{"id":277822,"date":"2020-12-05T10:46:24","date_gmt":"2020-12-05T15:46:24","guid":{"rendered":"https:\/\/canadianinquirer.net\/v1\/?p=277822"},"modified":"2020-12-05T10:46:24","modified_gmt":"2020-12-05T15:46:24","slug":"what-happened-when-the-only-er-doctor-in-a-rural-town-got-covid","status":"publish","type":"post","link":"https:\/\/canadianinquirer.net\/v1\/2020\/12\/05\/what-happened-when-the-only-er-doctor-in-a-rural-town-got-covid\/","title":{"rendered":"What Happened When the Only ER Doctor in a Rural Town Got COVID"},"content":{"rendered":"
\"\"<\/a>
Papenfus is the lone full-time emergency room doctor in the town of 900, not far from the Kansas line. (Pexels photo)<\/figcaption><\/figure>\n

Kurt Papenfus, a doctor in Cheyenne Wells<\/a>, Colorado, started to feel sick around Halloween. He developed a scary cough, intestinal symptoms and a headache. In the midst of a pandemic, the news that he had COVID-19 wasn\u2019t surprising, but Papenfus\u2019 illness would have repercussions far beyond his own health.<\/p>\n

Papenfus is the lone full-time emergency room doctor in the town of 900, not far from the Kansas line.<\/p>\n

\u201cI\u2019m chief of staff and medical director of everything at\u00a0Keefe Memorial Hospital<\/a> currently in Cheyenne County, Colorado,\u201d he said.<\/p>\n

With Papenfus sick, the hospital scrambled to find a replacement. As coronavirus cases in rural Colorado, and the state\u2019s Eastern Plains especially, surge to unprecedented levels, Papenfus\u2019 illness is a test case for how the pandemic affects the fragile rural health care system.<\/p>\n

\u201cHe is the main guy. And it is a very large challenge,\u201d said Stella Worley, CEO of the hospital.<\/p>\n

If she couldn\u2019t find someone to fill in while he was sick, Worley might have to divert trauma and emergency patients nearly 40 miles north to Burlington.<\/p>\n

\u201cTime is life sometimes,\u201d she said. \u201cAnd that is not something you ever want to do.\u201d<\/p>\n

\u2018The \u2018Rona Beast Is a Very Nasty Beast\u2019<\/strong><\/p>\n

As deaths from the coronavirus have surpassed 250,000 in the U.S., new data show the pandemic has been particularly lethal in rural areas \u2014 it\u2019s taking lives in those areas at a rate reportedly nearly\u00a03.5 times higher<\/a>\u00a0than in metropolitan communities.<\/p>\n

About 63 people in Cheyenne County<\/a> have been diagnosed with COVID-19, most of them in the past three weeks.<\/p>\n

Papenfus, a lively 63-year-old, was discharged after a nine-day stay at St. Joseph\u2019s Hospital in Denver, and he was eager to sound the alarm about the disease he calls the \u2018rona.<\/p>\n

\u201cThe \u2018rona beast is a very nasty beast, and it is not fun. It has a very mean temper. It loves a fight, and it loves to keep coming after you,\u201d Papenfus said.<\/p>\n

He isn\u2019t sure where he picked it up but thinks it might have been on a trip east in October. He said he was meticulous on the plane, sitting in the front, last on, first off. But on landing at Denver International Airport, Papenfus boarded the crowded train to the terminal, and soon alarm bells went off in his head.<\/p>\n

\u201cThere are people literally like inches from me, and we\u2019re all crammed like sardines in this train,\u201d Papenfus said. \u201cAnd I\u2019m going, \u2018Oh, my God, I am in a superspreader event right now.’\u201d<\/p>\n

An airport spokeswoman declined to comment about Papenfus\u2019 experience.<\/p>\n

A week later, the symptoms hit. He tested positive and decided to drive himself the three hours to the hospital in Denver. \u201cI\u2019m not going to let anybody get in this car with me and get COVID, because I don\u2019t want to give anybody the \u2018rona,\u201d he said. County sheriff\u2019s deputies followed his car to ensure he made it.<\/p>\n

Once in the hospital, chest X-rays revealed he\u2019d developed pneumonia.<\/p>\n

\u201cDude, I didn\u2019t get a tap on the shoulder by \u2018rona, I got a big viral load,\u201d he texted a reporter, sending images of his chest scans that show large, opaque, white areas of his lung. Just a week earlier, his chest X-ray was normal, he said.<\/p>\n

Back in Cheyenne Wells, Dr. Christine Connolly picked up some of Papenfus\u2019 shifts, although she had to drive 10 hours each way from Fort Worth, Texas, to do it. She said the hospital staff is spread thin already.<\/p>\n

\u201cIt\u2019s not just the doctors; it\u2019s the nurses, you know. It\u2019s hard to get spare nurses,\u201d she said. \u201cThere\u2019s not a lot of spares of anything out that far.\u201d<\/p>\n

Besides himself, six other employees \u2014 out of a staff of 62 at Keefe Memorial \u2014 also recently got a positive test, Papenfus said.<\/p>\n

Hospitals on the Plains often send their sickest patients to bigger hospitals in Denver and Colorado Springs. But with so many people around the region getting sick, Connolly is getting worried hospitals could be overwhelmed. Health care leaders created a new command system to transfer patients around the state to make more room, but Connolly said there is a limit.<\/p>\n

\u201cIt\u2019s dangerous when the hospitals in the cities fill up, and when it becomes a problem for us to send out,\u201d she said.<\/p>\n

\u2018Bank Robbers Wear Masks Out There\u2019<\/strong><\/p>\n

The impact of Papenfus\u2019 absence stretches across Colorado\u2019s Eastern Plains. He usually worked shifts an hour to the northwest, at Lincoln Community Hospital<\/a> in Hugo. Its CEO, Kevin Stansbury, said the town mostly dodged the spring surge and his facility could take in recovering COVID patients from Colorado\u2019s cities. Now, Stansbury said, the virus is reaching places such as Lincoln County, population 5,700.<\/a>\u00a0It has had 144 cases, according to\u00a0state data<\/a>, and neighboring Kit Carson has had 301. Crowley County to the south, home to a privately managed state prison, has had 1,239 cases. It is far and away the No. 1 most affected county per capita in the state.<\/p>\n

\u201cSo those numbers are huge,\u201d Stansbury said. He said that as of mid-November about a half-dozen hospital staffers had tested positive for the virus; they think that outbreak is unrelated to Papenfus\u2019 case.<\/p>\n

Lincoln Community Hospital is ready once again to take recovering patients. Finances in rural health care are always tight, and accepting new patients would help.<\/p>\n

\u201cWe have the staff to do that, so long as my staff doesn\u2019t get ravaged with the disease,\u201d Stansbury said.<\/p>\n

Rural communities are particularly vulnerable. Residents tend to suffer from underlying health conditions that can make COVID-19 more severe, including high rates of cigarette smoking, high blood pressure and obesity. And Brock Slabach of the National Rural Health Association said 61% of rural hospitals do not have an intensive care unit.<\/p>\n

\u201cThis is an unprecedented situation that we find ourselves in right now,\u201d Slabach said. \u201cI don\u2019t think that in our lifetimes we\u2019ve seen anything like what is developing in terms of surge capacity.\u201d<\/p>\n

A couple of hours east of Cheyenne Wells, COVID-19 recently hit Gove County, Kansas, hard.<\/p>\n

The county\u2019s emergency management director, the local hospital CEO and more than 50 medical staff members tested positive. In a nursing home, most of the more than 30 residents caught the virus; six have died since late September, according to The Associated Press<\/a>. A county sheriff ended up in a hospital more than an hour from home, fighting to breathe, because of the lack of space at the local medical center.<\/p>\n

Papenfus fretted about his home county and its odds of fighting off the virus.<\/p>\n

\u201cThe western prairie isn\u2019t mask country,\u201d he said. \u201cPeople don\u2019t wear masks out there; bank robbers wear masks out there.\u201d He is urging Coloradans to stay vigilant, calling the virus an existential threat. \u201cIt\u2019s a huge wake-up call.\u201d<\/p>\n

Since being released from the hospital, Papenfus has had a rocky recovery. His wife, Joanne, drove him back to Cheyenne Wells, wearing an N95 mask and gloves, while he rode in the back on oxygen, coughing through the three-hour drive.<\/p>\n

Once back at home after that initial nine-day stay, Papenfus hunkered down, with the occasional trip outside to hang out with his pet falcon.<\/p>\n

But a week after going home, he started having nightly fevers. He had a CT scan done at Keefe Memorial, the hospital where he works. It revealed pneumonia in his lungs, so he went back to Denver, getting readmitted at St. Joseph\u2019s Hospital. This time, Papenfus arrived via ambulance.<\/p>\n

Finding a replacement for Papenfus at Keefe has been hard. The hospital is working with services that provide substitute physicians, but these days, with the coronavirus roaring across the country, the competition is fierce.<\/p>\n

\u201cThey\u2019re really scrambling to get coverage,\u201d Papenfus texted from his hospital bed. \u201cWhole county can\u2019t wait for my return but this illness has really taken me down.\u201d<\/p>\n

He said he was now at Day 35 from his first symptoms, lying in his hospital bed in Denver, \u201cwondering when I\u2019ll ever get back.\u201d Papenfus noted that COVID-19 has affected his critical thinking and that he will need to be cleared cognitively to return to work. He said he knows he won\u2019t have the physical stamina to get back to full duty \u201cfor a while, if ever.\u201d<\/p>\n

This story is from a reporting partnership that includes\u00a0Colorado Public Radio<\/a>,\u00a0NPR<\/a>\u00a0and\u00a0KHN.<\/em><\/p>\n

Subscribe<\/a> to KHN’s free Morning Briefing.<\/p>\n

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Kurt Papenfus, a doctor in Cheyenne Wells, Colorado, started to feel sick around Halloween. He developed a scary cough, intestinal …<\/p>\n","protected":false},"author":44,"featured_media":248198,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[37],"tags":[],"class_list":["post-277822","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","mauthors-john-daley","mauthors-colorado-public-radio","mauthors-kaiser-health-news"],"_links":{"self":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts\/277822","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/users\/44"}],"replies":[{"embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/comments?post=277822"}],"version-history":[{"count":1,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts\/277822\/revisions"}],"predecessor-version":[{"id":277823,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/posts\/277822\/revisions\/277823"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/media\/248198"}],"wp:attachment":[{"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/media?parent=277822"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/categories?post=277822"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/canadianinquirer.net\/v1\/wp-json\/wp\/v2\/tags?post=277822"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}