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Marcus J. Hopkins
Feb 14, 20233 min read

COVID-19 Risks Still High in Central Appalachia


COVID-19 Rates in Central Appalachia - February 14th, 2023. A map highlighting U.S. counties in green, yellow, or orange based upon the level of COVID-19 activity reported by those counties. These data are collected from the Centers for Disease Control & Prevention, 2023. Follow us @APPLIOrg on Facebook, Instagram, LinkedIn, Pinterest, Twitter, YouTube, and Post.
Source: Centers for Disease Control & Prevention, 2023

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:

  1. New cases: Total new COVID-19 cases per 100,000 population in the past 7 days

  2. Hospital admissions: New COVID-19 hospital admissions per 100,000 population in the past 7 days (regional)

  3. 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)

An historical map of the Central Appalachian Bituminous Coalfield from 1932
Source: Nelson, et al., 2013

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:



References


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/

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