Rural healthcare facing unique challenges with COVID-19

TRIBUNE, Kan. (KSNT) -- If you blink, you'll miss it. Tribune, Kansas is in the county of Greeley County -- Kansas' least populated county. The town of 742 people is only 15 minuets away from the Kansas/Colorado border, but it has a critical care access hospital and emergency room, a rarity in communities that small.

"It just kind of changed our delivery model all together, everything is kind of focused on COVID and COVID response essentially," said Trice Watts, CEO of Greeley County Health Services (GCHS). "However, we have had to do some increase in tele-med and home visits out here actually allows us to do some home visits with our doctors."

GCHS not only serves Tribune, but the surrounding area. The county north, Wallace, does not have a hospital or ER, patients either drive 27 minutes south to Tribune or 34 minutes north to Goodland.

Like healthcare around the country, coronavirus has had major impacts on rural healthcare, an area that was already struggling before the pandemic. One of those issues is staffing, especially now more than every with nurses, doctors and CNA's who might and will need to quarantine after exposures.

"We are very susceptible to staff shortages so in relation to our back up stock to fill those positions in the event that our staff is out on quarantine or exposure, we are very susceptible to crisis staffing levels in that event," Watts said.

The larger crisis is Tribune's distance to ICU's and other regional healthcare networks. Tribune is well over an hour away from the nearest ICU's, in Garden City and Hays. If both of those are at capacity then they rely on Denver, over three hours away, or Wichita, five hours. The worst case scenario is that you show up to the ER in Tribune having a stroke, heart attack or another medical emergency and they are not able to transfer you to a larger hospital.

"A routine acute patient here we are equipped to deal with that, until they need that ICU level of care we usually don't transfer anyways," Watts said. "So if the ICU is already full I think we are definitely susceptible to that risk of not only not having a place to go with our COVID patients but also stroke heart attack all of those conditions as well."

The reason hospitals like Greeley County transfers patients is because they simply do not have the resources to treat certain major medical emergencies, like heart attacks, strokes, etc. There isn't a cardiologist on staff that is able to respond to emergencies or an anesthesiologist, so the hospital relies on larger systems to take those patients. But if those larger healthcare networks are at capacity, there is no where for those patients to go.

"It's important to understand that the virus is here it is spreading and we are susceptible to over running a system if we don't take precautions," Watts said.

Greeley County does have a mask mandate. Earlier in the year, the Unified Greeley County Board of Supervisors opted out of the Governor's mask mandate, but following a rise in cases the board voted to implement one on Oct. 13.

No matter how small or large of a community, the impacts of coronavirus are being felt statewide.