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COVID-19 An Even Greater Burden For Rural Health Departments And Hospitals

COVID-19 testing at the Lima Memorial Health System.
Lima Memorial Health
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COVID-19 testing at the Lima Memorial Health System.

Maps of COVID-19 across Ohio show most all the state is experiencing severe spread, but the situation is even worse in rural areas. Allen, Hardin and Marion counties, just northwest of Columbus, are seeing around 1,000 new cases per 100,000 residents. The rate of cases is those county is nearly double the rate in Franklin County.

Many of the coronavirus patients in these counties end up in Allen County’s Lima Memorial Hospital. Chief medical officer Dennis Morris says it’s been a difficult couple of weeks.

“Fortunately, we’ve seen a slight decrease in admissions since last week, when we had a very high census of COVID patients,” Morris says. “We hope that continues, but we’ll see in the next few days if we get a surge from the holiday weekend.”

Lima Memorial serves a 10-county area, with smaller hospitals in the surrounding area referring their most critical COVID-19 patients there. Last week, the hospital had 36 coronavirus patients, about a third of its total capacity.

“We have implemented strategies this week to at least add another 20-30 beds if needed, looking ahead,” Morris says.

It’s hard to pinpoint why exactly these three counties have a higher rate of COVID than the rest of the state. Allen County’s health department, which reported 963 cases over the last two weeks, attributes it to the general surge impacting the nation.

Both Allen and Marion County have prisons (Allen Oakwood Correctional Institution and Marion Correctional Institution) with significant COVID-19 outbreaks.

Hardin County, which doesn't have a prison, has reported 349 COVID-19 cases in the last two weeks. Kenton Hardin Health Department spokeswoman Kelsey Ralston says her agency is being consumed by COVID-19 and desperately needs more employees.

“We have done some hiring for contact tracers, and as they get more funding, we try to get those people hired as quickly as possible,” Ralston says. “Considering that we’re already in a surge, it kind of puts you behind the 8-ball position.”

Kenton Hardin Health Department has nine full-time employees, and everyone on staff is trained or being trained to help with contact tracing on top of their regular work. Additionally, the county's health commissioner quit in August, citing personal reasons. 

Deputy health commissioner Cindy Keller will transition into the role permanently next month. But she’s also the director of nursing, a role that will need to be replaced.

“It’s impossible with the professional staff we have to do anything in a timely manner,” Keller says.

Ralston says the staffing problem makes it impossible to stay on top of COVID-19 messaging, not to mention other health concerns people turn to the department to address. The department cannot run immunization clinics or pre-natal and parenting classes, as it turns all its resources to pandemic reaction.

“I know we could use people answering phones,” Ralston says. “It’s to the point that we need more people in every position, not just contact tracing. Yes, the contact tracing is a place that we need it, but we need it other places too.”

All three counties are bracing for still another uptick in cases if there was significant community spread after last week’s Thanksgiving holiday – something health officials say should be coming in the next few days.