By John Mark Shaver Fairmont News Editor/State Journal

FAIRMONT — With the COVID-19 pandemic still working its way through the country, officials are worried that many community and rural hospitals in West Virginia won’t be handle the extra burden.

While West Virginia hasn’t been hit as hard as many other states, pre-existing issues related to the state’s public health system are causing worry. Debrin Jenkins, the executive director of the West Virginia Rural Health Association, said the state’s hospitals were already under severe stress before the pandemic hit.

“They’ve been running in the red for quite some time due to the way the payment schedules are set up,” Jenkins said. “I’m very concerned about these hospitals. They have a larger pool of people on Medicaid and Medicare and people who are uninsured, and they have to absorb those costs.

“We’re usually third in the nation in (elderly population). Along with that, we have the highest instances of diabetes, heart disease and Hepatitis C. … We have many people who have worked in high-risk industries like mining and logging. We have an opioid epidemic here. … There’s a perfect storm brewing here in West Virginia, unfortunately.”

Just as the pandemic began to hit West Virginia in mid-March, Fairmont Regional Medical Center permanently closed its doors after officials claimed the hospital lost more than $19 million over the course of three years.

While WVU Medicine has announced plans to set up shop in the former hospital’s building while construction crews build a new hospital, the hospital has remained non-functioning during the pandemic.

Mon Health Systems also has filed paperwork to potentially build a hospital and/or serve the Marion County area.

In a press conference with local media before the hospital closed — and before COVID-19 precautions went into place — Gov. Jim Justice expressed his concern that Fairmont Regional Medical Center’s closing would be the first domino to fall that could lead to other closures in the state.

“(People) should be afraid,” Justice said. “What it all boils right down to is, if we don’t take this thing head-on right now and try to find a solution, we’re going to lose hospitals all around the state. When we lose hospitals all around the state, we’ve got a problem like you wouldn’t imagine. We don’t need to have that happening.”

In a media call in April, Sen. Joe Manchin, too, expressed his concerns for the “strained and underresourced” health-care system, one that he said faces the same problems as many other areas of the country.

“We have lost, and not just in West Virginia but in the country, since 2010, 128 rural hospitals have closed, including eight this year already, and they’re on the chopping block every day, and we’ve got to make sure that we’re able to direct this assistance and payments directly to them,” Manchin said. “As you know, rural communities generally have higher rates of chronic health conditions like heart disease and diabetes, and all the hard work they usually do makes them susceptible, so we have to make sure that we’re able to meet that.

“Nearly 90 percent of patients who have been hospitalized for COVID-19 have underlying health conditions, so this is all something that we should basically be very attentive to.”

Jenkins said the state was not prepared to handle a pandemic of this magnitude, and that COVID-19 has already deeply impacted the state’s rural hospitals and health systems, even in areas in which the virus itself isn’t very active.

“(Hospitals) don’t have any way to get any kind of income because people aren’t getting surgeries,” Jenkins said. “It’s cutting in and making the ‘red’ deeper. As people get sick and they don’t have the staff, it could be a problem.

“People say you can use telehealth, but not in West Virginia because we don’t have that connectivity, and even if we did, the elderly population we have doesn’t have a computer or the knowledge of how to use it, so they can’t even field for telehealth.”

Thanks to the limited services offered under state social distancing guidelines and precautions, Jenkins said that if a person goes into one of these rural hospitals to get treated — whether it be for COVID-19 or something else — they currently don’t have the staffing and room to help if things take a turn for the worse or if there’s another spike in the virus.

“A lot of these hospitals have reduced a lot of services,” Jenkins said. “If someone comes in with something really, really serious, they try to stabilize it, and then (the patient) is moved to a larger hospital. If the pandemic hits here like I think it will — because I don’t think we’ve reached the peak by any means — those hospitals don’t have the depth and beds and PPEs and the staff.”

Because of the complexity of the issue, Jenkins said that she doesn’t believe Fairmont Regional will be the last West Virginia hospital to close, and she worries that worst of COVID-19 is yet to come for West Virginia.

“There’s going to be more hospital closures after this,” Jenkins said. “We’ll have driven them over the edge. It’ll cause more and more issues with the availability of quality healthcare, especially in rural areas. I think rural areas are going to be the next to be really hit, and I think there will be more deaths because nobody is going to think about us.”

Jenkins said that she laments that the state government and healthcare systems weren’t more prepared for the pandemic, and she hopes that the state’s hospitals and residents can do what they can to survive the COVID-19 pandemic.

“We should have been prepared for this,” Jenkins said. “We knew statistically and historically that a pandemic was coming... We were standing on the tracks, looking at the train, and we did nothing to get out of the way. That’s what really frustrates and angers me.”