The Ripple Effect Of One Rural Colorado Doctor Catching The Coronavirus

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Dr. Kurt Papenfus, the lone full-time ER physician at a hospital in the small rural Colorado town of Cheyenne Wells, was first hospitalized with COVID-19 in November.

Dr. Kurt Papenfus

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Dr. Kurt Papenfus

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A week later, the symptoms hit. He tested positive and decided to drive himself the three hours to the hospital in Denver. «I’m not going to let anybody get in this car with me and get COVID, because I don’t want to give anybody the ‘rona, he said. County sheriff’s deputies followed his car to be sure he made it.

Once in the hospital, chest X-rays revealed he’d developed pneumonia.

«Dude, I didn’t get a tap on the shoulder by ‘rona, I got a big viral load, he texted a reporter, sending images of his chest scans that show large, opaque, white areas of his lung. Just a week earlier, his chest X-ray was normal, he said.

Back in Cheyenne Wells, Dr. Christine Connolly picked up some of Papenfus’ shifts, although she had to drive 10 hours each way from Fort Worth, Texas, to do it. She says the hospital staff is spread thin already.

«It’s not just the doctors, it’s the nurses, you know. It’s hard to get spare nurses, she said. «There’s not a lot of spares of anything out that far.

Besides Papenfus, another six employees — out of a staff of 62 at Keefe Memorial Hospital — also recently got a positive test, Papenfus said.

Hospitals on the plains often send their sickest patients to bigger hospitals in Denver and Colorado Springs. But with so many people around the region getting sick, Connolly is getting worried hospitals could be overwhelmed. Health care leaders created a new command system to transfer patients around the state to make more room, but Connolly says there is a limit.

«It’s dangerous when the hospitals in the cities fill up, and when it becomes a problem for us to send out, she said.

«Bank robbers wear masks out there

The impact of Papenfus’ absence stretches across the Eastern Plains. He usually worked shifts an hour to the northwest, at Lincoln Community Hospital in Hugo. Its CEO, Kevin Stansbury, says the town mostly dodged the spring surge and his facility could take in recovering COVID-19 patients from Colorado’s cities. Now, Stansbury said the virus is reaching places like Lincoln County, population 4,000. It has had 144 cases according to state data, and neighboring Kit Carson has had 301. Crowley County to the south, which is home to a privately managed state prison, has had 1,239 cases. That makes it far and away the number one most affected county per capita in the state.

«So those numbers are huge, Stansbury said. He says as of mid-November about a half dozen hospital staffers had tested positive for the virus; they think it’s unrelated to Papenfus’ case.

The hospital is ready to once again take recovering patients. Finances in rural health care are always tight and accepting new patients would help.

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«We have the staff to do that, so long as my staff doesn’t get ravaged with the disease, Stansbury says.

Rural communities are particularly vulnerable. Residents tend to suffer from underlying health conditions that can make COVID-19 more severe including high rates of cigarette smoking, high blood pressure, and obesity. And Brock Slabach, with the National Rural Health Association, says 61% of rural hospitals do not have an intensive care unit.

«This is an unprecedented situation that we find ourselves in right now, Slabach said. «I don’t think that in our lifetimes we’ve seen anything like what is developing in terms of surge capacity.

A couple of hours east of Cheyenne Wells, COVID-19 recently hit Gove County, Kan., hard.

The county’s emergency management director, the local hospital CEO and more than 50 medical staff tested positive. In a nursing home there, most of the more than 30 residents caught the virus; six died since late September, according to the Associated Press. A county sheriff ended up in a hospital more than an hour from home, fighting to breathe, due to the lack of space at the local medical center.

Papenfus fretted about his home county and their odds of fighting off the virus.

«The western prairie isn’t mask country, he said. «People don’t wear masks out there; bank robbers wear masks out there. He is urging Coloradans to stay vigilant, calling the virus an existential threat. «It’s a huge wake up call.

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Since being released from the hospital, Papenfus’ recovery has been rocky. His wife Joanne drove him back to Cheyenne Wells, wearing an N-95 mask and gloves, while he rode in the back on oxygen, coughing through the three hour drive.

Once back at home, Papenfus hunkered down, with the occasional trip outside to hang out with his pet falcon.

But a week after getting home, he started having nightly fevers. He had a CT scan done at Keefe Memorial, the hospital where he works. It revealed pneumonia in his lungs, so last weekend he was back in Denver, getting readmitted at St. Joseph’s Hospital. This time, Papenfus arrived via ambulance.

Finding a replacement for Papenfus at Keefe has been hard. They’re working with services that provide substitute physicians, but these days, with coronavirus roaring around the country, the competition is fierce.

«They’re really scrambling to get coverage, Papenfus texted from his hospital bed. «Whole county can’t wait for my return but this illness has really taken me down.

He said he was now at Day 35 from his first symptoms, laying in his hospital bed in Denver, «wondering when I’ll ever get back. Papenfus noted COVID-19 has affected his critical thinking and that he’d need to be cleared cognitively to return to work. He said he knows he won’t have the physical stamina to get back to full duty «for a while if ever.