SALEM, Oregon. – Heather Griggs wears a phone to her ear in a makeshift office in the small courthouse that once served as a jail in rural Pendleton, a place known for its annual rodeo.
Her confident tone hides her tiredness when she tells the person on the other side that they may have been exposed to COVID-19. It’s a call he’s made a thousand times since March, but lately there has been a greater sense of urgency.
The coronavirus has passed through the small Oregon community, where farmers grow crops like potatoes, onions, and grains. In Umatilla County, where Pendleton is located, the rate of people testing positive for COVID-19 is approximately 16%. That’s a measure of how widespread the disease is in the community, and the World Health Organization recommends that it stay below 5%.
In the county with a population of 77,000, the virus has infected more than 1,000 people and killed nine, overwhelming its limited resources and employees.
“I’m tired,” said Griggs, who works as a contact tracker.
The pandemic spreading across major U.S. cities is now wreaking havoc on rural communities, with some registering the country’s newest confirmed per capita cases in the past two weeks. The virus is infecting thousands of often impoverished rural residents every day, flooding difficult healthcare systems and accumulating responsibility for government workers who often do multiple jobs for which they never signed up.
Officials attribute much of the spread in rural America to outbreaks in workplaces, housing facilities, and social gatherings. Food processing plants and farms, where people often work in tight spaces, have proven to be critical locations.
Umatilla County has the highest number of confirmed infections per capita in Oregon, sometimes reporting a figure this month higher than Multnomah County, which is 10 times larger and includes Portland. The increase in Umatilla and most rural Oregon counties is driving the state’s increase in confirmed cases.
In response to the pandemic, Umatilla County divided the tasks related to the virus among the 30-person public health department.
For Griggs, that meant his role in overseeing the agency’s mother-child section turned into contact seeking and research. She spends her days asking positive people about the tests they interacted with, and then calling to warn those people.
“We are a small county, so I don’t think there is a single public health person who has not been involved in some way,” said Griggs, who works with eight other contact trackers.
Other rural counties are also seeing virus cases soar.
Forested Hot Spring County in Arkansas leads the nation in the number of new confirmed cases per capita in the past two weeks, according to data compiled by The Associated Press.
Also near the top of the list are even more remote places, like Scurry and Crockett counties in Texas.
The Scurry County Judge announced last week that 169 inmates and 11 prison employees had tested positive for COVID-19. In Crockett County, whose population density is less than two people per square mile, 71 people tested positive. The number of infections is believed to be much higher because many people have not been tested, and studies suggest that people can become infected with the virus without feeling sick.
Officials acknowledge that rural case numbers are low compared to city totals, but even a slight increase can push a small community to the limit.
“We have found that we are really being overwhelmed by the rapid numbers in the increase that we are seeing now,” said Umatilla County Commissioner George Murdock. “We really need help.”
The county has received counseling, contact trackers, case investigators and teams from the state, but Murdock says more help may be needed. Officials need housing alternatives for people who have COVID-19 or who live with multiple families and field teams to serve at-risk residents and distribute federal aid to poor families, he said.
The fact that many rural jobs cannot be done from home has exacerbated the impact of the virus, Murdock said. Authorities have reported cases where people continued to work despite having mild coronavirus symptoms, leading to outbreaks.
“They are forced to go to work to survive. They have no benefits. You can’t telecommute on a production line, ”he said.
Of Oregon’s 23 rural counties, 12 have reported workplace outbreaks on farms or meat and seafood processing plants. Umatilla County has reported six workplace outbreaks since mid-June.
For most people, the new coronavirus causes mild or moderate symptoms, such as fever and cough, that disappear within two to three weeks. For some, especially older adults and people with existing health problems, it can cause more serious illnesses, such as pneumonia and death.
To cope with the increase in cases, rural governments are reorganizing and shuffling the responsibilities of workers who are already juggling multiple roles.
Lt. Melissa Ross updates journalists on drug arrests and fatal accidents as a public information officer for the Morrow County Sheriff in eastern Oregon. She also oversees the records and the civil department. In addition to her duties, she is now the spokesperson for the county’s Emergency Management Team, which provides updates on case numbers and other virus-related information.
“That’s what happens when you live in a small rural America, I guess,” said Ross.
Those communities depend on already limited medical systems.
Lake County, where southern Oregon meets California and Nevada, has only one hospital. The next one is 90 miles (145 kilometers) away.
To serve its 7,000 residents, the county took the unusual step of asking the Lake Health District to not only run the hospital but also monitor its health department during the pandemic.
“We believe it works best in coordinating care for our entire population,” said District CEO Charles Tveit. “That’s why we get involved.”
Murdock of Umatilla County said that while rural areas have fewer resources than major cities, they have the same responsibility to keep people safe.
“Out here, we are used to being alone,” he said. “But this is bigger than us.”
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Sara Cline is a member of the body of the Associated Press / Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercover issues.
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