“We’re dead center in the middle of the nation,” said Joplin Mayor Ryan Stanley. “It took so long to get to us.”
Now that it has arrived following a rapid statewide reopening, however, it’s hitting the region with a vengeance. After starting June with no active cases in the city, Joplin entered July at the heart of one of the country’s fastest growing coronavirus hot spots. And like many places that skipped the springtime surge only to be walloped this summer, it’s fighting back with a much-diminished arsenal.
Missouri’s stay-at-home order is gone and unlikely to return. Tests are in short supply. The hospital is bumping against capacity as coronavirus cases pile up and doctors work their way through a backlog of non-emergency procedures.
Meanwhile, the one measure that medical experts say could turn the coronavirus tide — widespread use of masks — has become mired in politics. Joplin’s city council spent nearly five hours debating whether to require them last week, only to reject the proposal by a single vote.
In a deeply conservative region where Donald Trump won nearly 80 percent of 2016’s presidential ballots, any attempt to force people to mask up was likely to backfire, Stanley concluded. Most residents who had spoken at the meeting argued against the measure, citing infringement of their personal freedom.
“I’m surprised it’s as divisive as it is,” said the mayor, who personally wears masks and advocates that others do the same, but who cast the deciding vote against mandating them. “If we’re having this crazy spike in the area, don’t you think we’d want to err on the side of caution?”
Joplin’s struggles to contain its outbreak reflect just how difficult it may be for places that are only now experiencing the virus for the first time to reclaim control. Collectively, they have the benefit of having watched other areas to see what works and what doesn’t.
But they are also reckoning with a population that long ago grew weary of making sacrifices to confront an enemy that seemed to exist only in theory.
“There’s a little bit of the boy who cried wolf,” said Toby Teeter, president of the Joplin Chamber of Commerce. “This town shut down when there were 18 cases total. Now, there are 100 a day [in the region]. People are almost numb to it.”
With many of the new national outbreaks concentrated in relatively rural and conservative areas, many people are also less trusting of medical advice.
“Eighty percent of people here are watching one channel and it’s downplaying the epidemic,” Teeter said, referring to Fox News. “So there’s a lot of confusion.”
Teeter has spearheaded efforts to increase mask use among business owners and their customers. Early in the epidemic, when masks were in short supply, he helped bring 32,000 to the city and distributed them to essential businesses, such as nursing homes, where they were badly needed.
Lately, he’s been working on a public education campaign to raise awareness about just how effective masks can be in containing the spread of the coronavirus.
But he said he has encountered stiff resistance. President Trump has famously refused to wear a mask in public, and has mocked those who do. The president’s example has had a pronounced impact in Joplin, Teeter said.
“You go to Walmart and you might see a couple hundred people shopping and only a dozen wearing masks,” he said. “This is not Washington and it’s not New York. It’s an uphill battle to get people to mask up.”
For a time this spring, watching from afar as case numbers exploded in big American cities was just about the only evidence that Joplin residents had that coronavirus was real.
The former mining hub, home to 50,000 people and bisected by Route 66, is tucked into the corner of southwest Missouri, near the borders of Arkansas, Oklahoma and Kansas. The surrounding region is marked by thick forests, picturesque waterfalls and few people.
There had been a handful of early spring cases in Joplin. But rather than take off, infection rates petered out. Hospitals that had braced for an onslaught — setting aside entire areas for patients sick with coronavirus and canceling elective care — were sleepy, not swarmed.
“There was a month where I was thinking of mothballing the isolation unit,” said Rob McNab, the physician who directs coronavirus care at Joplin’s Freeman Hospital, one of two medical centers in town. “It seemed like the wave was gone. It had passed us by.”
As was true across America, much of life had come to a halt in Joplin in mid-March, with schools shut down and gatherings forbidden. So when Missouri Gov. Mike Parson (R) announced plans for a sweeping reopening of businesses as of May 4, the city was more than ready.
Joplin came alive. Hair salons reopened. Restaurants filled up. Kids returned to ballfields.
The hum of normal activity had returned. But the virus wasn’t gone.
The area, McNab said, had been a victim of its own success. With little evidence of a real threat, the reaction to shut everything down had seemed excessive — even if it was actually effective in warding off a first wave.
“The reason there was nobody in that isolation unit was because these things worked,” McNab said. But instead of appreciation, “there was a sense of complacency. People were asking: Is it just like the flu? Is it overhyped by the media? People tend to find the answers that suit their desires.”
The effects of people acting on those desires were soon on display in the numbers posted by local health departments. They had had little to report for months. But that changed after Memorial Day as dozens of new cases were added daily.
“We went from 60 cases to 1,200 in 27 days,” said Stanley, using figures that include surrounding counties.
Some of the biggest regional outbreaks have come at chicken processing plants outside the city. At a Tyson Foods facility in McDonald County, less than an hour’s drive from Joplin, nearly 400 workers tested positive for the coronavirus late last month.
The majority were asymptomatic. But the cases have contributed to the viral spread that has also hit a Joplin nursing home and is circulating in the general population even as testing kits run low. Last week, the city recorded its first two coronavirus deaths. This week, it recorded five more.
Meanwhile, Freeman Hospital has been filling up as patients come from within Joplin — and far beyond. McNab has had to triple the size of the coronavirus unit in recent weeks, and he knows he can’t continue to expand indefinitely with the hospital already taking on its full load of non-coronavirus patients.
“How far can we take this before we have to transfer patients elsewhere?” he said. “That’s a scary conversation. We’ve never been in a situation where we can’t meet the needs of the community.”
There are few obvious tools to beat back the surge. Parson, the governor, has given no indication that he plans to reinstate the state’s stay-at-home order. Stanley, the mayor, said the city may have to consider rolling back the reopening locally, but acknowledged that would be difficult.
Schools, meanwhile, are slated to reopen next month.
Anthony Monteleone thought that requiring masks might be a relatively low-cost way to bend the curve. Late last month, the city council member in his second term proposed an ordinance modeled on those passed in other cities, including nearby Fayetteville, Ark. He was cautiously optimistic that it would pass.
Instead, it went down to defeat last week following a contentious debate. Those who spoke out against it said they were exasperated by the way the virus had affected their lives and would not tolerate the government introducing more disruptions — even one as minor as a cloth facial covering when out in public.
“Our civil rights are being trampled,” 69-year-old Dixie Hogan told the council. “We just want to return to normal.”
Monteleone was stunned. Wearing a mask seemed a small price to pay given the scale of the coronavirus threat. What will happen if the numbers keep growing, and larger sacrifices are required?
“It’s shocking when something so simple to save lives becomes so polarized,” he said. “As a nation, I just don’t know where we went wrong.”