What We're Reading: Rural Health Suffering; Transplants Deferred; 6 Feet Apart May Be Too Close

April 22, 2020
AJMC Staff
AJMC Staff

Some rural communities are only now seeing an uptick in coronavirus disease 2019 cases; lifesaving organ donations have seen precipitous drops as of late; the current social distancing measure of 6 feet may not apply in all cases.

Rural Communities Face Additional Challenges From COVID-19

Despite factors working in their favor to prevent the spread of coronavirus disease 2019 (COVID-19), such as a dispersed population and lack of public transport, according to MedPage Today, when the virus hits, rural communities are especially hard hit. Smaller hospitals, a work life that is often centered in industrial plants, and the inability to work from home are all factors that contribute to a faster spread of COVID-19 when it finally arrives in these communities. In addition, these areas suffer from a severe shortage of primary care physicians (40 for every 100,000 people) and specialists (30 for every 100,000). To help, the Bipartisan Policy Center is suggesting increasing total J-1 visas to provide more opportunities for international medical graduates to serve rural areas and financial relief in the form of 3% greater reimbursements for Medicare Critical Access Hospital services.

Organ Donations Are Being Deferred

With many hospitals continuing to experience influxes of patients with COVID-19, many organ transplant surgeries have been put off, reports Stat News, despite being deemed a lifesaving operation. In particular, kidney and pancreas surgeries are on hold because these patients can still receive treatment with insulin and through dialysis, respectively. Overall, organ donations have fallen by more than one-third (37%) at present, including those from living donors. Contributing factors have played into many decisions to delay a transplant, including lack of an adequate blood supply, ventilators, and hospital beds. Coronavirus-related testing delays have also led to delays in testing organs to see if they are suitable matches and free of the virus.

Is the Current Social Distancing Distance Sufficient?

Research from Canada shows that when people cough, their respiratory droplets can travel more than 6 feet, per Forbes, which is the current standard for social distancing. What does this mean in light of the current pandemic? It all comes down to the droplet size, researchers say, with smaller ones staying in the air longer and travelling farther, which increases risk of transmission and infection. This research centered on infection risk from the flu, but the study authors believe their results can carry over because cough droplets are produced and spread through both influenza and the coronavirus.