‘Election Day is over, and guess what?’

Tom Dean, a physician, on the dire situation in South Dakota
Tom Dean, a doctor in Wessington Springs, S.D., says of the coronavirus's impact: “These aren’t anonymous cases. These are my patients, my friends, my family. I know every single one."

Election Day is over, and guess what? The virus is still here. It didn’t just go away like the president said. We’re not rounding any corners. Nobody I know in South Dakota stopped talking about it because the voting is done. How could we? It’s right in our faces. It’s spreading. It keeps getting worse.

About this series
Voices from the Pandemic is an oral history of covid-19 and those affected.

Look, I’m as tired of hearing about covid as the president seems to be. I’m so sick of this virus, but what else should I be focused on, exactly? I’m one of three doctors in this county. We have to do a little bit of everything in a rural community, and this virus follows me wherever I go. We test people at our clinic, and probably about half are positive. We give them supplemental oxygen in our local hospital until they get critical, and then we have to transfer them to the ICU in Sioux Falls. I’m also a medical adviser for our nursing home, and it just had a big outbreak. Now they have eight or 10 empty beds.

Jerauld County is an out-of-the-way place. We don’t have a whole lot, but we’re proud of what we have, so it pains me that we’re becoming famous now for our statistics. One in every 20 people has gotten sick in about the last month. Our death rate is the highest in the country, but it’s more than that. These aren’t anonymous cases. These are my patients, my friends, my family. I know every single one.

We got lucky early in this pandemic, and I think that made us complacent. It was China, Seattle, New York. There was some hope in rural America that this might stay more of a big-city problem. We have about 2,000 people here spread out over 500 square miles of cows and wheat, so social distancing came naturally to us. The governor decided to kind of pretend it away and keep everything going as usual. You didn’t see too many people wearing masks. The school opened back up. They started playing football. I bet we went three months at the clinic without seeing a single positive test.

How do you go from nothing to the worst outbreak in the country? I don’t know. I don’t have a good answer. We started to see a few little pockets of it, but the virus seemed fairly contained. There was a small outbreak at a cafe, and that led to seven or eight cases in our farming community, but then it seemed to go away. There were a few cases up north at the beef jerky plant. A couple of our students came down with it. Then a few teachers. I went into the clinic one day this fall, and the phones were ringing off the hook. Coughs. Fevers. Chills. We tested people as they pulled up in their cars. We have rapid tests, so you hope and pray for those 15 minutes. I was worried about how fast this could spread through town. We have one grocery store, one bank, one pharmacy — it’s all the same Petri dish. I was worried about what would happen if covid got into the nursing home, where both of my parents lived. I told myself: Maybe it’s the flu or something seasonal that’s going around.

Positive. Positive. Positive. Positive. We had 11 new cases within about five hours.

Main Street in Wessington Springs. S.D. In the last month, about 1 in 20 residents has tested positive for the coronavirus. (Jenn Ackerman for The Washington Post)

I’ve been trying to convince people that this is an emergency, and we need to change our behavior. I’ve been practicing here for 42 years, so I’d like to think people trust me, but there’s a strong independent spirit that I love about South Dakota. My great grandfather came here as a homesteader in 1882 when it was nothing but wide-open spaces. My grandfather and my father hung onto our family farm during the Great Depression. We have a lot of people like that — stubborn and tough. They burn their own wood to get through winter. They take care of their land. They don’t want to be watched over or babysat or told what to do, and I can understand that, but I’d like to believe we’re still capable of making a communal sacrifice. Stay home. Be reasonable. Wear a mask.

I started writing a column for the local newspaper every week, trying to sound the alarm. “Don’t let your guard down.” “Armies that underestimate the opponent usually lose.” “The threat is real.” “We are in the middle of it.” “Act as if you have the virus.” “We are in trouble.”

But the numbers kept rising. Some of the nearby ICU’s filled up. The nursing home finally had its first positive test, and that was the phone call I’d been dreading. Those folks kept the virus out for more than six months, and they tried so hard. They immediately sectioned off one area of the building and set up their own covid isolation unit, but it’s a small facility, and it was already too late. The virus snuck in and went wild. Within a few days, most of the residents had tested positive. Two-thirds of the staff was out sick. They had these frail, confused, sick residents, and nobody could really take care of them. They tried to hire some temporary help, but some of the new nurses refused to treat any covid patients. “What? That’s everyone! What did you come here to do?”

I’m 75, and I’m a cancer survivor. I’m not claiming to be any kind of a hero. I’m slowing down and I’m partially retired. I’m clearly in that high-risk group, and I knew I couldn’t go in. I talked to the staff on the phone every day, and I did a fair number of video visits. How am I supposed to care for these people? Some have dementia. Others aren’t speaking. Even if I could be there at the bedside, this virus makes you powerless. It kind of does whatever it’s going to do. I’ve mostly provided moral support, maybe a little company to help with their loneliness. One woman had been my patient for 20 years, and she got it and died practically the next day. Another one of my friends — I guess can’t call him a patient because he never liked going to the doctor — he seemed to be getting better and then a few weeks later he died. There was no good news. It was one bad call after the next. My parents both tested positive — boom, boom.

My mother had been steadily losing ground for a while before covid, not eating, sleeping 22 hours a day. She kind of drifted off. My dad was different. He was clinically stable. He could get confused, but he was comfortable and fairly active. When the virus hit, he went downhill in a hurry. It attacked his lungs. He needed oxygen. His body got stressed. It took four days from his diagnosis to his death.

We wanted to hold a funeral outdoors while the weather was still warm, but my brother had a conflict, and then my granddaughter got sick. She probably gave it to my son-in-law, because now he’s got weakness, fatigue, shortness of breath. My daughter’s been okay so far, but you have to assume —. Anyway. We just have to wait.

A lot of people have suffered worse losses to this virus. My dad was over 100. My parents lived a good life, and they were at the end of their road. They got married 76 years ago during World War II once they’d finally saved up enough of their sugar rations to bake a proper wedding cake. They loved telling that story. Everybody was sacrificing for the war. It was a national effort. They were proud of it. The country had bigger problems, and their wedding cake could wait.

How can we get back to that? What happened to us? My hope now that this election is over is maybe we can take a break from tearing each other apart. The virus is still raging, and there’s no magic solution. It doesn’t just go away unless we stop it.

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