Covid Has Left Deep Wounds in America’s Rural Communities

Covid Has Left Deep Wounds in America’s Rural Communities

Covid Has Left Deep Wounds in America’s Rural Communities

The virus tore at the bonds of solidarity in rural areas like Vermont’s Northeast Kingdom. Many of the scars have yet to heal.

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By the time my research brought me to the town of Derby Line, Vt., in late summer 2021, opposition to Covid public health measures had hardened, just like the late summer dirt roads of the three-county area of Vermont’s Northeast Kingdom. School board meetings had become battlegrounds for debates on masking. Yet signs calling for a kidney donor for a local resident also peppered this remote outpost on the Canadian border.

As a public health researcher and practitioner who has lived in Vermont for eight years and has long experience in rural communities in the United States and overseas, I had been tracing the response in the region and the pandemic’s impact on rural communities in my research on Covid-19 and health equity in rural Northern New England since early 2020. Why, I wondered, would rural communities that mobilized to find an organ donor for their neighbor also resist the basic public health measures that would protect that very same, highly immunocompromised person from Covid?

But more than that, I wondered how the national Covid wars had found a landing strip in remote communities that had initially revived both the structures and spirit of the state’s herculean Hurricane Irene recovery effort a decade earlier to respond to the pandemic.

When Covid-19 first threatened to make landfall in rural Northern New England, villages divided their towns into grids and made lists of their vulnerable residents. General stores shifted to curbside delivery long before national supermarket chains did. Church bells rang at dusk for health care workers in the small hospitals anchoring remote towns. Villages networked by solidarity—if not broadband—saw the pandemic as a foreign threat and turned inward to protect themselves. In explaining the effectiveness of the Covid response in rural Northern New England, my research colleagues and I described a “rural ethos”—a constellation of compassion, pragmatism, and solidarity that facilitated swift action in the face of crisis.

The coronavirus still seemed a distant enemy in the region when it came out of lockdown in the summer of 2020. Spared the worst effects of the pandemic’s first wave, many in rural Northern New England saw the virus as a threat borne by out-of-state license plates and not by the friends and neighbors that organize showers for new parents and meal trains for the bereaved. But as the fall surge took root, residents of the region’s more remote communities increasingly saw the tools for controlling Covid, rather than the disease itself, as a threat. Social media and network TV replaced once-bustling general stores and potlucks as trading posts of information and village chatter, and with that came political leaders and pundits eager to peddle their wares—bleach, hydroxychloroquine, vaccine snake oil, and later ivermectin—to areas frayed by hardship.

Across rural America, these seeds of doubt found fertile ground in landscapes long worn bare of investments in health, education, and economic well-being. For decades, prisons had emerged as a growth industry in rural America as hospitals closed at record rates. Abandoned mills and farms, decaying downtowns, and shuttered primary care practices were a testament not simply to a loss of rural vitality but also to identity. In the Northeast Kingdom, short-term rentals for winter tourists proliferated as dwindling Census figures forced school consolidations. Sociologist Katherine Cramer describes a “rural consciousness,” or a politics of resentment rooted in the sense that rural communities do not receive their fair share of power, resources, or respect. Over time, the virus would settle into the deep fissures of Vermont’s imagined version of itself too.

Early in the state’s frenetic vaccine campaign, I stopped at a general store at the edge of the Northeast Kingdom. A welcoming attendant at the register who doubled as a home health care worker described the devastating toll Covid had taken on her patients. “Are you planning to get vaccinated?” I inquired. “If I haven’t had Covid yet, I’m not going to get it now,” she said. The vaccine was new; by contrast, the once-novel coronavirus was now intimately familiar. Her decision was born not of ill will but rather a belief that the defenses against the virus lay in her community.

I thought of the general store attendant when the Delta variant arrived as an uninvited guest at the state’s Covid victory celebration in the fall of 2021. “The simple fact is, this pandemic is being driven by the unvaccinated…. The three lowest vaccinated counties account for 25% of today’s cases, yet they only make up 10% of our state population,” Vermont’s governor said at a press conference in late fall 2021, ignoring data showing that the Delta variant was exacting a mounting toll on vaccinated residents in more populous counties as well. In rural communities marked by lawn signs betraying our purple political complexion, our national and state leaders found a perfect scapegoat for a virus and their collapsing political will to control it.

Indeed, rural communities became a good place in the US to bury our collective empathy along with the pandemic’s growing count of victims. Rural regions overtook urban areas in Covid mortality rates as the Delta variant took hold. Gaps in vaccination were becoming signposts to orient our collective anger at a pandemic that had returned like the invasive weeds lining roadways and rivers. “I have had it with the unvaccinated holding up our lives,” an acquaintance wrote on social media. Elsewhere, others decried the “spreadnecks” and proposed withholding care if they fell ill. In early spring of 2022, I drove north to a village that had once erected flags for every Vermonter lost to Covid. Instead of containing a memorial that had doubled in size, its green lay barren. The state’s post-vaccination deaths were joining the phantom losses from its still swelling overdose crisis—worthy of blame rather than our collective grief.

The Covid Public Health Emergency has ended, but the deep ruts carved by the pandemic have survived three freezes and melts. The tsunami-like Covid waves that crushed rural regions have finally ebbed, leaving already threadbare hospitals, EMS services, and pharmacies battered in their wake. Yet the rural ethos of villages that pull cars out of the mud and snow, answer volunteer fire calls late into the night, and deliver meals to the ailing also endures. In Vermont, a state that leads and lags, I see traces of a larger rural disconnect. We look eagerly for indicators to absolve us of obligation to rural communities but avoid those that blur our caricatures of them as postcard-perfect village centers or back roads desiccated of decency.

If we are to make good on this tragedy, we will see the totality of losses sustained by our rural neighbors and not simply those that blemished our pandemic success stories. The village mentality that permeates rural communities will crack through our society’s buckling foundation of toxic individuality. We will irrigate rural health deserts with the conditions for thriving lives instead of leaving them to be swept away by storms brewing far from our hills.

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