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KSMU is dedicated to broadcasting critically important information as our community experiences the COVID-19 pandemic. Below, you'll find our ongoing coverage.

As COVID-19 Swells In Rural Missouri, Rugged Individualism Starts To Have Statewide Consequences

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File photo, courtesy of Downtown Antiques
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The Downtown Antique Mall is one of several businesses and restaurants on the historic court square in West Plains, Missouri.

Early in the pandemic, Missouri’s rural counties were largely spared from COVID-19. 

But now, many of state’s highest rates of infection are in rural areas. In this first segment of our four-part series, COVID in the Rural Ozarks, we look at one county’s tension between rugged individualism and regulating public health.

A history of tension over government regulation 

The people of the rural Ozarks hills and hollows have long been known for their independence and their distrust of authority.  To understand why, you have to turn back several pages in the history books.

Ozarks folklorist Marideth Sisco of Howell County says the mistrust of government stretches back to at least the early 1900s, when state officials descended upon the rural Ozarks to offer “help” with agricultural projects. But officials upended traditional farming practices. And that didn’t sit well with locals who had journeyed here in covered wagons seeking opportunity to do things their own way. 

“The most hated phrase anybody could think of is, 'I’m from the government and I’m here to help you,'” Sisco said. 

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Credit Marideth Sisco
Marideth Sisco, a musician, folklorist and storyteller, lives in Howell County, Missouri.

Sisco said this distrust of outsiders—particularly the government—deepened in the 1960s when officials evicted rural residents to clear land for the Ozark National Scenic Riverways. 

“And so they came in to make the national park. And first of all, they took these historic homesteads that had been in the same family since early frontier days, and they handed a dollar or two and said, ‘Get out,'" Sisco said.

But now, some health leaders in Missouri’s metropolitan areas are worried that this fierce independence has become a stumbling block in the fight against the coronavirus.

How the rural COVID swell is impacting more populated areas

On Friday, Steve Edwards, president and CEO of CoxHealth in Springfield, tweeted that Howell County in south-central Missouri was the third-highest county for COVID admissions to the Springfield hospital for the second week in a row. 

The number of Howell County COVID patients admitted to the Springfield health care system was nearly a third of the number of COVID admissions from Greene County, even though the overall population of Howell is only one seventh the overall population of Greene County.

That tweet came on the same day that Springfield’s hospitals reached a staggering 184 hospitalizations for COVID-19.  To put that in perspective, the COVID unit at one of Springfield’s two main hospitals, CoxSouth, was built to accomodate 51 beds—in other words, rural patients are now causing a real strain on Springfield hospitals.

And yet, few municipalities or counties in rural areas currently have regulations on large groups, social distancing, or universal masking in public—even though the Centers for Disease Control and Prevention, or CDC, says those effectively slow the spread of the coronavirus.

Missouri is among the states that have not issued a statewide mandate for wearing face masks.

Without state mandates, rural governments face a thorny dilemma

That independent, Ozarks spirit was on full display at an August forum in West Plains, the county seat of Howell County. Many residents were there to passionately argue against a mask ordinance. The theme that emerged centered on freedom.  

West Plains Civic Center
Credit Meetmags.com
The West Plains Civic Center was the site of public discussion on a masking ordinance in August.

West Plains resident Joyce Oak said the ordinance would be a dangerous precedent. 

“We are on a slippery slope to totalitarian fascism, and it needs to be stopped,” Oak said from the podium.

Another resident, Clifton Earles, gave a fiery speech, calling City Council members “self-important” and “scalawags” for even considering the ordinance. 

“Since when do you even have the authority to mandate anything?" Earles asked. "You derive your authority from the consent of the governed. You work for us, you do not rule us, and we do not consent.” 

During that August forum on masks, many residents saw the ordinance as an overreaction because, at the time, COVID cases were low in Howell County compared to Springfield. That included resident Wayne Hunter. 

“Our hospital is not overflowing with COVID patients. Our morgues are not full of dead bodies. And this mask mandate is unnecessary and misguided,” Hunter said. 

But things have changed since then.

Cases in Howell County have climbed from 40 to about 1,400, and several families are reporting that the local hospital couldn’t admit their loved ones with COVID-19 because it had reached capacity. The hospital, Ozarks Medical Center, declined our request for an interview.

So far, at least 20 Howell County residents have died from the disease. And according to the public health department, every nursing home in Howell County except one currently has an outbreak of COVID-19.

A handful of residents at that forum supported a mask mandate. Terry Sanders was one of them. 

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Credit Facebook Live Screenshot / Governor Mike Parson on Facebook
Missouri's governor, Mike Parson, center, has not issued a statewide mandate for face coverings. Instead, he has left the decision up to local governments.

“I, for one, am willing to be inconvenienced a little bit and wear a mask for 90 days," Sanders said. "If doing so keeps one other person safe in our community, it’s worth every bit of the headache.”

But the masking ordinance failed to pass in West Plains.

Even at a public health board meeting on October 6, the president of the Howell County Health Department board, Dr. Robert Shaw, opposed a masking mandate. Our audio of that is courtesy the West Plains Daily Quill, a local newspaper. 

“And I’m fine to say, ‘No, I do not recommend a mask ordinance,'” Shaw said in the public meeting. 

Shaw said a mask mandate would be too controlling and hard to enforce. He argued it would hurt the local economy too much and, once again, pointed to freedom.

“And it comes down to this: at what point do we draw the line between individual freedom, and doing something that protects other people, and not doing something that protects other people?” Shaw asked. 

While the county health department isn’t recommending a mask mandate, it is working to control the spread of COVID-19 after infections occur. The health department is hiring more contact tracers and they’re working seven days a week to fight the surging tide of cases.

We reached out to the Howell County Health Department for further comment but we were unable to connect by our deadline.

Impact on elderly, special needs residents

Meanwhile, West Plains resident Susan DeMuria wishes local authorities would issue new restrictions—because leaving it up to “personal responsibility” isn’t stemming the tide. DeMuria has asthma and she’s spent almost the entire pandemic isolating and gardening at her home.

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Credit Photo submitted
Susan and Michael DeMuria live in West Plains, Missouri.

"I have been in the ICU with asthma, and I know what it's like not to be able to breathe. So, for me this is real. I know what this feels like, and I am petrified," she said, on the verge of tears.

She moved to West Plains about 15 years ago with her husband, who’s a cardiovascular perfusionist at a Columbia hospital. The couple decided not to see each other for a while because of DeMuria’s asthma, which is a health risk for COVID-19 complications.

She says she feels hurt that people around her don’t believe in masking or other health precautions. 

“I just really did not feel that they cared about people like me at the city level, at the county level, at the state level," DeMuria said. "And I’m without my husband, who is working every day and doing things to help people, literally keeping people alive, and I can’t even go to the grocery store.” 

DeMuria said while others refuse to follow temporary, public health rules because of their freedom, it’s actually restricting the freedoms of more vulnerable people—like the elderly or those with medical needs.

On Friday, West Plains officials issued a new policy requiring masks in city buildings. But for everywhere else in Howell County, the official position is:  masks, distancing and keeping gatherings small are just encouraged, not required. 

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Credit Daniel Robers / Pixabay
World public health agencies have identified that the pandemic disease COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2.

The World Health Organization has said a general rule of thumb for determining if the virus is under control is if the percent of positive coronavirus tests is below 5%.

Missouri’s health department reported Saturday that the positivity rate over the last seven days is 19.7% statewide.  Howell County’s positivity rate sits at 29.6 %.  Six counties reported rates above 50%, and all six of those are considered rural.

KSMU-Ozarks Public Radio is streaming at www.ksmu.org. From your radio, hear KSMU in the following cities on these channels: KSMU: 91.1 FM - Springfield; KSMS: 90.5 FM - Point Lookout/Branson; KSMW: 90.3 FM - West Plains; 88.7 FM - Mountain Grove; 98.9 FM - Joplin; and 103.7 FM - Neosho.

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