Cattle-branding season in the panhandle of Nebraska, but this spring things look completely different. What it was usually one of the biggest social events of the year in a state where the cattle makes two-thirds of farm income is reduced to the essentials: no children, no elderly members of the crew and a packed lunch instead of large festive gatherings. “This is not the year your daughter to have a friend out of town to experience a brand,” he warned a local message. “Even if the calves are to be marked may not mean precautions below the difference between life and death for a lover.” It can be seen here, but the risk of COVID-19 pandemic is very real, said Kim Engel, director of the Panhandle Health District public. From May 5 his area had seen 55 cases tested positive for 1,063 people who have recovered from it most, and no deaths. But with only 31 fans for 87,000 people in his district 15,000 square miles, even a small spike in the number of cases could quickly overwhelm local health system. “We are still waiting for our suggestions,” Engel said, stressing that will not look like urban outbreaks, national headlines have dominated. “We are not out of the woods, and we are afraid, we’re really just starting this upward curve.” In mid-April, said Minister Donald Trump, the parties largely rural part of the heart were in the clear, taking into regions such as Engels than those who “literally tomorrow,” might think because they saw the reopening “a different lot compared to New York . ” It ‘a topic that has been repeated by many governors, longer stay-at-home orders resisted, the lack of urban density by exercising as a sedative. “It ‘s so important not to make the news and views of New York City and to think that what is Lemmon, South Dakota in a month face,” said the governor Kristi Noem a press conference on April 1. “It’s not absolutely true”. But as the leader of the country speak the reopening of the economy with tax, it is these regions of the United States, who are in danger under the most part. An analysis of district level time COVID-19 showcases the virus only now arriving in much of rural America. That is, some of these sparsely populated areas could abandon the guard as the disease to strike. Just over a month ago, on 1 April of each circle he had documented in America with more than 100,000 inhabitants COVID-19 infection, while only a quarter of those with 9,000 or fewer people had a confirmed case. is the average number of infections per capita eight times in rural America grew in time: In the last month, attacked as urban areas for their lives against the entrenched illness, the virus continued to spread outward to the most counties thin populated and from 3 May, when 60% of the smaller counties had more in at least one case. COVID-19 arrival in America Rural threatens a particularly vulnerable group of people. Many of these regions have an older, poorer people and less hospital equipment and medical personnel. A total of 18 million people living in the counties, hospitals, but have no intensive care, and about a quarter of people over the age of 60. In Nebraska, for example, 81 counties have a single bed ICU and also quarantine a couple of nurses or doctors could leave quickly without medical clinics and hospitals. A recent mapping analysis of nationwide load COVID-19 detected by scientists at Princeton University that the “burden of disease and per capita relative health demand from population centers can be removed higher.” Until now, aid from the federal government, both in money and the best leadership was stained and rural health officials as angels are concerned. More show than a dozen local officials and health in rural areas and in smaller cities across the country when they are struggling to convince their communities to keep their companies closed and avoid social contacts in places where not even feel the real threat and a couple of local political argument is exaggerated. In these parts of the country, curve means in the long, despite economic pressures, it is stretching up into flattening future. Life or death is how it plays out, it is said, it will depend on who chooses the public to believe final. “It ‘a mixed message to our population,” says Carol Moehrle, the director of the Department of Health Idaho North Central District neighborhood. “Now the public is saying,” Who do we trust? I mean, some of our politicians that it is not even true, or that this is more than we trust or public health? “Stay up to date on the growing threat to global health, by signing up for our daily crown newsletter. Mangum, Oklahoma has already learned the hard way how the pristine areas of the country a traveler staying away a hotspot before. After a Tulsa 15 Shepherd March visited preach to a forward congregation unknowingly contracted some of the people who have interacted with the virus, found a state. Three days testing after his visit, the 55-year-old priest was the first Oklahoman of COVID-19 die. Until then, an increasing number of infections among Mangum 2,700 residents was quickly diffused. Five weeks later, 31 patients and 21 staff in the only nursing home in the city have been infected with the virus and five deaths. in a way, the city was easy to rapid movements of their leaders. “not in a million years, we think this is something that we have ever faced,” says the mayor, Mary Jane Scott. “We do not think [COVID-19] will be great in rural Oklahoma.” The city rapidly implemented a curfew and a face mask policy for all public spaces and from 4 May it had spread to a new community is evidence, he said, But, like the rest of the country, rural areas find it difficult to remain closed, especially since many believe the worst is over. Crystal Miller was at his home in Lexington, Kentucky a pot of chili to the evening of March 6, when he received the call. As the director of the District Department of Health Wedco in north-central Kentucky, it had the spread of the outbreak was closely monitored. But it was not the first case of state expected in Harrison County, a rural area of 19,000 cows outnumber people would take two-to-one appear. “I will never forget this day,” he says. The County residents reacted instinctively weeks “social distance” before becoming part of the national vocabulary. Schools were closed and people stayed away from large gatherings to limit their business travel and public exposure. The next day, “I noticed that no one in the Wal-Mart parking lot was,” said Miller. “Our community responded immediately, based on fear.” Now, after more than seven weeks of closure and stay of domestic orders the county has a history of success that the virus included 16 cases and no deaths, that caution gave way to economic pressure. “Miller” The people, the right thing will do, but in this Kentucky people in the area are frustrated and start thinking “Have we destroyed the sufficiency of the curve? Says. In some rural areas of the country, to re-open the desire is always bad. Idaho Republican Gov. Brad Little was a stay-at-home, to March 25 Until then, Blaine County, home of the famous ski resort of Sun Valley, a hot spot for a crown burst through the area, at a point quickly it became more than the infection rates in New York and Italy and the closing down of the local hospital. But it will take a long time, not for some of the biggest anti-government rural population to begin the back of the state. push early April, the state of Idaho Republican. Heather Scott, representing Bonner County, urged their constituents to do just that. “Trump the underlying media hate agendas worldwide and socialist who push forward, we GESAG t is an emergency situation, and it is a “pandemic, Scott said in a video update on April 2 through its official account sent legislation. The governor had “bought in this frenzy” of living matter domestic policy, he said, and would not end without pressure. This public call to action such as health Moehrle, Idaho North Central District Health Department, in part because it falls on fertile ground in their five counties knows concern officials there. The natural social distancing of life in this region makes many feel immune. “It ‘hard to get into the public, because many of them do not think is a great thing to be isolated, it is their way of life in any case, they are not feeing the threat,” he says. But the danger for all these counties is real and growing. Still-control spread and take pursuit meet next epidemic in many of these places are impossible to predict in the area, health officials say. While some counties are protected can continue to find those who can not have a late-COVID increase of 19 cases, it could quickly turn tragic. In the district, which saw the first case in Kentucky, for example, health facilities have only six beds in intensive care. Moehrle district in Idaho, which has the largest elderly population in the state, has 15 beds for five counties. Since May 4, the region had a total of 68 cases, including 16 last week alone and 13 deaths. His department had prepared for a late wave, he tells TIME, with the week Gov. Littles to stay home, to try and protective clothing in stock and prepare the health care system as much as possible. But she knows that for many of its inhabitants, an increase of cases will mean death. “He just nothing to offer their vaccines, no treatment,” he says. “We are so far behind the curve of the metropolitan areas,” says Möhrle. “We have yet to beat for the bomb.” From Washington President Trump urges rural America still has to go to work. He has his health officials repeatedly rejected warnings that its pressure to open the country prematurely once again, will lead to more deaths. It also has the possibility of later, more serious wave released in the fall, officials say local health TIME is one of their main concerns. Also opening soon Trump, health officials in its reduced funding measures in the government’s move was announced for the next outbreak. On April 22, the Department of Health and Human Services announced it would award $165 million in additional funds for 1,779 small hospitals in rural areas to fight the pandemic, as well as additional funds for 14 tele-health resource centers. Of this amount, $2.2 million for programs in Idaho will be approximately $3.9 million in Kentucky, $5.4 million and $5.1 million in Nebraska Oklahoma. Federation official guide has been a mixed bag, too. According to the CDC director Robert Redfield, designed “the US recovery is a careful, data-driven, county-by-county approach” to start the public health and the need to equilibrate the economy. In some parts of the country, districts can quarantine the strength of county-level self. Small towns like Mangum, outbreaks have suffered often found themselves shunned by their neighbors. Mary Jane Scott says the mayor: “Do not go to Mangum, ‘and I do not blame them all the small towns around us have started to say.” But for many smaller counties, also staged a means for trip recovery and trade “re-opening” to carry goods, people and Crown with them. This is a growing concern. “What we’re really facing that these areas have neighbors,” said Lori Tremmel Freeman, who heads the National Association of County and City Health Officials. “You have neighbors who are very closely linked, even though they are 20 miles away, or just across the border, where people go to the supermarket.” Finally, the main one being the infection are for rural America by citizens, even smaller happened to fewer cases, as in Mangum and Tulsa. A repeat that both urban and rural residents have to keep sacrificing in order to avoid, says Bruce Dart, director of the Tulsa Health Department. His father, a 91-year-old Air Force veteran, struggling with the financial statements and psychological to close the restaurant bar has spent decades building. “It would be my heart breaks my business to see my existence, the pipes go down,” Dart says, but “if we open there is an increase in cases, and as bad as the economic impact, we can from the rest . we can not recover from death. “How long will it take to keep rural America need to stay the measures to ensure the application? Government analysts, epidemiologists and local health authorities all give different answers, but agree that the demographics and health systems dug small average neighborhood that until a vaccine is a risk. Nebraska, where officials against large groups or older workers had warned in the spring branding cattle participate is to wait, begin to relax the guidelines at least until the beginning of July social distancing or a second wave of infection risk, according to the Institute for Health Metrics and evaluation at the University of Washington. The estimate for Kentucky, Idaho and Oklahoma is around mid to late June. But the relaxation of social distancing would come with conditions that would be impossible to implement in these areas “mitigation strategies include testing, contact tracing, isolation, and limiting the size of gathering”, the researchers said. Meanwhile, public health officials in some counties, no major outbreaks have seen they are interested, they will drown before the second wave hits. In Bonner County, Idaho, Sheriff Daryl Wheeler published a letter on April 2, the governor to name a small pressing an emergency meeting of the state legislature, if the officials of the American Public Health were wrong to assess the severity of the pandemic. “I do not believe that the suspension of the Constitution was smart because COVID-19 is nothing like the plague,” he wrote. ask in reply signed more than 320 of the local newspaper published a letter the district medical people, “the course” and its health officials rely on, despite the seemingly small percentage of cases. “Idaho is off less than 10-COVID have confirmed 19 cases, more than 1,000 cases over the past 20 days,” he wrote. “Our regional ICU capacity is already tight and the pandemic is not yet fully penetrate our area. This is a medical emergency! We are in this challenge.” -With reporting by Chris Wilson / Washington Please send tips, leads and stories from the front to [email protected].