Coosa County is one of eight counties in Alabama without a hospital and the only one without a public health department – leaving it with no outlets to distribute vaccines for COVID-19.
State officials began distributing 500 doses to county health departments last week. But Coosa County didn’t receive any, said Sheldon Hutcherson, director of the county’s emergency management. A list of vaccine distribution sites published by the Alabama Department of Public Health didn’t include any locations in Coosa County.
“I’m worried we’re being overlooked because we don’t have a health department,” Hutcherson said.
The Coosa County health department closed in 2016, a victim of budget cuts, according to The Anniston Star. A year later, a nurse practitioner closed the only medical clinic in Rockford, the county seat.
That left the town without any medical services for adults until Accordia Health opened in November 2019. Another small clinic operates in Goodwater in the northeastern corner of the county. Coosa County, which has about 10,000 residents, has a single pediatrician and one dentist.
Coosa County sits about an hour south of Birmingham in one of the most rural pockets of the state. Rockford, located near the center of Coosa County, has fewer than 500 residents. Goodwater has about 1,400.
John Burke spent many of his summers in Coosa County when he was growing up, helping his grandparents work land that had been in the family since the 1820s. Several years ago, he decided to move from Birmingham to Coosa County to start a business.
He launched Coosa Fancy Heritage Farm last year, a small operation focused on heirloom vegetables and pasture-raised pork. Many of his neighbors raise timber or keep land for hunting, paying little in the way of property taxes.
“There really are no businesses,” Burke said. “The land here is really cheap, but you don’t get any infrastructure.”
Coosa County is one of the least-populated counties in Alabama, and it has been shrinking for decades. Although it is the only county in the state without a health department, many other small counties have offices that only operate part time.
Health officials have expressed concern about vaccine rollout in rural Alabama since the U.S. Food and Drug Administration authorized the Pfizer vaccine in mid-December. Initial shipments of that vaccine went to hospitals with ultracold storage, bypassing many of the smaller facilities across the state. Authorization of the Moderna vaccine, which does not have the same temperature requirements, opened distribution to more sites.
Relying on the local health department won’t work in Coosa County and may be difficult in other rural counties. Officials told Hutcherson that Coosa County’s vaccines would be distributed by the neighboring Tallapoosa County Health Department, but he said he’s concerned about getting those doses to the people who need them.
Dr. Karen Landers, area health officer for the Alabama Department of Public Health, said the agency is still working on a plan for Coosa County.
“Coosa County is covered by the East Central District counties as that county does not have a local health department,” Landers said. “The Alabama Department of Public Health (ADPH) is enrolling private providers in Coosa County to address local needs.”
Rural counties already have lower rates of vaccination than urban areas. Residents struggle with lack of access to transportation and few healthcare providers.
Coosa County has not been hit as hard by COVID-19 as other rural areas, but the number of new cases has jumped in recent weeks. After months of averaging one or two new cases a day, the county now averages more than four. The county has had 591 cases and 11 deaths from the virus, according to state data.
Burke said most people in the southern part of Coosa County travel to Alexander City to get healthcare and people in the north go to Sylacauga. Both towns are about 20 to 30 miles away from most parts of Coosa County. It’s not a huge burden for him, but many residents are older and poorer and may have trouble traveling several miles for care.
“There are a lot of older people in poor health here who would benefit from access to the vaccine,” Burke said. “Unfortunately, because healthcare access is so limited most don’t even attempt to seek it out. Also, there are many in the county who believe COVID is a hoax or at least not as serious as presented by the media.”
Coosa County officials have tried to find ways to generate more tax revenue for the county, according to The Anniston Star. Its school system and sheriff’s office have also struggled with low funding over the years.
Burke said the county used to have more medical providers, but over the years, many have closed.
“I don’t think that this is necessarily a failing of Coosa County,” he said. “This is about the business of healthcare and healthcare pulling out of rural areas like this.”
Updated at 9:23 a.m. on Jan. 13 to correct the number of dentists in Coosa County