COVID-19 is dangerous for seniors. But that threat increases in rural counties where care is far away.

from the virus than others. A USA TODAY analysis found that in 341 counties — or 11% of all U.S. counties — at least 25% of residents are 65 or older. Nationwide, only 16% of the population is over 65, according to the census.When it comes to states that have high concentrations of seniors, Texas leads the nation with 27 of those 341 elderly-heavy counties, followed by Nebraska, Michigan, Montana, Florida and North Carolina.

“This is the worst possible situation,” says Alan Morgan, CEO of the National Rural Health Association, a nonprofit that provides leadership for rural health matters. “Rural America is older, sicker and poorer. Now combine that with 2,000 rural hospitals where 1,300 have 25 or fewer beds, half of which have just one ventilator on site. Our system was designed for efficiency, not surge capacity.

“In the best of times, many of these people have issues accessing health care, whether it’s getting to facilities or just a lack of doctors in their area to begin with,” says Franzini. “Keep in mind, this isn’t just about whether people get the virus, it’s about keeping up with regular health care issues that now can be an issue.

“We’re rural, so social distancing isn’t hard for us, but, yes, everyone’s concerned about us getting overwhelmed here if things get bad,” says Brown. His Critical Access Hospital — facilities established in rural areas by a 1997 federal program — has 25 beds, three ICU units and three ventilators used to treat those suffering from COVID-19-induced lung collapse.

Those sorts of distances are also familiar to those seeking medical assistance in Montana, which, at seven people per square miles, trails only Wyoming and Alaska for population density. Montana has 19 counties with between 25% and 31% seniors.

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