<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1604085345802.png" alt="The coronavirus positivity rate in southwestern Kansas' Finney County was 31% from Oct. 12-16. The county's has added 700 cases in a month. Corinne Boyer / Kansas News Service" />
 <figcaption>The coronavirus positivity rate in southwestern Kansas' Finney County was 31% from Oct. 12-16. The county's has added 700 cases in a month. Corinne Boyer / Kansas News Service</figcaption>
 </figure>By NOMIN UJIYEDIIN <a href="https://www.kcur.org/news/2020-10-30/western-kansas-is-full-of-coronavirus-hot-spots-tying-up-icu-beds">Kansas News Service</a>For the first time during the pandemic. Dr. Drew Miller was unable to
 send a severely ill COVID patient to the intensive care unit.Miller
 and other staff at the Kearny County Hospital, in southwestern Kansas, 
had done what they could last weekend, putting the patient on a maximum 
oxygen flow. But the closest ICU in the area was one county over — St. 
Catherine Hospital in Garden City — and it was full. The nearest open 
ICU bed was in Kansas City, seven hours away.By the time an ICU bed opened up at St. Catherine, the patient needed to be intubated and was in much worse condition.The
 experience was “uncomfortable. And unwanted,” said Miller, who is the 
hospital’s chief of staff and the county’s lead medical officer.It
 brought home a reality that many in western Kansas have been trying to 
avoid: The coronavirus is here, it is getting worse and it will put a 
strain on a rural health care system that is already sparse and 
understaffed. Overall, Kansas has more than 85,000 cases. And as 
of Friday, five rural Kansas counties were among the top 20 U.S. 
counties with the highest number of COVID-19 cases per resident, 
according to <a href="https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html" target="_blank">The New York Times</a>.Kearny
 County is not one of them. It had opted out of the state’s mask 
mandate, as permitted this summer. But on Oct. 14, the county began <a href="https://www.kearnycountykansas.com/wp-content/uploads/2015/02/Resolution-20-2110142020.pdf" target="_blank">requiring masks</a> in public spaces and limiting mass gatherings to 25% occupancy.As of Friday, the county has seen 160 <a href="https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas" target="_blank">COVID-19 cases</a> over the course of the pandemic, 58 of them diagnosed in October. It’s <a href="https://www.kearnycountyhospital.com/covid-19-public-risk-level-guidelines/" target="_blank">currently</a> at Level 4, the highest level on a county-created <a href="http://www.kearnycountyhospital.com/wp-content/uploads/2020/08/Alert-Guidelines.pdf" target="_blank">rubric</a>
 of pandemic severity, indicating a rapidly increasing number of people 
are testing positive for COVID-19 and seeking medical treatment.Even so, Miller said, it’s been hard to convey the growing threat of the virus, especially with such widespread misinformation.“Our
 county health voice has just been drowned out,” Miller said. “It’s hard
 to get people to wear a mask when they don’t feel it, when they don’t 
see what we see every day, which is more sick people and more severe 
cases.”<h2>The absence of mask mandates</h2>In nearby Finney County, <a href="https://www.finneycounty.org/755/Coronavirus-COVID-19" target="_blank">positivity rates</a>
 for the coronavirus reached 31% between Oct. 12-16. As of Friday, there
 had been 2,766 cases in the county, 700 of them reported since Sept. 
30.The virus is spreading widely throughout the community, Finney County Health Department Director Colleen Drees said.“I
 wouldn’t say that there’s any specific outbreaks that are causing it,” 
Drees said. “We’ve had several people that have reported that they’re 
not sure where they contracted COVID because they’re unsure of who near 
them was sick.”Earlier this year, Finney, Ford and Seward counties — home to four meatpacking plants and 25% of the nation’s beef processing — <a href="https://www.hppr.org/post/emails-show-kansas-agencies-helped-keep-meatpacking-plants-open-despite-concerns-about" target="_blank">saw a massive spike in cases</a>. According to <a href="https://www.coronavirus.kdheks.gov/160/COVID-19-in-Kansas" target="_blank">state data</a>,
 21 clusters have been linked to meatpacking plants, as well as more 
than 3,600 cases, 113 hospitalizations and 19 deaths. Unlike in other 
places, the plants in western Kansas did not close.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1604085485371.png" alt="The National Beef plant in Dodge City was the site of coronavirus cases earlier this year. Bethany Wood" />
 <figcaption>The National Beef plant in Dodge City was the site of coronavirus cases earlier this year. Bethany Wood</figcaption>
 </figure>Dr. R.C. Trotter, an advisor for Ford County, said its numbers (3,491
 as of Oct. 30) are no longer as concerning. To his knowledge, the 
county does not track current moving averages of positivity rates or 
case numbers, which are common measures for COVID severity.Ford 
County does not have a mask order, but Trotter said he sees most people 
wearing masks in public places, and many indoor gatherings have been 
cancelled. He called the question of a mandate “political.”“I sit
 on the fence, I’ll be honest,” he said. “Is it worth it for me to go 
out and fall on the sword, which quite honestly, a lot of public health 
officers are? We’re seeing the rebuttal for that.”While other 
health officials have warned for months that the fall and winter would 
bring a rise in cases — which appears to be happening across a large 
swath of the country — Trotter said he doesn’t think there’s any 
scientific evidence that the colder weather increases cases.“It’s conjecture. We don’t know,” he said.Officials
 in the Finney County government and in Garden City, the largest city 
and county seat, have yet to issue any orders relating to coronavirus 
precautions, such as a mask mandate, gathering ban or social distancing 
rules. Leaders opted out of Gov. Laura Kelly’s statewide mask mandate in
 the summer.The county’s medical director has asked the county and city governments for a mask order through the summer and fall.The
 county commission meets next on Monday, Nov. 2. Commissioner Dave Jones
 said COVID would likely be on the agenda, but he wasn’t sure whether a 
mask order would be. Jones also said he was concerned a mask mandate 
would be too overbearing on local schools, and preferred to let the 
districts make that decision.Finney County Commissioner Duane 
Drees supports mask wearing, social distancing and other recommendations
 of doctors, but said he doesn’t feel a mandate is necessary or even 
enforceable.“There is a limit to what common sense and the public
 will tolerate,” he said. “You don’t need a law to protect people from 
their own self. That’s why God gave us common sense.”Drees said 
social distancing and gathering limits also would be hard to enforce, 
especially in a county with such a large population of people from 
different ethnicities.“African cultures, Asian cultures, 
Hispanic. Family unit is very important to most of these cultures,” he 
said. “And they tend to get together as a family unit more than the 
traditional resident.”Families who have been in the area for "100
 years," Drees continued, “we tend to have assimilated much more and 
drifted away from the family orientation.”He believes it’s harder to tell recent immigrants to follow social distancing rules.“Are they going to pay attention? I doubt it,” Drees said.Garden
 City Manager Matt Allen said the municipal government decided at the 
beginning of the pandemic to defer to the county government for a 
unified message.While a mask mandate is tentatively on the agenda
 for the city’s Nov. 3 meeting, he said it was unclear whether the city 
would decide to depart from the county.<figure>
 <img src="https://media.eaglewebservices.com/public/2020/10/1604085530551.png" alt="St. Catherine Hospital in Garden City has eight ICU beds. Corinne Boyer" />
 <figcaption>St. Catherine Hospital in Garden City has eight ICU beds. Corinne Boyer</figcaption>
 </figure><h2>‘We are desperate’</h2>Finney County Medical 
Director, Dr. Lindsay Byrnes, said she often observes people going 
unmasked in public spaces. When she went to the county administration 
building to vote this week, only one poll worker was wearing a mask, she
 said. Most government employees were not.“I think our leadership failed to take a strong stance and encourage it,” she said.She
 pushed for a mask mandate through the summer and fall. It’s the best 
way, she said, to ensure county residents comply with health precautions
 during a critical time.A recently published <a href="https://ipsr.ku.edu/covid19/images/MaskMandateUpdate.pdf" target="_blank">study from the University of Kansas</a>
 shows counties with mask mandates decreased their seven-day rolling 
averages of daily cases per 100,000 people, while counties without 
mandates have seen those averages increase.“We are desperate to 
explain that this must be a community-wide effort,” Byrnes said. “It 
cannot be only the burden of the health care system. It cannot be the 
burden of a few, it has to be everyone working in concert.”Byrnes
 said school teachers and hospital staff in the county have had to stay 
home from work because they’ve caught the virus out in the community, 
not at their workplaces. That indicates that the virus is widespread, 
and that schools and hospitals may be incapacitated just when the 
community needs them, she said.St. Catherine Hospital in Garden 
City only has eight ICU beds. Patients in serious condition are 
sometimes transferred to facilities in Wichita, Denver or other large 
cities within a few hours’ flight, Byrnes said.If hospitals in those areas also become full, Finney County won’t have any other options.“It’s not sustainable,” she said. “My colleagues are saying, ‘Please, anybody do something. We can’t do this by ourselves.’”It
 feels like health care providers have been abandoned, Byrnes said. She 
used to believe southwest Kansas, where she grew up, was a place where 
neighbors helped each other, no questions asked. But the resistance to 
masks has led her to question her community.“These are the people
 that would go out and cut your wheat if you were in the hospital or had
 a problem in the family,” she said. “Why is this different now? What 
happened? Why aren’t people willing to take care of each other?”Nomin
 Ujiyediin reports on criminal justice and social welfare for the Kansas
 News Service. You can email her at nomin@kcur.org and follow
 her on Twitter <a href="https://twitter.com/nominuj" target="_blank">@NominUJ</a>.

SW Kansas is full of coronavirus hot spots, tying up ICU beds