. The outbreak began in rural Kansas, gathering momentum and relentlessly killing nearly 50 million people worldwide as tens of thousands of troops were deployed during World War I, spreading that virus like wildfire.

Certainly, we did not have a medical or scientific understanding of the situation back then. However, it is widely believed that the rapid spread of the virus in 1918 was primarily a result of the unwillingness to impose a strict quarantine at the expense of our country’s war effort. As was true then and is true now, physical distancing in all of our communities is paramount to bringing the virus under control by slowing the spread and saving the lives of thousands in our state and region in the coming months.

In the absence of a national shelter-in-place policy that mandates more uniform physical distancing across the country, this past week a few more states joined the ranks of those heeding the merits of widespread, systematic physical distancing. All of our states and municipalities must join this effort. We need to act now to unify efforts across the country, making the current patchwork approach more seamless and mandating lifesaving efforts of physical isolation to slow the spread of the pandemic. Sweeping, comprehensive measures would help send a powerful, clear message to urban and rural communities alike that staying home is the only way to fight the onslaught of this disease.

Keep in mind, too, that what our rural communities do now will determine their long-term well-being beyond the physical health of their populations. Middle America has long been the “breadbasket” of our country and the world. Just as important, this noble pursuit is time-sensitive, and our farmers only get one opportunity to plant and tend to next season’s crops. With the planting season upon us, this cruel virus has the ability to irreparably affect our farming communities, destroying their livelihood and devastating our nation’s food supply.

Our rural towns that don’t yet have community spread of the COVID-19 virus have a distinct opportunity to get ahead of much of the rest of the country by actually containing the virus instead of being overwhelmed by its effects.

Right now, by choosing to shelter in place and practice physical distancing, we have the power to prevent further spread of the disease rather than face the daunting job of keeping up with treating the critically ill. Doing so could be a lifeline not only for citizens in our region, but in turn for our entire country.

Dr. Marc B. Hahn is president and CEO of Kansas City University, which opened a Joplin campus in 2017.

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