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Why rural areas may be the next hotspot for COVID-19

Dr. Alice Chen, General Internist in Washington, D.C. & Former Executive Director for Doctors for America, joins Yahoo Finance’s Kristin Myers to discuss her concerns for COVID-19, after coronavirus task force coordinator Dr. Deborah Birx noted that rural areas not immune to the pandemic.

Video Transcript

KRISTIN MYERS: Cases around the country, as I had mentioned, have now hit over 4.6 million as the president has called Dr. Deborah Birx-- she's the nation's coordinator on fighting coronavirus. He calls her performance, quote, "pathetic."

So for more on this, we're joined now by Dr. Alice Chen. She's a general internist in Washington, DC, and a former executive director with Doctors for America. Dr. Chen, thank you so much for joining us today.

So I want to start with Dr. Deborah Birx. She's come out with some warnings lately, recently calling what we're seeing right now and the surges in cases a new phase of the pandemic. Would you agree with that assessment, or is this just what we all expected if states were reopening too soon and too quickly?

ALICE CHEN: Thanks so much for having me, Kristin. You know, unfortunately-- [SIGHS]-- the fact is that we knew. We knew this was going to happen. Doctors, public-health experts, everyone who was really paying attention to the science and the public health, we knew that if we-- you know, we knew that we screwed up as a country to begin with. We didn't have the testing in place. We weren't ready with the messaging. We didn't have leadership from the top telling us to take this seriously.

And then we shut down for a little bit, and then we reopened way too fast. And we knew-- I could just-- I could see that train coming down the pike, and it was so frustrating knowing that states were opening up. We didn't have enough masks. We didn't have enough tests. We didn't have enough contact tracers to tell people if they had been infected-- if they had been exposed to someone who was infected. We knew this was going to happen.

And we also knew that it wasn't inevitable. This isn't the way it has to be. You look at the curves in Europe. You look at the curves in Asia. They went up. They came down. They brought it all-- they brought it down before they decided to start opening things up, and that's where, unfortunately, we have-- you know, we've taken the wrong turn with COVID.

KRISTIN MYERS: So you use the metaphor of a train. I'm glad you mention that because it almost feels as if we are on a runaway train right now. So as a part of those warnings, she also warned Americans living in rural areas. We've seen a lot of the outbreaks in the South. We've seen them in the West. In your mind, how concerned are you of those rural areas where folks might say, listen, I don't see my neighbor very often. I don't need to wear a mask. I'm, you know, out on a farm. What is the big deal? I mean, is this the next place that you might see huge surges happening?

ALICE CHEN: I am very concerned about rural areas, and I have been from the beginning for two reasons. One is that if you live in a rural area, it's understandable that you would have this sense of more security than if you're living in the middle of Manhattan because you are in a less populated area.

But the fact is that wherever people interact with one another and you're not in a completely enclosed bubble like the space station, you're going to be exposed. Especially at the rate that it has been spreading across the country, it is just something that is very likely to happen to rural communities.

And the challenge, especially for rural communities, is that many rural communities do not have a hospital nearby. And if you do, it is a very small one that does not have the capacity if you had all of the sudden five very, very sick people show up in the hospital. One family worth of people who got very sick from COVID, they're going to be overwhelmed.

I have a friend who practices medicine in rural Maine, and she had a patient that she wanted to send to the hospital because of COVID. She called them ahead. She said, OK, I have a patient who's coming. And they said, well, when he arrives, have him stay in his car because we only have one isolation bed, and it's being used. So you have to think about there may not be quite as much exposure, but your risk is so much higher because the resources aren't there.

KRISTIN MYERS: I don't know if you saw my jaw drop just then that they only had one isolation bed. That's an incredibly scary thought. So then I have to ask where-- you know, you're talking about these reopenings. They reopened way too quickly, way too early.

As we are listening to this constant debate almost every single day about reopening schools then, where do you stand on this issue? Does that need to be a regional thing, or does this need to be something that in the United States says, listen, in August, no one does anything. No one goes anywhere. We are shutting the country down and trying to get a handle on this. And schools, we're not sending anyone back to school.

ALICE CHEN: You know, to be honest, as a mom who's very eager to have my kids go to school-- they're so young, and being on Zoom is just really, really hard for a three-year-old. It's just hard to get them to sit down and learn. I so want us to open schools, and there's a part of me that just wants us to shut it all down. Shut it all down not just for the schools but for our seniors, for everybody who wants to be able to open a business and be able to breathe freely and say, OK, I'm going to be OK if I open my barber shop, my restaurant. We're going to be OK. We're not going to have to shut down tomorrow.

We really, really need to bring the virus way, way, way, way, way, way down. One way is by shutting down. Another way is by making sure that we are all wearing masks. And this is so hard because we have had very inconsistent leadership from the top. We've had a president who does not always take the coronavirus seriously. Sometimes he does, but most of the time he doesn't.

And that has trickled down to a lot of people saying, I don't need to wear a mask. I can go out to a bar. I can go to a party. I can have a big-- you know, there was somebody who had a big wedding, and they just stuck everybody in through the church basement, and then they had people get infected.

We have to take this really, really, really seriously if we want to live our normal lives. People think, oh, well, it's a choice between either not living my normal life and hiding from this virus or living my normal life. To me as a doctor, as a public-health person, you know, we have to all very drastically shift how we're thinking about ourselves, our activities. Where are those masks? Don't go out if you don't need to. Bring that virus way down so that we can open things back up again and we can-- you know, we have to make sure we have enough tests, we have enough contact tracers, people who--

KRISTIN MYERS: Right.

ALICE CHEN: [INAUDIBLE] catching infections as they come--

KRISTIN MYERS: Right.

ALICE CHEN: --so we can catch it all and keep our economy open.

KRISTIN MYERS: So I want to try to end this on a positive note after, unfortunately, a lot of bad news it seems like. But I want to talk about Eli Lilly, the drug maker. That's up almost 2% today. For anyone at home, they're in the late-stage trials of an antibody drug.

I mean, when you hear news like that, especially that they're rolling it out in nursing homes, which have been very hard hit by this virus-- I mean, how much optimism do you get that we could see some sort of vaccine or drug going forward?

ALICE CHEN: I think it can't be understated how extraordinary a moment this is in medical innovation that this huge swath of medical researchers are all working on this same problem and are working as quickly as possible to try to solve this. Whether it's treatments or vaccines, medical science is motoring because this is so important.

And particularly with this little Eli Lilly drug-- and we'll see whether or not it works out. But the fact that they are focusing on nursing-home populations brings me hope because it is so hard that this is a population that is both hard hit by the virus and also is so hard hit by the isolation that's being required of them in order to keep them all safe. So I'm excited to see how many drugs and vaccines and companies and people are just stepping up to the plate and trying to make this all better for all of us.

KRISTIN MYERS: All right, we'll have to leave that there. General internist Dr. Alice Chen, thank you so much for joining us today.

ALICE CHEN: Thank you so much for having me.