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Small towns continue to struggle during the COVID-19 pandemic. 

While the world has largely focused on how the COVID-19 pandemic has affected international cities and central hubs for millions of people, rural towns like Sibley, Iowa, have often been overlooked. 

“Figuring out how we were going to be able to safely test people for COVID without infecting ourselves and others was a big challenge, especially in a rural environment with not a lot of resources,” said Rachel Wilcinot, a doctor of osteopathic medicine at the Osceola Regional Health Center in Sibley.

Sibley is a town with less than 3,000 residents, which encompasses a Midwestern, rural community. Residents say the county fair is nearly considered to be a holiday and also has sweet corn stands that line the same corners every year. Those who live in Sibley say the town has always been extremely tight-knit and locally based, however, while its locality adds to the town’s charm, it also posed a large challenge during the pandemic.

”I think the hardest part [...] was from getting where we were locally, making local decisions and then adjusting to the guidance as it came out and being blocked into ‘you’ve got to do what you’re told,’” said James Craig, the superintendent of the Sibley-Ocheyedan School District. “You can’t not follow the guidance you receive and put the district in danger of liability if something were to happen.”

Candi Norgaard, a medical laboratory technician at the Osceola Regional Health Center, explained the difficulty of changing guidelines.

“At the beginning, it was minute by minute [that] they [health care professionals] were changing it [COVID-19 guidelines]. Then hour by hour. There were so many unknowns and nobody really knew what was going on,” Norgaard said. 

Norgaard continued to detail the differences of what her job entails daily versus what it entailed before the pandemic.

Norgaard said that as a small town health center, only a few employees have to do a wide range of jobs and tasks. For example, according to Norgaard, on an average day, she would draw a patient’s blood, process the specimen, run the samples and send them over to the clinic.

In addition to the daily tasks, Norgaard said there is also a set time from 1 p.m. to 3 p.m. that there is testing for coronavirus every five minutes.  

Instead of the mass testing centers that are scattered around the world and across the United States, Norgaard details the two-person method of COVID-19 testing small health facilities use instead. 

”We have one person that gowns… and we have what we call is a ‘buddy,’ who stands inside the emergency door. So we go outside, talk to the patient and collect the specimen, and then we roll it up in a bag and they hold open a clean bag. We put it in that bag and take it inside,” Norgaard said.

According to Norgaard, having a small medical staff provide care for even five inpatient individuals can be extremely time-consuming. She said testing and caring for COVID-19 patients can take up to multiple hours for a single employee.

When asked about how COVID-19 precautions, such as wearing masks and social distancing, have affected her job, Wilcinot contributed another challenge. 

“[...] it [wearing a mask] has really affected patient interaction,” Wilcinot said. “A large number of my elderly patients rely on reading my lips to fully hear and understand me, and so communication has been much more poor.”

Wilcinot also said some patients do not feel comfortable with her touching them. 

“I have been asked a few times to not listen to a patient’s heart or lungs,” Wilcinot said. 

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Main Street in Sibley, Iowa.

When discussing how COVID-19 and its precautions have affected the community, Julie Ackerman, owner of The Porch on Main, a local ice cream parlor and gift shop, said that while the residents of Sibley are trying to stay positive, it remains to be a losing battle.

“People are trying to stay upbeat, but after awhile, it’s just exhausting,” Ackerman said. “I’m on a lot of committees, and so the activities that we had planned for November and December can’t happen. So I think people are sad.”

While Ackerman said her shop hasn’t experienced much financial trouble due to the virus, much to the help of social media and online sales, Craig offered a different perspective.

Craig discussed how the regulations for school activities will affect the school’s income. According to Craig, only being able to allow a certain amount of spectators at school events and sports games will drastically decrease the amount of income the school makes.

”When you have to pay for officials, and officials cost you $500 to $600 a night and you’re only bringing in $200 to $300 on your gate, where you’d normally bring in $900 to $1,500 dollars, it’s a significant impact,” Craig said.

In addition to timing, communication and financial challenges, COVID-19 has also brought more political conflicts. Craig said there are challenges around the conversation because they seem to not be about health at all. 

“[...] I strongly believe that this is not a political rights issue, I think it’s a public health issue, and some people don’t get that,” Norgaard said. “They’re [citizens of Sibley] more worried about their rights being taken away.”

While Wilcinot and Ackerman both said the residents of Sibley are being cautious and respectful of one another, Wilcinot continued to say there are many differing opinions on the COVID-19 regulations. 

“I expect this is everywhere, but I have definitely noticed a wide range of opinions on mask wearing, personal freedoms, attending school, etc. In general however, I think the community has been respectful of each other,” Wilcinot said.

Norgaard, however, said residents of Sibley think COVID-19 is the same as the flu, but she has witnessed that COVID-19 is very different from the flu. 

While Ackerman, Craig, Norgaard and Wilcinot all expressed the stress and intensity of COVID-19 and its effects on the citizens of the community, Wilcinot offered the importance of continuing hope.

“Don’t get me wrong, I wear my mask at work and do my best to protect my patients, and I have had a handful of patients pass away from the virus,” Wilcinot said. “I also see every day what the new rules and regulations do to the mental and physical health of my elderly nursing home patients, to the anxiety- and depression-ridden teens and to the patients whose diagnosis of another life-threatening disease has been delayed.

“In some instances, I think the nearby or even personal reality has made people take the virus more seriously, but it has also made a large number of people realize they want to get on with their lives.” 

Wilcinot said how her faith in a higher power has made it easier to cope with the constant stress of the virus and has encouraged her to stay motivated.

“I know that the same power helps me to care for people to the utmost of my ability, so I trust daily that I am doing my best, and what is meant to happen will happen,” Wilcinot said.

Craig also expressed the importance of adapting and pressing onward.

“So, as we move forward, as the guidance changed and the science changed and the situation changed, we’ve been able to adapt […]," Craig said. "We’re moving forward.”

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