COVID-19 Risks Still High in Central Appalachia
By: Marcus J. Hopkins
February 14th, 2023
A recent report from Kentucky Today brought attention to the levels of Coronavirus-19 (COVID-19) in Kentucky's 120 counties. According to their reporting on February 10th, 5 Kentucky counties remained in the Red, or high risk, zone, 40 counties remained in the Yellow, or moderate risk zone, and the remaining 75 counties had progressed to the Green, or low risk, zone (Latek, 2023).
The Centers for Disease Control and Prevention (CDC) determines COVID-19 Community Levels by examining three metrics to assess the level of risk in each U.S. county:
New cases: Total new COVID-19 cases per 100,000 population in the past 7 days
Hospital admissions: New COVID-19 hospital admissions per 100,000 population in the past 7 days (regional)
Hospital beds used: The 7-day average percent of staffed inpatient beds occupied by COVID-19 patients (regional) (CDC, 2022).
From both the map in Latek's reporting and the map that the Appalachian Learning Initiative (APPLI, pronounced like "apply") retrieved on February 14th, 2023, counties in the central Appalachian Region, including those in Kentucky, Tennessee, Virginia, and West Virginia, are still rated as being moderate- or high-risk.
Many of the counties in those areas lie along major U.S. Interstates, including:
Interstate 79 (connecting Morgantown, WV, to Charleston, WV)
Interstate 64 (connecting Charleston, WV, to Lousiville, KY)
Interstate 75 (connecting Louisville, KY, to Knoxville, TN)
Interstate 81 (connecting Knoxville, TN, to Wytheville, VA)
In addition to those major Interstates, the counties still hardest hit by COVID-19 lie in the Central Appalachian bituminous coalfield that spans from central Pennsylvania to northern Alabama (Nelson, et al., 2013).
While the initial push for COVID-19 vaccination was successful in those coalfield counties, follow-up for the second dose in the primary two-dose series was low, with between just 40% and 69.9% of the population in those counties receiving the entire primary series (CDC, 2023).
While definitive research has yet to be completed and is unlikely to be completed for several years, a combination of factors is thought to have contributed to vaccine hesitancy in the region, including, but not limited to:
Limited access to vaccine supplies, particularly in rural and geographically isolated counties
Low health literacy
Transportation barriers, including a lack of public transportation and unreliable personal transportation
Healthcare access barriers, including a lack of operating hours for vaccine delivery
Generational mistrust of government institutions
Misinformation and disinformation about the COVID-19 vaccine, specifically, and vaccines in general
With local, state, and federal elected and appointed officials informing the public that the worst of COVID-19 is behind us, many counties have chosen to either reduce or end their coverage of the COVID-19 pandemic, particularly those in parts of the country where leaders balked at common and science-based public health measures, such as quarantines, vaccine requirements, and shutdowns.
Persons living in counties where the COVID-19 Community Levels indicate a moderate-to-high-risk of contracting COVID can find a vaccine location near them by using the following website:
Centers for Disease Control and Prevention. (2022, August 11). COVID-19 by County. Atlanta, GA: United States Department of Health and Human Services: Centers for Disease Control and Prevention: National Center for Immunization and Respiratory Diseases: Division of Viral Diseases. https://www.cdc.gov/coronavirus/2019-ncov/your-health/covid-by-county.html
Centers for Disease Control and Prevention. (2023, February 14). COVID-19 Integrated County View. Atlanta, GA: United States Department of Health and Human Services: Centers for Disease Control and Prevention: National Center for Immunization and Respiratory Diseases: Division of Viral Diseases. https://covid.cdc.gov/covid-data-tracker/#county-view?list_select_state=all_states&list_select_county=all_counties&data-type=Vaccinations&metric=Administered_Dose1_Pop_Pct&metric-vax=Series_Complete_Pop_Pct
Latek, T. (2023, February 10). COVID community levels showing more green counties. Louisville, KY: Kentucky Today. https://www.kentuckytoday.com/news/covid-community-levels-showing-more-green-counties/article_48abbe22-a983-11ed-96fc-ff4e64ca5bbd.html
Nelson, R.K., et al. (2013). Atlas of the Historical Geography of the United States, ed. John K. Wright. Washington, D.C.: Carnegie Institution. https://dsl.richmond.edu/historicalatlas/6/a/