How the Response to COVID-19 Could Positively Impact Rural Patients

Proper care for rural patients in America poses a real challenge. Imagine suffering a brain injury and the nearest city of 100,000 residents or more is 3 hours away. I use this specific population because in the U.S., it almost always requires this size of city to fully represent the sufficient amount of healthcare disciplines required for complex illnesses, such as encephalitis—inflammation of the brain.

The physical location of rural patients often impedes access to qualified professionals with knowledge of or experience with the brain disorder, encephalitis. However, as the healthcare world has quickly adapted to tele-health, new opportunities for diagnosis and treatment is suddenly possible to those in remote locations. Tele-health is a means of connecting virtually with a healthcare provider via a secure portal using a computer or phone. Usually, both parties can see as well as hear each other, adding a more personalized experience.

As complex patients, those with encephalitis typically require oversight from multiple healthcare disciplines. Based on the implications and extent of damage to the brain due to encephalitis, a patient may need access to neurology, psychiatry, neuropsychology, physical therapy, internal medicine, pulmonology, speech therapy, psychology, immunology and epidemiology. In smaller populations, there is limited or potentially no access to some of these specialists.

The likelihood of driving from a rural area to a larger city with all of these disciplines and seeing all the healthcare professionals needed for ongoing care is remote without incurring the additional cost of staying for several days, and adding the burden of the essential medical costs. Even if a patient makes the trip, it’s unlikely that they’ll see the most knowledgeable team of doctors who have a thorough understanding of encephalitis all within a 2- to 3-day span.

So how does COVID-19 produce any beneficial outcome when we consider the staggering number of infected people suffering and the alarming number of deaths? As the board president of Encephalitis411, a nonprofit that aims to improve the quality of life for those impacted by encephalitis, I see a silver lining for our rural followers, those patients and caregivers who access our hotline and ask for referrals in the absence of local help.

While tele-health has grown in acceptance, this platform has catapulted since COVID-19’s surge while officials create more stringent means of social distancing. Tele-health is playing a critical role in day-to-day access to healthcare professionals. Patients in rural areas now have the same access as those who live within 5 miles of their doctors. This is a landmark turning point in supporting those who have been sorely under-served in the past. And in cases like COVID-19, telehealth keeps patients with weaker immune systems away from people who may be contagious but not yet symptomatic. This means a safer means of communication for everyone.

My hope is that when COVID-19 is somewhat in the rearview mirror, whenever that may be, that we don’t return to “normalcy” in providing healthcare. I urge that tele-health becomes a common alternative, a platform to serve anyone, regardless of location. There are also many technologies available that provide remote monitoring using common devices such as our phones and iPads.

Will insurers or payors need to change their policies? Yes! As an example, with my current insurer, I can only see providers in my home state. And one would think that living in a metro as huge as DFW that I’d have access to leading professionals regardless of healthcare discipline. Not true. Just prior to the “shelter in place” orders, I traveled on my own dime paying my own hotel, meals and rental car expenses in addition to three days of day-long therapy in Montana with a therapist who specializes in vestibular disorders. Such an example should be a challenge for insurers to revisit their plans and provide access to the right specialist, regardless of location. They need to open their minds to treating our suffering and not placing barriers to necessary treatments based on geography within the States.

In current discussions about the COVID-19 virus, infectious-type encephalitis survivors are not believed to be at a higher risk of the rest of the population, according to doctors in the UK. They did state that auto-immune encephalitis survivors may be at higher risk if they are currently undergoing treatment or have concluded treatment in the last 6 months. So, if you have AE, please don’t go out unless you are going to a treatment. Please wear gloves and a mask to take necessary precautions. Otherwise, I encourage everyone to shelter in place and don’t take the risk. Ask for help. It’s ok.

I wish everyone safety and good health in this unprecedented time. Our first responders are putting their lives on the line. The term “first responder” has expanded beyond healthcare providers to grocery store checkers and stockers, mail and package delivery people, food delivery drivers, pharmacy staff, educators and those officials in the position of deciding the best care and precautions to stop the spread of this invisible enemy. Thank you for what you are doing to keep America going.

Becky Dennis is the author of Amazon’s top-rated book, Brain Wreck. She is also one of the founders and board president of

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