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UNMC chancellor discusses coronavirus, rural health concerns

Staff Writer
Syracuse Journal-Democrat

Jeffrey P. Gold, M.D., chancellor of the University of Nebraska Medical Center recently answered questions focused on concerns about coronavirus for a rural audience.

WHAT ARE SOME OF THE TOP RURAL CONCERNS REGARDING THE CORONAVIRUS?

“I would put at the top of the list accurate information sharing – ability to communicate in a timely fashion with up-to-date information to physicians, nurses, pharmacists and others regarding training, regarding precautions, regarding appropriate use of protective equipment – think masks, gowns, caps and things along that nature.”

WHAT ARE SOME OF THE TOP RURAL CONCERNS REGARDING THE CORONAVIRUS?

“Equipment and supplies -- do our critical access hospitals and small community hospitals have an adequate amount of that? I can tell you I the large cities we are struggling with that. While we do have a reasonable amount of that material on hand, it’s certainly not infinite and if this continues to grow, as it has along the coasts to rural America, those supplies are going to be particularly limited in our rural and particularly critical access hospitals.”

WHAT ARE SOME OF THE TOP RURAL CONCERNS REGARDING THE CORONAVIRUS?

“If individuals show up with the signs and symptoms of COVID-19 or coronavirus disease, what capabilities will our rural hospitals have to make that diagnosis, to provide timely testing and access and then get those specimens into the hands of a laboratory that’s got the capacity to make a determination in a timely fashion. Hospitals and health systems in rural America need to be watching very carefully.”

DO YOU SEE SURGE CAPACITY FOR RURAL HOSPITALS BEING AN ISSUE?

“I think it’s very much unknown at this time. If you look at other parts of the world, think Italy or certainly in China, and any other parts, we have seen outbreaks in those communities that in both the rural and the urban communities. You know we see a concentration of that in the large urban communities in America now and certainly other parts of the world and that’s because of the density of the population and the way the virus spreads by droplet transmission. But as people travel across the country from urban to rural communities back and forth, you know, think about people that are part of our supply chain, people who work for our railroads, people who work for trucking industries, farmers and ranchers who have to bring things back and forth to different markets. That’s when the interaction between individuals who have either been exposed actually even be ill and not know it themselves can occur and then unknowingly they would bring that back to their rural community.”

DO YOU FEEL RURAL HOSPITALS ARE PREPARED TO HANDLE THESE CASES?

“What’s going to happen in the rural communities actually is on a somewhat different scale. If one or two nurses or one or two physicians were to have to be quarantined or become ill in a large urban medical center, they could be covered for relatively easily. But if one of two critical physicians or nurses, pharmacists, etc., in a small critical access hospital were to become ill, that could be an impact of a totally different proportion. So we have to watch very carefully, stay tightly connected to what’s going on in the rural hospitals and attempt to try to prevent exceeding the capacity of what those hospitals may need to deliver.”

BROADBAND AND TELEHEALTH HAVE BEEN A BIG ISSUES FOR RURAL COMMUNITIES. CAN THESE PLAY A ROLE IN ADDRESSING CORONAVIRUS?

“We believe they can, they should and they will. Certainly the ability to deliver telehealth services which is what exactly what we want to do. So if there are individuals who have a fever of a cough or is somewhat short of breath, and they’re not sure what to do, in a rural or an urban setting, the best thing to do is make a phone call rather than get in the car and head off to your local emergency room or health professions office. But telehealth also is going to play a role in screening, it’s going to play a role in how we manage critically important supplies and equipment, and it’s also going to be a way of supporting families because people are going to have all kinds of very important questions – should I go to work, shouldn’t I go to work, etcetera, and telehealth can help do that.”