Since the Great Recession, cuts in federal, state, and local budgets have also shrunk local public health departments by the equivalent of 26,000 full-time jobs. Once a vaccine is developed and approved, state health departments say an estimated $8 billion will be needed for distribution.
Another challenge: Overcoming the class and racial barriers that have allowed poor people and people of color to bear the brunt of the pandemic – both as patients and as front-line workers, Mr. Auerbach says. “We’re seeing that very clearly in COVID, but this has really been a long-standing phenomenon in health.”
Q: How prepared is rural America?
When the coronavirus first hit, rural America saw little risk. But it has turned out the risks are significant. Hardest hit now is North Dakota, from urban Fargo even to rural Cavalier County on the Canadian border. Geography poses an obstacle, as rural Americans often have to travel quite far to get medical care. Demographics are another. America’s 60 million rural residents are older and are diagnosed with chronic health problems at higher rates than the national average, so they’re considered more at risk from the virus. One other big challenge: health infrastructure. Rural hospitals have only 1% of the nation’s intensive care beds.
And the shortfalls aren’t all in rural areas. The lack of personal protective equipment remains a chronic problem, especially in hot spots for the virus. A U.S. Public Interest Research Group report in late October detailed crucial shortages in nearly 3,000 nursing homes around the country. Smaller hospitals haven’t been able to stock up on gloves and masks as larger hospitals have. Still, compared with the acute shortages last spring, the overall picture appears less bleak. Masks that were next to impossible to find in the spring have become ubiquitous, thanks to entrepreneurs as well as medical-supply specialists.
Enterprising companies have moved into ventilator production, alleviating that crunch. And relief organizations have stepped in to try to get the protective equipment to those who need it most. Since the start of the pandemic, Direct Relief, a California-based aid organization, has shipped more than 43 million masks, 7 million gloves, and millions of other items to health facilities in the U.S. and the world.
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