Randolph County sits atop Chambers County, which in normal times is nothing more than geographical fact. But we’re amid a global pandemic, which has decimated normalcy, and of all places Chambers County has become Alabama’s latest coronavirus hotspot.
Below Chambers County is Lee County. Combined they’ve reported more than 200 confirmed cases of COVID-19 — roughly a tenth of the state’s entire total.
Tanner Medical Center of East Alabama, in Wedowee, isn’t that far away. There is no surge there, no apocalyptic outbreak.
“I think we’re prepared for that,” said Missie Robertson, Tanner’s assistant chief nursing officer and vice president of institutional performance and patient safety. “We don’t look forward to it. But I think it’s better to just put your head down and plan to be ready.”
Because of politics and poverty and the state’s refusal to expand Medicaid under the Affordable Care Act, rural health care in Alabama existed on the fiscal margins well before COVID-19 arrived. Thirteen Alabama hospitals have closed in the last eight years, including seven in rural communities. Of the 45 rural hospitals remaining in Alabama, 12 are considered in economic danger, according to data from the Chartis Group, a healthcare analytics firm.
The east Alabama counties that hug the Georgia line are largely rural, swaths of pastoral land speckled with small cities and smaller towns. Roanoke’s 6,000 residents make it the largest city in Randolph County, whose population barely eclipses Anniston’s.
Alan Morgan, chief executive officer of the National Rural Health Association, wasn’t speaking specifically about Randolph County when he gave an interview this week to The Los Angeles Times. But heed his words.
“There is literally no room for error here,” he said. “Rural America is a tinderbox of a health-care crisis for those most in need.”
While the novel coronavirus has arrived in Randolph County — 13 confirmed cases and one death, according to the Alabama Department of Public Health, as of Tuesday afternoon — there is no coronavirus-caused health-care crisis at Wedowee’s hospital, best as I can tell. Pray it stays that way.
As part of the Georgia-based Tanner Health System, the hospital isn’t David facing Goliath. Randolph County benefits from that. Resources can be shared. Personnel can be shifted. Strength in numbers.
And in planning.
Robertson, also a registered nurse, offered details Tuesday about how Tanner’s hospitals have expanded their critical care areas and “girded up” their medical and clinical staffs and aggressively tested those with symptoms. “I’m less of an alarmist and more of a stand-in-place-and-be-prepared person,” she said.
Drive-through coronavirus testing, with a doctor’s orders, is happening at Tanner’s Carrollton, Ga., location; emergency-room testing is happening at its other sites. Sixteen percent of the tests conducted at Tanner sites have returned positive, Robertson said.
Additional “zones of negative pressure” have been created to augment the negative-pressure rooms hospitals require to safely care for contagious patients.
By design, no coronavirus-positive patients are hospitalized in Wedowee. Patients who test positive in Randolph County and need hospitalization are transferred to Carrollton or Villa Rica, also a Tanner facility. Wedowee’s rooms are reserved for what Tanner administrator Jerry Morris calls “swing bed” patients who need further rehabilitative care following procedures like heart surgeries and hip replacements.
“If you’re a rural hospital today, it can be very challenging from a resource perspective and your supply chain but also your employee base,” Morris said. “Fortunately we don’t have to deal with that here in Wedowee because of our relationship with Tanner.”
Compare that to what’s taking place up U.S. 431 here in Calhoun County, where it’s getting real. Representatives of the Army Corps of Engineers are expected Wednesday to scout for locations to house patients should COVID-19 cases overwhelm Anniston’s Regional Medical Center and its sister hospital, Stringfellow Memorial.
How real? Imagine patients convalescing at the Oxford Civic Center or Pete Mathews Coliseum at Jacksonville State University. Those are images none of us would ever forget.
For the time being Randolph County’s story is much different, perhaps even positive. It’s a surprising twist to an otherwise awful time. But to its south is Chambers County and an example of how rural America is nevertheless at risk. Seclusion is no bulwark from this indiscriminate disease.
“We actually are very fortunate,” Robertson said, “in that we are very prepared.”