Health Care

Vermont bucks the trend of rural Covid growth

A sign advertises a Covid-19 pop-up test site Wednesday outside Londonderry’s Flood Brook School. Photo by Kevin O’Connor/VTDigger

At a press conference Friday, the state’s Covid-19 modeling expert had a warning: While infections are starting to drop nationally, the current wave is far from over.

The nation is still averaging 50,000 cases per day, said Michael Pieciak, head of the Department of Financial Regulation. And deaths are still rising. 

“An American died every 80 seconds from Covid-19 in the past week, a grim reality that we are likely to continue to see in the weeks ahead,” he said.

This current wave has far surpassed the first months of the crisis, which peaked at just over 30,000 infections a day. The surge is different from the first in another way: It’s hitting rural areas rather than urban ones.

The hardest-hit areas in March and April were some of the country’s most urbanized areas like Seattle, Boston, New York and New Jersey. 

But now, some of the highest totals are in Southern, Midwestern and Western states, although urban areas in Florida and California are hard-hit as well.

“In the beginning months of the pandemic Covid-19 infections were far more prevalent in highly populous urban centers, then spread steadily outward into suburbs and rural communities,” Pieciak said.

Yet Vermont, the second-most rural state in the nation after Maine, has not had the same rise in cases. Why hasn’t Vermont seen the same trend?

Pieciak attributed it to the way the state has responded to the virus. 

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“Vermont is not doing well by accident, but because of the hard work of Vermonters, and those who are working on their behalf as well,” he said.

Vermont indeed has a better track record compared with rural regions on a few metrics, all of which could have contributed to its relatively low rate. One factor is residents’ compliance with social distancing and mask guidelines. 

A survey of 250,000 Americans published in the New York Times prior to Gov. Phil Scott’s mask order showed that Vermont has a higher rate of mask-wearing than most Southern or Midwestern states, although it falls behind New York, Massachusetts and other Northeastern neighbors. 

Vermont is also doing a good job of testing compared to its rural cousins, and just about everyone else, too. 

Data shows Vermont had the lowest positivity rate in the nation, with only 0.5% of its tests coming back positive in the past 14 days, indicating the state is testing enough people in proportion to its population.

By contrast, Mississippi has a positivity rate of about 20%.

Vermont also has several natural advantages compared with other rural states that could be a factor.

Vermont has a low poverty rate compared with Southern states, which could play into its ability to combat the virus. Low-wage workers are more likely to have interaction with the public and are less likely to be able to work remotely.

Lower-income Americans are also more likely to have health conditions that could affect their outcomes with Covid. Researchers have warned that many rural areas have the potent combination of a concentration of pre-existing conditions and low access to health care providers.

One recent example illustrates that disparity: The recent outbreak in Mississippi’s Tallahatchie County Correctional Facility, which houses more than 200 Vermont prisoners. So far, 146 of those Vermont prisoners have tested positive for the virus — by far the largest facility outbreak among Vermont prisoners.

In Tallahatchie County, where the prison is located, nearly a third of residents and a quarter of residents under 65 live below the poverty line, according to Census data. Vermont has a poverty rate of roughly 10%.

Residents of Tallahatchie County have a life expectancy of 74 years, compared to Vermont’s life expectancy of 80 years. The county also has fewer hospital beds, fewer primary care doctors and a lower health insurance rate than Vermont.

So as Vermont combats the spread of Covid among its prisoner population in Mississippi, Commissioner Jim Baker of the Department of Corrections said the community around it is struggling with an increase in cases. 

“[The DOC is] as successful as we are, thanks in large part, to a low community spread, especially around the areas that surround us. This is not the case in Mississippi, where it is located in some of the highest spread in the country,” he said.

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Erin Petenko

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