By Beth Prusaczyk, PhD, Department of Medicine, Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri

The rapid spread of COVID-19 across the United States (US) demands a similarly rapid scientific response to mitigate the impact. While the initial scientific discourse about the virus appropriately focused on virology, clinical features, and therapeutics, there is now equal, if not greater, attention on the public health practices that are immediately needed to slow the spread as the response shifts from―containment‖ to―mitigation.

To mitigate the spread of the virus, numerous states have enacted policies that restrict their residents statewide, such as closing all schools, limiting gatherings over a certain amount, or issuing ―shelter in place/stay at home‖ orders for all non-essential activities. These―social or physical distancing‖ practices are seen by many public health experts as the most effective tools currently available to slow the transmission of the virus.

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With nearly all of the 50 states in some form of lockdown to fight the spread of COVID-19, WalletHub today released updated rankings for the Most Aggressive States Against the Coronavirus, as well as accompanying videos.

To identify which states are taking the most aggressive actions to combat coronavirus, WalletHub compared the 50 states and the District of Columbia across 51 key metrics. The data set ranges from tested cases of COVID-19 per capita to school closures, ICU beds, and shelter-in-place policies. Below, you can see highlights from WalletHub’s report, along with a summary of the largest changes in rank from our previous report and a Q&A with WalletHub analysts.

Note: Rankings reflect data available as of 1 p.m. ET on April 6, 2020.

On April 3, CMS Administrator Seema Verma, Deborah Birx, MD, White House Coronavirus Task Force, and officials from the FDA, CDC, and FEMA participated in a call on COVID-19 Flexibilities. Several physician guests on the front lines presented best practices from their COVID-19 experience(s). You can listen to the conversation here.

As the coronavirus spreads across the country, the related anxiety, fear, and depression also threaten the health of Americans. Mental health experts say the combination of rising death tolls and social isolation make it difficult to cope with the pandemic. As the Director of the Office of Rural Mental Health Research, Andrea Beckel-Mitchener explains that rural communities often pursue counseling less often due to the “stigma to seeking help.” Further, rural areas often have less access to mental health care. Telehealth has received growing support recently and can greatly improve mental health care in rural communities. For tips on coping with social distancing and isolation, check out the advice given by Substance Abuse and Mental Health Services Administration.

Politico reports that in a April 2, 2020 news briefing, Dr. Deborah Birx, the White House coronavirus coordinator, announced that rapid point-of-care tests will distributed to areas of the country where current COVID-19 testing is scarcest. “These are new tests, and we have prioritized the groups that we think have the least access to testing now,” Dr. Birx said. “Priority will be given to Indian Health Services and rural areas that do not have access to labs that perform high-volume coronavirus tests.”

With the support from the National Rural Health Association, 41 senators and 81 representatives wrote a letter to HHS Secretary Azar urging the administration to fairly distribute aid to rural hospitals and health clinics. Under the CARES Act, the HHS Secretary has flexibility in how the $100 billion fund will be allocated to struggling providers. The lawmakers requested that funding be provided to rural hospitals quickly, as many are running low on money while preparing for the coronavirus. NRHA is concerned that large health systems (who also need help) will consume the funds due to small rural providers’ inability to compete for the funds. We are advocating for a rural set-aside to be established within these funds to ensure that rural providers can access this important, much-needed funding.

Daily Yonder

By Craig Settles

Rural America already has a shortage of hospital beds. Telehealth could help move some patients to a new type of facility powered by broadband. New temporary regulations in response to COVID-19 will allow the change.

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Daily Yonder

By Bill Bishop, Tim Marema and Jan Pytalski

The novel coronavirus continues to spread across rural America, according to data USA Facts has compiled from state health authorities. Yesterday, April 1, an additional 58 rural counties reported their first Covid-19 cases.

The impact of the novel coronavirus varies across the rural landscape. On average, there were 14.1 cases of COVID-19 for every 100,000 rural residents. That rate is well below the national rate of 55.9 cases per 100,000 residents.

But most of us don’t live in an “average” county. There are 80 rural counties with infection rates above the national average (shown in red in the map). And some rural counties have COVID-19 infection rates among the highest in the country.

Some of the highest rates are in Rocky Mountain ski counties. (The Yonder reported this phenomenon last week.)  Blaine County, Idaho, has a COVID-19 infection rate of 1,164 per 100,000. For comparison, the Bronx in New York City reported a rate of 598.6, the highest tally of any central city area.

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