Reaching rural residents

Hospitals struggle with COVID-19 increases while many still refuse vaccines

click to enlarge Reaching rural residents
Credit: Rachel Otwell
A billboard in Petersburg features Rich Brauer, a former Republican state legislator who represented the area.

"We have individuals who get COVID and then ask if they can have a vaccine," Dr. Rajesh Govindaiah told Illinois Times. He's senior vice president and chief medical officer for Memorial Health System. "The vaccine does not treat COVID. The vaccine prevents you from getting COVID in the first place. And if you get COVID, it makes you have a milder illness." For those already infected with COVID-19, the vaccine is useless, because it takes time to build up immunity.

"My daughter's going to in-person school. I want her to go to in-person school for the rest of the school year," said Govindaiah. "In order for that to happen, we're going to have to double down on masking and vaccination."

Both Govindaiah and Dr. Marc Shelton, Hospital Sisters Health System chief clinical officer, said area hospitals have seen a sharp uptick in COVID-19 patients over the summer. They both anticipate that the situation will get worse before it gets better. Not enough people are vaccinated and the newer delta variant is more contagious than previous strains of the virus.

"We have had a dramatic increase in the number of hospital admissions in our 15 hospitals throughout Illinois and Wisconsin," said Shelton. "We were down to eight total inpatients in our 15 hospitals as of five, six weeks ago." That number had risen to 135, Shelton said during an Aug. 20 Illinois Times interview. He added that vaccine hesitancy is more prevalent in rural areas. Hospitals are having to limit visitors – in some areas to no visitors at all – as a result of the uptick in COVID-19 cases.

Govindaiah said part of the lag in rural vaccination rates could be a lack of accessibility. Some rural residents may struggle to find transportation to vaccine appointments, for instance. "It's complicated, but it's very concerning."

Distrust

Petersburg has multiple billboards promoting vaccination. Leaders say there is plenty of money to get the word out and vaccines have been widely available. Still, not enough people are getting the shots.

On Aug. 18, health officials came together in Petersburg to plead with residents to get vaccinated. According to state data from Aug. 23, 45.87% of Menard County's total population was fully vaccinated. In nearby Sangamon County, 52.3% of the the total population was fully vaccinated. Statewide, the percentage of fully vaccinated residents was 60.6%.

Dr. Joe Bilyeu works for Memorial in Petersburg as a family physician. He said at his clinic, "We're seeing a big spike in COVID. I like to call it the pandemic of the unimmunized, because that's who's coming in positive." In a typical flu season, he said he usually would see 400-500 patients infected with influenza. But last year? He can remember only one flu case coming to his office. "Masks work," he said.

Distrust could be a reason some are hesitant. Both masks and vaccines have become sources of vitriolic rhetoric. Analysis of Fox News – a source generally affiliated with conservative thinkers – shows why some may question the vaccines. Media Matters for America analysis, published Aug. 19, shows, "In a six-week period from June 28 through Aug. 8, Media Matters found that nearly 60% of the network's vaccine segments included claims undermining or downplaying vaccinations."

State Rep. Tim Butler, R-Springfield, was at the Petersburg press conference and addressed the distrust along party lines. "This is controversial and it's become unfortunately politicized," he said. "People should be vaccinated. I think those of us in public positions should be encouraging people to do that." Butler said he'd prefer certain decisions, like mask rules, be left up to local officials rather than the governor. Still, he said, "Vaccinations work, masks work."

Bilyeu said misinformation and fear might play into why some are hesitant about vaccines. For those who forgo vaccination, he said COVID-19 infection is a matter of when, not if. Bilyeu said some might be put off by the Food and Drug Administration emergency authorization of vaccines, and approval might help reassure them. On Aug. 23, the FDA announced its approval of the Pfizer COVID-19 vaccine. Many hope that for some of the vaccine hesitant, the development will help convince them.

Be kind

Vaccinations don't just protect the individuals who get them, they protect others in their community. Many kids who have headed back to school are too young for vaccines. While infected kids generally have mild symptoms, some do end up with severe cases. The more cases in the community, the more likely more kids will suffer. Getting the shot is partially about protecting other people, said Shelton, who added that Pope Francis has called getting vaccinated "an act of love."

As hospitals grapple with higher counts of patients than they had seen during much of the pandemic, burnout and worker shortages are problems. Memorial recently released a statement asking clients to be kind to staff.

Govindaiah urged people to consider the big picture. "The request to be kind and quite frankly the request to get vaccinated are not just about you," he said. Instead, all of us should take a hard look at how our actions, or inaction, impact the greater community.

COVID-19 vaccinations are available to those 12 years and older and are free of charge. You can schedule an appointment in either Sangamon or Menard counties at scdph.org. Anyone in Illinois can get assistance in setting up a vaccination appointment by calling a toll-free Illinois Department of Public Health hotline at 833-621-1284.

Contact Rachel Otwell at [email protected].