From The St. Louis Post-Dispatch

MORE AND more coronavirus victims from rural Missouri are being transported to St. Louis or Kansas City hospitals, further straining already overwhelmed urban health care systems.

Kaiser Health News reports that in one Kansas City health network, fully a quarter of its coronavirus patients are from outside the metro area, with two-thirds of those patients in need of intensive care. Some overwhelmed St. Louis hospitals have had to refuse transfers of rural patients.

Yet much of the populace in rural areas continues to act as if there’s no threat in the air. That is, until an ambulance ride into the city becomes necessary.

This situation is unsustainable.

It should qualify as common sense that coronavirus spikes around America are most pronounced where political leaders have resisted mask mandates and other precautions. A Sunday New York Times analysis confirmed a clear correlation between the strength of states’ pandemic policies and their infection rates. “The worst outbreaks in the country now are in places where policymakers did the least to prevent transmission,” the analysis noted. It was based on voluminous, detailed data gathered by the University of Oxford. “States with stronger policy responses over the long run are seeing comparatively smaller outbreaks.”

It’s a tragic oddity of American culture today that the strength of those policy responses so often differs with political ideology. States and cities controlled by Democrats have been quicker this year to implement mask orders and other directives. Republican-run jurisdictions have been slower to embrace such policies, based on some combination of general conservative philosophy against government mandates, along with President Donald Trump’s corrosive undermining of trust in science.

Kaiser Health News found that the spikes in small-population rural areas of Missouri and Kansas — where pandemic health mandates are rare, and where the few rules in place are routinely ignored — has been exacerbated by the fact that rural residents tend to be older than the norm, with higher rates of heart disease, obesity and other underlying health problems.

Add the fact that three out of four rural counties in those two states have no intensive-care units, and it creates a deluge of rural victims crowding into urban hospitals. “We’ve had this huge swing that’s occurred because they’re not wearing masks” in rural areas, said Kansas City’s frustrated health director, Dr. Rex Archer, “and yes, that’s putting pressure on our hospitals, which is unfair to our residents that might be denied an ICU bed.”

Missouri Gov. Mike Parson still stubbornly rejects calls by medical professionals to issue a statewide mask order. But no policy will work if our rural neighbors continue to act as if the pandemic is some urban issue that doesn’t concern them. The virus doesn’t respect municipal boundaries — and these days, it’s spending time out in the country.

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