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A dangerous mix: Rural living, chronic illness and COVID-19

The CDC says long-standing systemic inequities put both people from racial and ethnic minority groups and rural communities at increased risk of getting sick.

PRAIRIE, Mississippi — COVID-19 hit Prairie native Shirley Judd suddenly and hard. One day in late August, she felt fine; the next, she could barely move.

As soon as the symptoms struck, Judd called her aunt to take her to West Point to see a doctor, where she tested positive for COVID-19.

"When I got home, I had to go straight to bed. I couldn't even sit up or do anything. I had headaches starting off, and I was just shaking, throwing up," Judd said. "After about four days, or five, that's when my throat got so sore I couldn't swallow. I couldn't eat anything."

She visited another doctor in Houston on Labor Day and received shots and antibiotics. By Wednesday, her condition worsened. She was losing weight, and her mouth was swollen. At approximately 8 a.m., she checked into the North Mississippi Medical Center in Tupelo for treatment.

What made Judd's experience more harrowing was that she has multiple sclerosis, a chronic illness that affects the central nervous system. Judd is 53 and has been on disability for the condition since 1987. She has had two hip replacements because of MS, and changes treatments every two years. She receives infusion treatments every six months and thought her initial illness resulted from MS flaring rather than a COVID-19 diagnosis.

The Centers for Disease Control and Prevention have long said people with underlying medical conditions and older adults are at increased risk for severe illness from COVID-19. While the National Multiple Sclerosis Society website states that current evidence suggests MS doesn't increase the risk of dying from the COVID-19, possible long-term consequences of MS, age and higher levels of disability can increase the risk of being hospitalized for COVID-19.

Credit: AP
In this undated photo, Shirley Judd, of Prairie poses in Prairie, Miss. Judd was diagnosed with COVID-19 in late August, and because she has multiple sclerosis, the disease hit her especially hard. (Adam Robison/The Northeast Mississippi Daily Journal via AP)

Judd's primary concern was maintaining her household while recovering, and she's grateful family members stepped in to help. Family friend Lee Thomas did most of her cooking and cleaning, and cousins Yolanda Ewing and Chris Ewing helped bring supplies and food to her.

"Everything and everybody was really good about helping me out until I got straightened out and could get around," Judd said. "That was a blessing."

Judd also received financial support from Okolona-based nonprofit Excel Inc. by applying for the COVID-19 Support Fund, which is available to people affected by COVID-19. The organization paid her water and light bills while she was recovering.

"With Excel, I appreciate what they did because at the time, I couldn't do anything," Judd said. "It was a blessing and a miracle."

Judd is also Black and lives in a rural community, both factors the CDC claims might require extra precautions against COVID-19. As of Oct. 11, Black Chickasaw residents of Non-Hispanic and unknown ethnicity were 49% of Chickasaw's 777 cases since March 11, according to the Mississippi State Department of Health. The U.S. Census Bureau estimates Black people are approximately 45% of Chickasaw's population. Statewide, Black people account for 48% of COVID-18 cases as of Oct. 4, despite only representing 38% of the state's 3 million residents. White residents make up 57% of the state population, but only represent 44% of Mississippi's COVID-19 cases.

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Long-standing systemic health and social inequities put both people from racial and ethnic minority groups and rural communities at increased risk of getting sick and dying from COVID-19, according to the CDC. Discrimination, health care access, occupation, income and education gaps and housing are all factors that cause people of color to be at higher risk. Judd's mother lives with her, and she often watches her young grandchild for her only son. She mostly stays home except to go to the doctor, but believes she possibly caught COVID-19 from family transmission. Her mother, who Judd cares for, caught COVID-19 after she did and also went into the hospital for three days.

Rural communities are also impacted by less access to health care and insurance, are more likely to be smokers, or suffer from high blood pressure and obesity.

For Judd, living in Prairie meant she had to travel over 15 minutes whenever she needed to see a doctor. By the time Judd reached Tupelo for additional treatment, it was more than two weeks after her diagnosis, and she now tested negative for the virus.

Despite this, Judd wasn't yet in the clear. Concerned by swelling around Judd's throat, doctors performed an X-ray and found a cyst had developed on her tonsils, requiring emergency surgery. This was in early September.

"It hurt, and it was so painful, but they had to do what they had to do … (and) they had to do it right then," Judd said.

After surgery was complete and she was healing, Judd realized how serious her condition had become. Her doctor told her without surgery, the cyst would have been life-threatening.

"I knew it was bad, but I didn't know what it was," she said.

Since surgery, Judd can eat and swallow much better, and follow-up appointments with her doctor have confirmed her tonsils are healing. She's also continued with regular MS treatments and plans to get a flu shot. The first week out of the hospital was rough, but Judd said she started feeling better by the second week and was able to get up again.

"When I started getting up, washing, that's when I knew I was feeling good. I just got up and started doing things around the house, and sweeping up," Judd said. "Day by day, week by week rather, it was getting better and better."

While she was scared to have COVID-19 with MS, she is grateful she made it through. While she didn't take COVID-19 as seriously before, she said her experience required her to lean on her faith. She prayed often, asking the Lord for strength to face COVID-19.

"If it wasn't for the good Lord, I couldn't have made it," Judd said. "I don't see how I made it with the condition I was in already, but I made it through."

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