New data reveals coronavirus hotspots brewing across the south, where the pandemic is set to 'hit hard'

• Data analysts at UChicago say they're concerned that the South may be the next hot spots to be 'hit hard' by the coronavirus in the US
• This is based on data that they've been looking at on the county level, the latest of which has shown emerging hotspots in areas near Albany, Georgia and New Orleans, Louisiana.
• Some areas may feel the impact of the virus more severely than others because of factors like limited hospital resources, delayed enforcement of social distancing guidance, and limited healthcare access, especially in more rural areas, according to Marynia Kolak, assistant director for health informatics at the Center for Spatial Data Science at the University of Chicago (CSDS)
• George Pink, deputy director of the North Carolina Rural Health Research Program, said that hospitals in rural areas, especially those in the South, tend to be strapped for both cash and personnel.
• A crisis like COVID-19, he said, may lead some residents to seek care in urban settings because they aren't able to get what they need in their own communities. It could also push some already struggling hospitals into bankruptcy.
• Read live updates about the coronavirus here

The next areas to be hit hard in the US by coronavirus outbreaks may be in the south.

While severe outbreaks in states like New York have gained much of the attention, analyzing infection rates compared to population in smaller areas reveals more troubled areas. States like Louisiana and Georgia have areas with infection rates similar to New York city.

New York City has a confirmed count of 51.07 COVID-19 virus cases per 10,000 people, according to data from the Center for Spatial Data Science at the University of Chicago as of Thursday. Dougherty County in Georgia and the New Orleans area of Louisiana have similar rates, of 51.18 and 47.07 cases per 10,000 people, respectively.

Some states in the West, like Idaho and Colorado, have concerning areas as well. Blaine, the county in Idaho where Sun Valley is located, has one of the highest rates of confirmed cases in the US with 87.30 cases per 10,000 people. Gunnison, a mountainous area in Colorado, has a rate of 49.59 cases per 10,000 people.

'We're catching it one to two days before it gets really obvious in the news'

"It's changing on a regular basis for sure," said Marynia Kolak, assistant director for health informatics at the Center for Spatial Data Science at the University of Chicago (CSDS). She told Business Insider that last week she was concerned about bigger cities like Miami, Detroit, and Chicago, that seemed "just as severe as NYC from a stats perspective."

But looking at cases on a population-weighted basis especially, the data shows clusters of cases before they become obvious to the public, especially in the south.

Albany, Georgia, Kolak said, is one of the first such clusters CSDS found. Once she saw a cluster there, Kolak said she reached out to friends in the area to see what they were seeing on the ground.

"They send back local news reports of ICU beds being filled up," Kolak said.

Read more: The next wave of coronavirus outbreaks is threatening cities from New Orleans to Philadelphia, and it reveals the US is on pace for a national epidemic

When the group saw St. Louis show up on their radar this week, Kolak said she thought the huge leap in numbers may have been a bug at first until they got news that the area had one of the highest changes in COVID-19 cases overnight

"That's almost the frustrating part," Kolak said. "We're catching it one to two days before it gets really obvious in the news, but locally people are already aware of it."

'It's a compounding crisis'

The south is an area Kolak is particularly worried about. Those states have some of the highest uninsured rates in the US, because lawmakers decided not to expand health insurance coverage to low income people via the Medicaid program.

"I think the south is going to get hit pretty hard," Kolak said. "It's a compounding crisis where a lot of states there chose not to expand Medicaid, and there's generally a lot less access to health insurance."

Kolak listed a host of challenges facing rural areas: lower incomes, more seniors, delayed enforcement of social distancing guidance, and less access to hospitals and healthcare services.

"It just creates this perfect storm of things," she said. "It seems like the closer you are to an area that's been strongly hit, the more likely you are to take it seriously and stay home but even if there are just a few cases somewhere, this is such an infectious disease. Containing it is so important."

There is also strong evidence to suggest that COVID-19 patients with underlying health conditions, like high blood pressure, diabetes, and heart disease, are at higher risk for death once they contract the virus. 2017 data from the Centers for Disease Control and Prevention indicates that residents in the south have some of the highest rates of high blood pressure in the US.

Rural hospitals are in a more difficult financial situation

George Pink, deputy director of the North Carolina Rural Health Research Program, said that hospitals in rural areas, especially those in the south, tend to be strapped for both cash and personnel.

"Rural hospitals across the country are less profitable and in more precarious financial positions than urban hospitals," Pink said. "But amongst hospitals losing money, a disproportionately higher percentage are in the south."

Read more: NYC's healthcare workers are at a greater risk of getting the novel coronavirus. They're also not getting tested.

This means that a lot of rural hospitals in the south are going into this epidemic in a risky financial position.

"I'm expecting to see some rural hospitals close because they don't have any cash," said Pink.

And while hospitals in urban areas like New York City are already facing a shortage of healthcare workers amid the crisis, rural areas - which already often have a shortage of physicians and nurses in rural areas - may face even harsher realities.

"If some of them get sick or decide the job is not worth the risk, they don't want to expose their families, the staffing could be just as much of a crunch issue as the cash," Pink said. And this could lead some residents to seek care in urban settings because they aren't able to get what they need in their own communities.

"There's going to some people getting care elsewhere, places other than where they would usually get their care," Pink said.

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