Coronavirus Is Spreading Through Rural South’s High-Risk Population – Reopening Economies Will Make It Worse
By Anne Cafer and Meagen Rosenthal
In the rural South, the COVID-19 pandemic is becoming a silent disaster.
As rural residents commute to jobs in cities and transportation hubs, they're being exposed to the virus and bringing it home to a population already at risk.
Chronic diseases that can lead to more severe COVID-19 symptoms are common across the rural South. The population is older and poorer than much of the country, and the health care system has been deteriorating for years as hospitals lose staff and close.
Despite the population's vulnerability, Southern states have been a stronghold of resistance to federal and international recommendations around COVID-19 protective measures. Most of the states' delays and refusals to enact "shelter-at-home" policies were tied to economic arguments.
Now, governors are using the same economic reasons for loosening those restrictions. Georgia Gov. Brian Kemp called for reopening several types of businesses, including hair salons, starting Friday and restaurants and even theaters starting Monday, despite concerns from public health officials. Mississippi is also considering lifting its shelter-at-home orders for economic reasons. When that happens, service workers, once partially protected from exposure, will find themselves at greater risk.
As University of Mississippi sociologists who work with rural communities on a range of resilience issues, especially health, we are concerned about the economic and health consequences of returning to business before the region is prepared to protect its residents.
Rural Commuters on the Urban Front Lines
Rural areas may seem isolated from the coronavirus threat, but in the South, one in 12 rural residents commutes to an urban hub for work. Many of those jobs are on the front lines of health care and service industries, where exposure to other people is hard to avoid.
In much of the South, "shelter-at-home" orders have had loose interpretations of "essential personnel" who are exempted from the order. They include employees in high-exposure jobs – cashiers, fast food workers and registered nurses, all among the largest employment areas for Southern states. Many of these workers are less likely to have sick leave or be able to work from home. And they are paid lower wages, so many still go to work even when they're sick.
These workers have been saved some exposure while restaurants shifted to drive-through operations and social distancing was encouraged. However, if other Southern states follow Georgia's lead and begin lifting their current protections, workers' chances of being exposed to someone infectious with the coronavirus rise.
Mississippi's rural infection numbers stand out in particular: 62% of the state's coronavirus cases as of mid-April were in rural counties, and the state had counted more than 200 deaths. Rural infection rates were higher than in urban areas: 181 cases per 100,000 people compared to 128 in urban counties. The South as a whole had more urban cases, but still a high rural infection rate.
The South Isn’t Prepared for a COVID-19 Surge
Southern states are already scrambling to manage both detection of coronavirus cases and treatment of the disease. Their testing capacity, essential to controlling the pandemic, has been increasing but remains sporadic and well below the national average. Access to care is increasingly difficult.
Mississippi has just over 400 ICU beds in its largest hospital service area, Jackson. Currently, 100 of those are occupied. Conservative estimates predict that needs for rural ICU beds will double to more than 800 in the next six months under moderate coronavirus infection projections.
Ventilators are an even bigger concern. University of Mississippi Medical Center has only about 125 to 150 ventilators in its facilities, and officials estimate 40% to half are in use on any given day.
The rural South's health profile adds to the risk. The region has higher rates of chronic medical conditions that have been found to significantly increase the likelihood that a person infected with the coronavirus will develop severe COVID-19. Among the first 159 people to die from COVID-19 in Mississippi, over half had cardiovascular disease, over 40% had diabetes or high blood pressure, and one-third were obese.
Much of the care for these patients is being delivered through a shrinking rural health care system. Of the 128 rural hospital closures across the country in the last 10 years, over half were in the South. The pandemic has created more financial troubles for rural hospitals as nonessential procedures have been postponed. Every county in Mississippi is considered underserved, meaning residents don't have enough doctors, even if they have access to a health care facility.
Testing and Investing in Health Care Long-Term
In the short term, Southern states need to increase their testing for coronavirus cases. Per capita, the South administered about 20% fewer tests. Many southern states currently rely on pop-up testing at sites temporarily opened in locations where other facilities are not available. Permanent, well-stocked testing centers would help residents know where to go.
In the long-term, these states need to invest in their rural health infrastructure.
Rural hospitals and pharmacies are essential to reducing long-term risk among rural Southerners, particularly those with chronic health conditions. They are also important "economic anchors" for their communities. According to the American Hospital Association statistics, every dollar spent by a hospital supports US$2.30 of additional business activity within the community and hospitals are a top source of private sector jobs.
Anne Cafer is an Assistant Professor of Sociology at University of Mississippi.
Meagen Rosenthal is an Assistant Professor of Pharmacy Administration at University of Mississippi.
Disclosure statement: Anne Cafer receives funding from Carnegie Foundation, Walmart Giving Foundation. Meagen Rosenthal receives funding from Walmart Giving Foundation, Eshleman Institute for Innovation: Discovery Grants Program, Mississippi Department of Health, UNC TraCS Institute (pilot grant).
Reposted with permission from The Conversation.
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Jean-Marc Neveu and Olivier Civil never expected to find themselves battling against disposable mask pollution.
When they founded their recycling start-up Plaxtil in 2017, it was textile waste they set their sights on. The project developed a process that turned fabrics into a new recyclable material they describe as "ecological plastic."
Mounting Piles of Waste<p>It is not only the streets of Chatellerault where pandemic pollution is piling-up, but also the world's beaches and oceans. Once there, they can take up to 450 years to degrade and disappear.</p><p>Esther Röling, co-organizer of the annual Adventure Clean Up Challenge held on Hong Kong Island, has seen this waste firsthand. In October the sports challenge pitted teams against one another in a competition to remove trash from 13 hard-to-reach coastal areas around the city.</p><p>They find tons of both disposable and reusable masks, said Röling. "You wonder how it ended up there. Was it just thrown on the ground? Or was it in a garbage bag that broke open?"</p><p>Almost 10,000 kilometers away in Antibes on the sunny French Riviera, it's a similar picture. For the past few months, divers and clean-up volunteers working with an ocean clean-up non-profit called Operation Mer Propre have been collecting an increasing number of masks found on land and in the sea.</p><p>"Since the beginning of the lockdown when we started to count, we've reached 800, 900, [and now in total] 1000 masks," said co-founder Joko Peltier. </p><p>According to <a href="https://unctad.org/news/growing-plastic-pollution-wake-covid-19-how-trade-policy-can-help" target="_blank">UN estimates</a>, up to 75% of all coronavirus-related plastic could end up as waste in oceans and landfills.</p>
The Limits of Recycling<p>Yet not all are convinced the recycling of this waste is possible on a global scale. </p><p>"What those citizen groups are doing is really beneficial but once they collect it, it should just go to a landfill or an incinerator. They shouldn't necessarily expect it to get recycled," said Jonathan Krones, an industrial ecologist and visiting assistant professor of environmental studies at Boston College.</p><p>That's because mask recycling programs like Plaxtil are few and far between and most don't have the benefit of a readily adaptable production process. </p><p>Even in countries with solid recycling infrastructure, he says, the system is designed to separate out specific types of waste like bottles or cardboard.</p><p>"I imagine that it would be technically feasible to develop a separation process to filter out masks, but there simply aren't enough of them to make that economical," he said.</p><p>Collection is a big hurdle, he adds. Since each mask only weighs a fraction of a gram and they're scattered on roads or mixed with other trash, it is difficult and costly. </p><p>"You need a lot of raw material of the right quality to make investing in the recycling technology and the recycling system worthwhile," he said.<span></span><br></p>
Hemp, Sugar Cane and Sustainable Alternatives<p>Some projects are instead addressing the material used to make masks.</p><p>French company Geochanvre have created a mask made primarily from hemp, while in Australia, researchers at the Queensland University of Technology are experimenting with a disposable product made from agricultural waste. </p><p>Biodegradable options are exciting alternatives to reduce the fossil fuels needed for the creation of plastic-based masks, said Krones, but they don't absolve the wearer from the responsibility of what happens afterwards. </p><p>Bio-based masks often need their own composing solutions, he explains, because in landfill they can produce high amounts of the greenhouse gas methane when anaerobic bacteria feeds on the organic material. Methane is known to be significantly more potent than carbon dioxide.</p><p>"I think as long as we have in our mind that we want to have disposability, we're going to have to wrestle with a variety of different sorts of environmental tradeoffs," he said, adding that reusable, fabric masks are the best option available to most people.</p><p>Precimask is developing a clear face covering with an optional visor made from hard plastic, designed to be long-lasting.<br></p><p>Air enters either side of the cheeks through a technology normally found in pool filters and car exhaust systems, said company spokeswoman Juliette Chambet.</p><p>"We wanted to make ceramic-based filters that would be washable and cleanable, which would allow them to be reused as many times as desired without having to buy a new consumable or produce waste," she said. </p><p>Ultimately, encouraging mask wearers to think about the entire lifecycle of a mask is key, explains Neveu. </p><p>"We want people who put on the masks to realize that they are also responsible for the waste, he said. "It's not inevitable that this [pandemic] will become an environmental catastrophe.</p><p><em>Reposted with permission from </em><em><a href="https://www.dw.com/en/covid-19-recycling-pollution-trash-pandemic/a-55707817" target="_blank">Deutsche Welle</a>.</em><a href="https://www.ecowatch.com/r/entryeditor/2649032193#/" target="_self"></a></p>
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