Preventing a ‘twindemic’ in rural America

As COVID-19 continues to threaten the lives of Americans across the country, and indeed people across the world, we are reminded that we will soon be navigating yet another uncertain fall and winter season. Only this year, we could be facing what many experts are referring to as a “twindemic” as reduced COVID-19 restrictions and a prolonged lack of exposure to the flu could perpetuate a more active flu and pneumonia season. This one-two punch to our immune systems could prove disastrous for all Americans but especially for those living in rural communities.

Rural Americans have been some of the hardest hit by the pandemic. According to the USDA’s Economic Research Service, rural Americans are more vulnerable to severe illness or death from COVID-19 than urban residents due to factors such as underlying health problems, older age and lack of health insurance. These factors are only worsened because nearly a quarter of rural residents live in counties with high mortality due to underlying medical conditions, almost eight times greater than the rate for urban residents. Additionally, many rural residents live in counties where they are vulnerable because of distance to an intensive care hospital — 35 times greater than the percentage for urban residents.

With 93 percent of high-distance counties being rural, living far from intensive care hospitals means those Americans will face an even greater challenge in accessing care when they need it. Adding to this geographic challenge is the fact that since 2005, 181 rural hospitals have closed permanently across the United States.

As more Americans embraced virtual physician/patient visits over the past year and a half, this too has proven difficult for many living in rural communities given the lack of high-speed internet. More than 14 million Americans across the country, including nearly one in five rural Americans, continue to lack access to high-speed broadband. This not only prohibits virtual visits but also makes it harder to make appointments for COVID-19 vaccinations and testing.

These are tough hurdles to overcome in normal times, but layer on a pandemic and potentially more deadly flu and pneumonia season, and we could be facing the worst health care crisis rural America has seen in years.

Preventing serious illness is possible, but we must take steps now to break through the barriers that so many Americans face and ensure broad access to care and treatment for the most vulnerable. This will require our elected officials and health care experts to explore new ways to bring the care outside of the clinic and to the rural residents who cannot travel, enlisting trusted members of the community to talk about the facts behind vaccines and establishing sustainable processes for distributing vaccines to the more remote areas of our country. We as citizens can also encourage our friends and neighbors to continue to follow the Centers of Disease Control and Prevention’s (CDC) guidelines for reducing COVID-19 exposure and keeping up with routine check-ups and vaccinations.

While certainly more challenging for those living in rural areas, this one step of ensuring vaccinations are current, could mean life and death for so many vulnerable Americans. During a normal year, 1.3 million people will visit emergency departments in the U.S. each year with pneumonia and nearly 50,000 people will die from pneumonia. While these diseases do not discriminate who they infect, the facts are that older Americans are at a greater risk of death from both COVID-19 and pneumonia and therefore must do everything they can to protect themselves.

Fortunately, the Food and Drug Administration (FDA) recently approved two new vaccines for pneumonia which cover more variants of the virus than the currently available vaccines. This means that those vaccinated with these new options will have broader protection against contracting pneumonia. The CDC’s Advisory Committee on Immunization Practices (ACIP) is set to provide recommendations for the use of these vaccines at their planned meeting in October.

We implore the CDC to expedite this process and ensure vulnerable Americans across the country age 50 and over will have access to the most effective vaccines before the flu and pneumonia season is underway. Just as we are laser-focused on increasing COVID-19 vaccination rates, we must remain diligent in ensuring we are using every tool available to protect against the repercussions of a “twindemic”. Together, we can overcome these healthcare threats if we all have access to the most effective tools to protect ourselves.

Betsy Huber is president of the National Grange, America’s oldest agricultural, rural life and small-town citizen advocacy organization.