LITTLE ROCK, Ark. — Cleburne County in north central Arkansas is being lauded for its success in controlling an outbreak of coronavirus cases in a sign of what may need to be done in other rural areas of the country.
"Being in a rural area, you don't expect to have a big outbreak like we did, but we were trying to prepare for whatever was coming," said Dr. John Herring, a family practitioner who helped treat patients at Baptist Health Heber Springs clinics. "It was very interesting. It was a very uneasy feeling at first."
Those first cases arrived on March 13, with the first positive test confirmed three days later. Most were connected to one church, Greers Ferry First Assembly, that found out the hard way that you don't need to have COVID-19 symptoms to spread the virus.
"When we found out that there was a large group that were probably going to be positive, it seemed a little overwhelming," said Dr. Herring.
Heber Springs, the Cleburne County seat, has a 25-bed small hospital. Public health experts are warning smaller, rural communities to prepare for the virus arriving and threatening to overrun small hospitals. Chronic underfunding, and now low cash flow, as elective surgeries are put on hold have small communities vulnerable.
Two important things happened that kept the system in Cleburne County from being overrun.
"We really need to give credit to the local health care providers there," said Dr. Jennifer Dillaha, the director of outbreak response for the Arkansas Dept. of Health. "They were very early in arranging access to testing."
While most of the state tried to come to terms with new orders to begin social distancing, health experts got buy-in from the stricken in that county to lock down.
"Those people who were positive for COVID-19 were able to isolate and those who had been exposed were able to quarantine," said Dr. Dillaha.
Dr. Herring said awareness of avoiding unnecessary trips and six-foot spacing set in quickly.
Almost a month after the first case, Cleburne County has around 70 positive results and four deaths. There are also two deaths in neighboring counties attributed to the cluster. But the slow trickle of new cases has won praise from Governor Asa Hutchinson, who singled out the county for flattening the curve.
Dr. Herring said despite the sorrow, there is light that can be shined for similar communities, especially now that he's seeing some of the formally hospitalized in for follow-up visits.
"To see some of the patients come back that are doing well and have recovered, it just gives us all hope that that can happen," he said.
Both Herring and Dillaha also point to a strong network of clinics and hospitals that got seriously ill patients to larger facilities in Little Rock. The Heber Springs clinics also never had to worry about a shortage of personal protective equipment.