COVID-19 in a rural health system in New York - case series and an approach to management

• Main Authors: Eyal Kedar, Regina Scott, Daniel Soule, Carly Lovelett, Kyle Tower, Kylie Broughal, Daniel Jaremczuk, Sara Mohaddes, Imre Rainey-Spence, Timothy Atkinson
• Format: Article
• Language: English
• Published: James Cook University 2021-07-01
• Series: Rural and Remote Health
• Subjects: clinical care networks; COVID-19; healthcare disparities; rural health research; rural healthcare delivery; USA.
• Online Access: https://www.rrh.org.au/journal/article/6464/

Introduction: Many rural hospitals and health systems in the USA lack sufficient resources to treat COVID-19. St Lawrence Health (SLH) developed a system for managing inpatient COVID-19 hospital admissions in St Lawrence County, an underserved rural county that is the largest county in New York State. Methods: SLH used a hub-and-spoke system to route COVID-19 patients to its flagship hospital. It further assembled a small clinical team to manage admitted COVID-19 patients and to stay abreast of a quickly changing body of literature and standard of care. A review of clinical data was completed for patients who were treated by SLH's inpatient COVID-19 treatment team between 20 March and 22 May 2020. Results: Twenty COVID-19 patients were identified. Sixteen patients (80%) met National Institutes of Health criteria for severe or critical disease. One patient died. No patients were transferred to other hospitals. Conclusion: During the first 2 months of the pandemic, the authors were able to manage hospitalized COVID-19 patients in their rural community. Development of similar treatment models in other rural areas should be considered.