Rural Hospitals and COVID-19

Anyone who knows my background would know that I’ve spent most of my life living in a big city. So, you might be asking why I’d take an interest in rural hospitals during COVID-19, and why others should take an interest in this topic as well. There are really three answers to that “why” question:

(1) many rural hospitals were in danger before the pandemic,

(2) many rural hospitals may be in even more danger of closing as a result of the pandemic, and (3) such closures would reduce access to care for many during this pandemic.

Even before COVID-19, many rural hospitals had been closing at an alarming rate. The problem has been particularly bad in poor rural areas here in the United States. The reason for this is often attributed, at least in part, to the fact that some states have decided not to opt for Medicaid expansion, a move that affects the finances of hospitals severely.[1]

With COVID-19, this situation is expected to get even worse, unfortunately, especially in the states that have not expanded Medicaid. That’s not to say that the pandemic isn’t taking a toll on other places, but that toll is expected to be particularly bad in places that have not seen this expansion.[2]

What this will mean is potentially more rural hospital closures, especially in poor rural areas.

It means that many in these places who need urgent care for anything, whether it be for COVID-19 or something else, will need to wait longer to get urgent care that they need, ranging from heart attacks to severe strokes. Furthermore, it will mean that people in the areas affected by these closures will need to travel further to get the care they need, in the process putting more of a burden on the hospitals that do survive (both hospitals that exist in rural areas and ones that do not exist in rural areas).

All of this, in turn, would affect places’ abilities to adequately address COVID-19. I am presenting a rather doomsday scenario because it does sound like a doomsday situation, unless rural hospitals get the help they need.

There are two ways forward from this crisis, as far as I can tell. First, states that have resisted Medicaid expansion should end that resistance immediately. Second, federal assistance to rural hospitals, which from what I have read has been inadequate, should be much more substantial.[3] This is not to say that the situation will be universally great even with these measures because the entire American healthcare system is feeling the strain from COVID-19. However, the measures I suggest above would hopefully slow down some of the financial bleeding many rural hospitals are experiencing.

For any of my readers who live in rural parts of the United States and may be affected by the closures of rural hospitals, you may want to do the following:

  1. See if your state has implemented Medicaid expansion. If not, put pressure on your state officials to expand Medicaid in their states.
  2. Contact your members of Congress (particularly if your member covers some rural areas) to ask them to make sure that rural hospitals are adequately addressing any future COVID-19 relief or stimulus plan.

Yes, I may be a city kid in many ways, but I also know that we need urban, suburban, and rural hospitals alike to be in adequate shape financially as they confront this pandemic. Anything less than that is irresponsible and may result in unnecessarily losses of life.


[1] This Forbes article explains how a lack of Medicaid expansion causes significant financial harm to many rural hospitals: https://www.forbes.com/sites/claryestes/2020/02/24/1-4-rural-hospitals-are-at-risk-of-closure-and-the-problem-is-getting-worse/

[2] https://www.npr.org/2020/04/09/829753752/small-town-hospitals-are-closing-just-as-coronavirus-arrives-in-rural-america

[3] https://www.thegazette.com/subject/news/health/iowa-rural-critical-access-hospitals-money-problems-coronavirus-relief-20201019. This source, which is the paper of record for much of Eastern Iowa, has been consistently covering the issue of federal assistance to rural hospitals.

Blog Wrap-Up: Calendar Year 2020

Okay, so I know this is my blog wrap-up post for this calendar year, but in typical 2020 fashion, not even this wrap-up post could be done as normal…

Given the surge in COVID in New York City, I just wanted to give a brief update on COVID here right now, before going on to the main subject of the post, which is the blog wrap-up for this year. Here are some quick updates:

  • Everyone in my immediate family is still COVID-free.
  • That being said, the positivity rate continues to rise where I am, and in the zip code just north of mine, the test positivity rate is approaching a whopping 13%. Needless to say, I still very much feel like we are heading in the wrong direction where I am, in my part of New York City (southern Queens).
  • For the first time since mid-May, New York State is reporting over 100 deaths a day from COVID on a regular basis.
  • For those worried about what I’m doing over the holidays, worry not—I am not traveling during them, and I’m taking care of myself right where I am.

I know this is not the typical way to start a blog wrap-up post for the calendar year, but I figured that it would be better to give a COVID update now, during the middle of the holidays, instead of waiting completely until after the holidays.

Okay, now for my originally scheduled wrap-up post…

Honestly, at times it has felt like just too much to keep up with everything, both personally and blog-wise. I’m guessing that many of my readers might say the same—that it was a struggle to keep up with all that was going on.

And yet, we persevered. We’ve made it through 2020.

In light of all that went on this year in the United States (and in the world), talking about what this year in blogging has been like for me feels a little insignificant. That being said, I would like to highlight some pages on my blog that seem relevant, given all that is going on right now:

  1. My Coronavirus Diary page. This page classified as “Coronavirus Diary” is broken up into two categories: the weekly updates from New York City (something I did for a couple of months when the pandemic was particularly bad in my hometown) and blog posts about injustices related to COVID-19.
  2. My blog’s page on racial issues. While I have some posts on that page that precede the killing of George Floyd, some of my older content is as relevant as ever, in light of Mr. Floyd’s death. Some posts that may be worth a read (especially if you’re someone who’s followed the blog in the past few months) include ones on how institutional racism affects policing, how the fight for African American Civil Rights is not over, and what white guilt is.
  3. The page I have for the “What Is” blog series. The goal of this series is to hopefully help many of us better understand terms that are often used in social justice circles that some of us may struggle to understand.
  4. The page I have for “blog advice” posts. Since I’ve gained a substantial following, I want to make sure that my own tips on blogging get passed down to both current and future bloggers. I will say that this is taking a back seat to my COVID update posts for now, but whenever this pandemic settles down (and I really believe it’s a “when” and not an “if”), I will continue giving blogging advice.

I want to end this wrap-up post by offering a few “thank-yous”:

First, thank you to those who nominated me for blogging awards. This includes Em at Invincible Woman on Wheels, for the Ideal Inspiration Blogging Award; the blog Living Everyday, for the Outstanding Blogger Award; and Keith V at On My Mind Today for the Blogger Recognition Blog Award.[1]

Thank you, of course, to all my readers this year. I know many people are feeling quite fatigued from all the screen time we’re having, so I don’t take lightly the fact that people are using a little bit of that screen time by reading my blog.

A thank you goes to all the essential workers, such as those in grocery stores, those keeping mass transit running, fire fighters, and many others who kept things functioning as best as they can during COVID. Many of these people had to deal with COVID in their workplaces yet did the best they could to make sure things were kept running—without help from our essential workers during this time, it would be impossible for us to see our most basic needs met.

Most of all, thank you to our EMTs, nurses, doctors, and other medical workers who’ve been helping during this time of pandemic. I am grateful for the work you all do. You all deserve better than the ignoring of basic public health guidance that has led to many of you feeling overwhelmed.

Finally, I just want to wish that everyone has a healthy and safe holiday season.

I will not be publishing a post for the rest of the week, in observance of New Year’s Day.


[1] I still need to do an award post, as this too has taken a back seat for now to the COVID update posts. That being said, I do want to at least acknowledge that I got nominated for this award!

Coronavirus Update From New York City: December 17, 2020

Currently, many of us here in the northeastern region of the United States are in the process of digging out from a major snowstorm. I hope that all of my readers who were hit by the storm are warm and safe.

Everyone in my family is continuing to avoid the coronavirus, but it is getting more and more nervy as zip codes around us are seeing concerning rises in positivity rates. To add insult to injury (in terms of being on edge with COVID) is the fact that my parents in particular have seen a few places in our neighborhood where people are not wearing their masks and practicing social distancing as they should. I know I’m a broken record in saying this, but please wear your mask and practice social distancing! Also, when you wear your mask, wear it over your mouth and your nose, like the person in the photo below.

The person in the photo is me, by the way.

It’s not just my family who’s getting nervous about COVID, either. New York City is also getting nervous, as evidenced by a shutdown of outdoor dining that started last Monday, as well as noises of a more complete shutdown after the holidays (as to why we’re waiting for the holidays to do this if the situation is that serious, I’m not quite sure). The nervousness is understandable–with stories across the country of hospitals being overwhelmed, the fact that hospitalization and ICU rates are on the increase at a time when we don’t have a ton of hospital and ICU beds available to begin with in New York City is a cause for nervousness.[1]

At this time that many hospitals are being stretched thin due to this pandemic, I offer a simple plea: please listen to guidance from your public health officials about holiday gatherings, even if it means staying home. I know, understand, and appreciate that it is tough to not visit family you desperately want to visit–I know that because I desperately want to visit my mom’s parents too. However, a visit to them, even if it were allowed by their senior living community (which it is not), could potentially put them at severe risk because of their age and the condition they are in. Many of us here in the states could put our relatives in similar potential peril if we visited them. As much as we may love our relatives, the best way to love them may be to stay home and minimize the chances of relatives getting the virus.

My warning aside, I do wish everyone a good, healthy, and safe holiday season. Let’s care for each other and love each other at this time by doing all we can to keep each other healthy.

My last post for this calendar year will be on December 28th. That post will function as a combination of a COVID update post and an end-of-year wrap-up post for this blog.


[1] https://projects.thecity.nyc/2020_03_covid-19-tracker/?_ga=2.239467267.1478419328.1608083101-1077310081.1606063751

Gaslighting in Contexts Other Than Relationships

I was absolutely overwhelmed with the response to my “what is” post last week about gaslighting. I never know when a post will resonate with my readers, and I could tell that my post resonated with quite a few of you. It’s unfortunate that so many related to the post because of their experiences as victims of gaslighting, but I’m also hopeful that some people will come to a better understanding of their experiences through reading that post.

However, I think it is worth doing a follow-up post because of things I’ve learned even since last Monday, and things people should learn as well, about gaslighting in contexts other than one-on-one relationships with other people.

In saying this, it is worth remembering that gaslighting is “a specific type of manipulation where the manipulator is trying to get someone else (or a group of people) to question their own reality, memory or perceptions.”[1]

Phrases like the following can be commonplace:

Of course that didn’t happen. You’re being crazy.”

“Your mind must be playing games.”

“It’s all in your head.”

“You’re being too sensitive.”

These challenges to one’s reality, memory, and perceptions happen a lot in relationships, as I said in my post last Monday, but they can also happen in other contexts.

One other context in which gaslighting can happen is politics—something that a couple of the comments in response to my post pointed out last Monday. When a politician makes a person, or a whole group of people, question their own reality, that is political gaslighting. In fact, as controversial as it may be for me to say this, I think that the American people are a victim of President Donald Trump’s gaslighting regarding the election results—he is trying to get the entire country to doubt the basic reality that he lost, so that he could be president for four more years (or for life). Thankfully, no amount of gaslighting can result in giving Trump an election that he undoubtedly lost, but in the meantime the American people have to deal with the fact that he has successfully convinced a group of people of a reality that simply does not exist. And, when you have someone with a large platform who engages in an act of political gaslighting, the result is that a group of people gets convinced of a reality that does not exist (as is the case here with the election and President Trump).

Yet another context that gaslighting can exist is in the experiences of people with disabilities, racial minorities, LGBTQ+ people, and other groups that face discrimination. Reading a post from Jackie at Disability & Determination helped me recognize that gaslighting absolutely exists in this context. Jackie’s post talked about gaslighting in the context of the disability community—it is painfully common in the disability community for someone to question or doubt the reality that there are certain things you aren’t able to do, or at least not do in the same way, as an able-bodied individual (or dismiss the reality of the disability in general). It can exist in the context of LGBTQ+ individuals through people who counter their perceptions of their sexual or gender identity, in the context of Black people through people who try to divert attention to how difficult they also have things in life, in the context of poor people by countering any notion that they are working hard yet struggling to still get by (saying that they simply need to work harder), and much more. Groups of people face discrimination and are gaslit about their own experiences of discrimination—a double whammy.

There may be other major manifestations of gaslighting that I did not cover either in last week’s post or this post; if so, please let me know in the comments section below. However, it is clear to me now that in addition to gaslighting rearing its ugly head in relationships, it can also rear its ugly head in other forms, such as in politics and the experiences of people in groups that face discrimination.


[1] My definition comes from here: https://www.nbcnews.com/better/health/what-gaslighting-how-do-you-know-if-it-s-happening-ncna890866

Coronavirus Update From New York City: December 10, 2020 (COVID Test Edition)

I hope all of my readers are healthy and safe during a time when the pandemic is getting truly scary in parts of the United States, and the world. It is particularly sobering that we had more deaths from the virus yesterday than the entire country did from terrorist attacks on September 11, 2001.

New York City is starting to see its hospitalizations and ICU beds used due to COVID rise. Data seems to indicate that we have a few hundred ICU beds still available and a few thousand hospital beds, but with COVID rates on the rise, as well as hospital and ICU beds used due to COVID on the rise, we should not get complacent here in New York City. If you want to track data in New York on a day-to-day basis, I highly recommend your visiting the coronavirus tracker webpage for an online newspaper called The City.

With statistics trending in the wrong direction, there are noises about more things shutting down in New York City before long. Things such as indoor dining, which have been open at a reduced capacity for the past few months, may be in danger of shutting down completely in order to try and not let this virus go too out of control again. I fear though that we may be too late–since many ignored the warnings of our public health experts with regards to behaviors during the recent Thanksgiving holiday, I expect the virus to continue to get worse in New York, and nationwide. I hope I am wrong.

I want to spend most of my post though talking about my experience with getting a COVID-19 test. I got a COVID-19 test for the first time on Sunday so I thought it was worth sharing what the experience was like…

So, to give some backstory, a couple of family members had some symptoms of COVID-19 due to something that was acting like a head cold. Even though it was acting as something no more serious than a head cold for them, I decided to get a COVID test anyway since there is some overlap between COVID symptoms and head cold symptoms.

The test itself was not too bad. Having swabs go into your nose is not the most pleasant feeling in the world, but that didn’t last for long. All in all, for a virus so serious and so deadly, it was not a particularly painful experience. Having blood drawn is to me a much more unpleasant experience than the COVID test that was administered to me.

The experience beyond the test was a lot more mixed. Positives of the experience include receiving free masks, getting free hand sanitizer (not sanitizer I personally needed, but some people do want and/or need that), and a relatively simple process to ensure that I learned the results of my test (which came back negative, by the way, so I don’t have COVID). Negatives of the experience include standing in a long line in cold weather (it was a walk-in site and not a drive-in site) and the fact that the seating area where some people were waiting for test results had some individuals who were unmasked. Overall, if I felt COVID symptoms or knowingly came into contact with someone who tested positive for COVID, I would still get a test and strongly advise people in a similar sort of situation to also get a test. That being said, I think that in order to successfully test and perform contact tracing, we need to make the COVID testing process as pleasant as possible–something that New York City is I think trying to do through the free masks and hand sanitizer, but needs to improve on through more testing sites (something which admittedly may be difficult to achieve if we do not have adequate tests available to begin with).

Hopefully, my mixed review does not scare anyone away from getting a COVID test! In spite of my mixed review of the testing experience, I am glad to have the peace-of-mind of having that negative COVID test. And, if it was found out that I tested positive, appropriate actions could be taken so that others could quarantine accordingly, and protect others yet from the virus. While the testing experience itself was not ideal, testing is important and needs to exist more widely. What’s also important is social distancing and wearing your mask over your mouth and your nose.