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COVID-19 data forecasts trouble for a dozen states without stay-at-home orders

Rural counties could be hit especially hard by the virus

By: Jill Riepenhoff, Lee Zurik, Megan Luther and Jamie Grey

Originally published: April 3, 2020

(InvestigateTV) – A new warning for Beadle County in South Dakota is stark: time is running out to save lives.

In fact, it’s a dire prediction a nonprofit organization applies to multiple counties in South Dakota because of a lack of state restrictions.

If strict, stay-at-home orders are not issued by April 18, hospital overload would result as soon as April 27, according to new modeling from COVID Act Now, created to help communities prepare for the pandemic. The models predict as many as 9,000 people could die if there is only limited action taken in the state and 3,000 with social distancing mandates for three months.

South Dakota remains the only state in the country that has not ordered its 900,000 residents to stay home or to practice social distancing.

The organization’s model, now drilled to the county level in all 50 states, layers predictions of hospital overrun, deaths and rates of infection against the states’ current level of restrictions.

The model was created by data scientists, epidemiologists and physicians with degrees from Cornell and Yale. It first was used in California then expanded to include all states and now counties.

Its founders said that the state map received more than 10 million hits in a week.

One model being used by the White House predicts South Dakota will hit its peak on May 4. That Institute for Health Metrics and Evaluation data analysis predicts with full social distancing far fewer deaths – around 200 – but also an ICU bed shortage in the state.

This model, developed initially for the University of Washington School of Medicine, utilizes government data, the World Health Organization and hospital networks.

South Dakota’s Gov. Kristi Noem (R) has yet to file an executive order for enforcing any closures.

Eleven other states including Alabama, Oklahoma, South Carolina and Texas haven’t taken the most restrictive measure of ordering all residents statewide to stay at home. Rather, residents have been ordered to practice social distancing and closed some businesses.

The clock is ticking for each of those states, researchers said.

“The data is unambiguous,” said Alaska State Rep. Jonathan Kreiss-Tompkin, a Democrat and a founder of the COVID Act Now group. “Acting now, acting early and aggressively saves lives.”

Kreiss-Tompkin and two other founders held a press briefing April 2 about their newly-released county data. In March, the group released state level data, which they said has been used by several state officials to help shape their responses to the global pandemic.

Hear from Dr. Nirav Shah during the March 2 news briefing. Shah is a senior scholar at the Stanford University Clinical Excellence Research Center and Former New York State Department of Health Commissioner. 

The new data puts a fine point on small and rural counties that have largely escaped the spotlight but not the virus.

“Rural America is not immune,” said Max Henderson, a data scientist.

And, because of the lack of healthcare, those areas “may get hit harder,” Henderson said.

Some cities and counties in these 12 states have issued stay-at-home orders for their own residents. But the policies vary. For example, one South Dakota city allowed hair salons to stay open.

More than half of the nation’s counties don’t have a single ICU bed. In 770 of those counties – home to more than 20 million people – coronavirus already hit their communities by April 1, according to an InvestigateTV analysis of Kaiser Health News data on hospital bed data.

And many of those counties are in states where governors have not ordered them to stay at home. For residents in those counties, their situations could become dire by month’s end.

The Act Now model using March 31 data shows that:
· Chambers County, Alabama could exceed hospital-bed capacity May 6 with the current restrictions in place.
· In Claredon County, South Carolina, where there is a voluntary stay home order for high risk groups, hospitals will run out of bed space May 4.
· In Osage County, Oklahoma, the hospital capacity will run out April 27.

In each of those counties, the models predict hundreds could die.

By comparison, Van Wert County Ohio likely will not ever overload the hospital capacity, the data shows, because of early action by Gov. Mike DeWine (R). He closed schools March 12, bars and restaurants March 15 and issued a stay-at-home order March 23.

Even Ohio’s large metropolitan areas such as Cleveland and Columbus may avoid catastrophe because of the deep restrictions, the model shows.

On April 1, Georgia Gov. Brian Kemp announced he was issuing stay at home orders. They may have come too late for at least one county.

Dougherty County, home to Albany, Georgia, has more cases of COVID-19 per capita than any other county in the state.

It is among the virus’ hottest spots in the nation based on per capita rates. It also has the third-highest death rate among counties in the U.S.

It’s first case was detected in early March. By mid-March, there were no available ICU beds even as dozens of patients needed them.

The situation is so desperate that earlier this week, Kemp called in the National Guard to help.

The map below shows states with statewide shelter-in-place orders (orange) and states without an order (green). Some states without a statewide order have counties or cities that have made their own equivalent orders. 

InvestigateTV reached out to the governors’ offices in each of those 12 states. None were available for interviews.

A spokesman for Wyoming Gov. Mark Gordon (R) said state leaders were exploring additional measures.

South Dakota Gov. Kristi Noem (R) said a press briefing April 1 that state modeling shows that the peak of the virus will not hit the state until August, thus leaving plenty of time for preparations.

“Now that we’re looking at a peak infection date possibly into July and August, I ask everybody out there to consider, the lifestyle they’re living today, ‘can you do that until July and August?’,” Noem said.

The state’s health secretary added, “The consensus around the number of people that are likely to get infected is 30% of our population,” Malsam-Rysdon said.

Act Now pegs the infection rate around 70% of all residents.

In Alabama, Gov. Kay Ivey (R) held a Q&A session on Twitter on April 2.

When asked why she didn’t make such an order for Alabama, Ivey tweeted: “Each state has to weigh their own set of factors. I’m in communication with local, state & federal officials on a daily basis. We are taking a measured approach to keep Alabamians healthy, safe & working, wherever possible.”

Dr. Nirav Shah, a senior scholar at Stanford University Clinical Excellence Research Center, said that governors who have failed to act with the full force of their powers are putting residents at risk.

“It’s a false choice between lives and livelihoods,” said Shah, another Act Now founder and a former health commission for the state of New York. “You first have to focus on saving lives. Then we can get back to work.”

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