DODGE CITY — In the midst of a worsening pandemic, as coronavirus instances climbed, elected leaders in a former frontier city well-known for its gunfights confronted a alternative.

They might go a masks mandate on the urging of well being specialists, or reject the measure blasted by some as a violation of their private freedoms.

The 5 commissioners of Dodge City, Kansas, a politically purple cattle group of some 27,000 folks, had resisted such measures all summer time and into fall. Like different elements of rural and small-city America, Dodge City had principally returned to regular after shaking off the pandemic’s first wave.

But then a second wave hit Dodge City. People began getting sick once more.

By the time commissioners handed the masks mandate on Nov. 16, greater than 1 out of each 10 county residents had contracted the virus. At least a dozen of them had died.

Kansas National Guard member Jessica Pal collects a pattern at a drive-thru COVID-19 testing website Wednesday, May 20, 2020 in Dodge City, Kan. Kansas Army and Air Force medical guard models have already examined 100-200 folks each day since establishing the testing website practically a month in the past in an try and stem the unfold of the brand new coronavirus.

COVID-19 has unfold quick and lethal in Dodge City and different small cities the place residents ignored public well being pointers and refused to put on masks. Many folks lived as they all the time had: going to work, buying and visiting associates with out fear.

In communities the place mask-wearing has develop into a political inflection level, the toll of the virus has surpassed even essentially the most terrifying early days seen in America’s large cities.

A USA TODAY evaluation discovered that in current months, the weekly charges of newly reported instances are highest in rural counties and solely barely decrease in different non-metropolitan communities.

The development began on Aug. 7, and inside two months, folks in rural counties had been nearly twice as more likely to have already contracted COVID-19 throughout the final week in comparison with individuals who dwell in city areas. Counties with metropolis populations that complete 20,000 to 250,000 folks — like Dodge City’s residence of Ford County — present the same hole, reporting 54% extra instances within the earlier week than metropolitan areas on common.

Since mid-November, the weekly fee of COVID-19 deaths in rural America has been increased than it has ever been in city counties.

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“The rural communities were kind of lulled into complacency, feeling they were naturally blessed with open spaces and big sky and that COVID-19’s a metropolitan problem,” mentioned Dr. Lee Norman, Secretary of the Kansas Department of Health and Environment. “But the chickens have come home to roost.”

Dodge City officers knew COVID-19 was severe from the beginning, mentioned Mayor Joyce Warshaw. But it wasn’t till the specter of flu season and the rise in nationwide instances that the town fee felt compelled to go a masks mandate, she mentioned.

By then, Warshaw had been personally affected, as her daughter had contracted COVID-19. Warshaw’s aunt additionally just lately died from the virus.

“We just felt like we had to do something so everybody was aware of how important it was for everybody to be responsible for each other’s health and well-being,” she mentioned.

But weeks later, residents overtly defy the mandate. And, as of early December, police had finished nothing to implement it.

At Red Beard Coffee on Gunsmoke Street earlier this month, there have been no indicators reminding folks to placed on masks. Neither the employees nor most clients wore them.

At Tacos Jalisco on Wyatt Earp Boulevard, indicators in English and Spanish alerted clients to the masks protocol, however neither employees nor most clients wore them inside throughout a current go to by USA TODAY.

Wearing a masks, a employee at Dodge City Brewing in Dodge City, Kansas, cleans the bar behind an indication reminding clients they’re required to put on a masks inside when not consuming or consuming, subsequent to a “complaint department” signal with a mock grenade.

Business homeowners who attempt to implement the masks mandate usually face resistance.

At the Ensueno Boutique on 2nd Avenue, proprietor Andres Lima, 61, mentioned he’s been requiring clients and employees to put on masks because the summer time, no matter what the federal government required. His retailer has bilingual masks guidelines posted on the entrance doorways, and retailer clerk Esthela Cisneros is pregnant.

“It’s for the safety of the people who work here and for the people who come in,” he mentioned, talking amidst wedding ceremony robes and glowing quinceañera clothes. “Some people say ‘I’m not sick,’ but we tell them, ‘that’s not the problem. For your safety, you need to wear one.’”

As of Dec. 4, native police had issued no tickets for violations of the masks ordinance. The police division had acquired just a few complaints about folks flouting the rule, mentioned Dodge City Police Chief Drew Francis.

Other complaints, he mentioned, have already come from opponents of the mandate.

“We have taken several complaints from community members speaking directly to officers about their position that this is unconstitutional government overreach and wanting to know if the police department is going to allow itself to be used to oppress the people,” Francis mentioned.

COVID within the Wild West

Steeped in Wild West lore, Dodge City prides itself on the unbiased cowboy ethos.

In the 1800s, it served as a vacation spot for cattle headed for the railroad, attracting cowboys, gamblers, buffalo hunters and troopers. The metropolis grew to become well-known for its saloons, outlaws and legendary lawmen like Wyatt Earp. It cemented its place in trendy historical past when it served because the backdrop for the tv present Gunsmoke for 20 years.

A metal cutout of cowboy’s driving towards the sundown welcomes guests to Dodge City, Kansas.

Dodge City is essentially the most populous city in Ford County and one of many largest cities in western Kansas.

Almost a 3rd of residents are foreign-born, 62% are Hispanic. The median family revenue is $52,000, about 10% decrease than state and nationwide averages, in response to current U.S. Census Bureau estimates.

The group is surrounded by cattle feedlots that provide Dodge City’s two meat packing vegetation, which make use of hundreds of individuals. Along the principle avenue, Wyatt Earp Boulevard, car-parts shops sit alongside heavy-equipment dealerships and fertilizer depots. Large fuel stations promote diesel gas to energy the regular stream of vans delivering cattle to the processing vegetation and hauling beef merchandise to shops nationwide.

Workers put on protecting masks as they stroll outdoors the National Beef meatpacking plant, Tuesday, May 19, 2020, in Dodge City, Kan. Ford County, residence to Dodge City, has essentially the most constructive COVID-19 checks per capita within the state largely attributable to outbreaks within the county’s two meatpacking vegetation.

COVID-19 was first found in Kansas in early March and, because the illness picked up steam, Gov. Laura Kelly, a Democrat, ordered a short lived, statewide stay-at-home order. Schools closed. Businesses shuttered. People stayed residence.

Still, the illness unfold furiously by Ford County. On March 17, officers introduced the primary case of COVID-19 locally. Soon, viral clusters that began within the packing vegetation led to an increase in instances that, at one level, made Ford County one of many worst hotspots in Kansas.

In Kansas — like many of the U.S. — the virus has disproportionately harmed non-white and Hispanic households. Statewide, the speed of reported instances is twice as excessive amongst Hispanic residents and the speed of deaths is 27% increased. (Kansas doesn’t publish race or ethnicity COVID-19 information at a county degree.) Especially within the spring and summer time, quite a few outbreaks had been recognized at meat packing vegetation that rent many Hispanic staff, together with the 2 beef processing vegetation in Dodge City.

Vehicles drive down Wyatt Earp Boulevard in Dodge City, Kansas.

City commissioners started holding their conferences on-line in April and acquired common updates from native well being officers. Dodge City leaders promoted good hygiene, social distancing and sporting masks, although they stopped wanting a mandate.

The metropolis fee resumed its in-person conferences on and off over the subsequent few months. When they met in individual, they sat at tables with more room between the elected officers, who recurrently wore masks.

“Let’s look at wearing a face covering as our statement that we are working to make Dodge City the best place to be,” the town wrote on its Facebook web page on July 3. “Let’s lead on this response to overcome this fast-spreading danger to our community.”

But many individuals refused. And when the lockdowns of the spring expired, mobility monitoring information exhibits many rural and small metropolis residents shortly resumed their regular lives.

In June, folks in rural communities throughout the nation, on common, visited retail and recreation institutions at charges just like earlier than the pandemic, in response to Google cellular phone information. By early July, counties with small cities additionally had been again to regular ranges. Urban residents had been slower to return, with visits to retail and recreation websites averaging about 15% beneath pre-pandemic ranges.

And the week of Independence Day, 75% of rural residents and 73% of small metropolis residents left residence in comparison with 68% of individuals in metropolitan areas, in response to the evaluation.

While Dodge City officers continued to stave off a masks mandate, residents on either side of the difficulty had been battling one another on a group Facebook web page.

“I live in a free country,” one individual wrote in July. “I will not wear a mask. Quit being a stupid crybaby liberal.”

“The arrogance and ignorance is just comical,” one other individual responded. “Like I said, no one is asking you to give up a kidney. If you define freedom by wearing a mask, you’re the stupid crybaby.”

Wearing a masks, Esthela Cisneros works at Ensueno Boutique in downtown Dodge City, Kansas. Her boss, Andres Lima, mentioned he is been requiring each employees and clients to put on masks inside the shop for months.

The decrease an infection charges earlier within the 12 months made it simple for officers, significantly these in purple communities like Dodge City that supported President Trump, to brush apart the recommendation of medical doctors, scientists and different well being officers. By early August, 77% of 105 counties in Kansas didn’t have already a masks mandate, in response to a CDC evaluation of information from the Kansas Health Institute.

Reduced case counts over the early summer time months created a false sense of safety, Norman mentioned.

“It’s not unique to the rural areas, but the rural areas were less likely to stick with masks, social distancing, limits on restaurant patronage and the like,” Norman mentioned.

A current research by the University of Kansas Institute for Policy and Social Research discovered a 50% drop within the unfold of COVID-19 in Kansas counties that had a masks mandate in comparison with these with out. Last month, the CDC printed an up to date model of the evaluation, reaching the identical conclusion: Mandates labored to cut back an infection charges and locations with out them noticed sooner case progress.

The political battle over masks has annoyed medical professionals in already stretched-thin rural hospitals, who’re seeing sick folks flooding into ill-equipped services. Leaders of metropolitan care facilities are also anxious as smaller services ask to ship their sufferers.

“People are suffering and dying,” said Dr. Angela Hewlett, medical director of the Nebraska Biocontainment Unit at the University of Nebraska Medical Center. “People are continuing to gather in groups and go out to restaurants and bars. I would ask people to stop politicizing the virus, stop politicizing the masks. This is not a political issue. This is life and death.”

COVID in schools

Like many others nationwide, Dodge City schools reopened in August, offering both in-person and virtual classes. About 95% of the 7,000-plus students returned for in-person learning, said Dodge City Public Schools spokeswoman Kerri Baker.

The schools implemented numerous safety measures, such as requiring students and staff to wear masks, placing hand sanitizer in high-traffic areas, spreading seats at least six feet apart and disinfecting routinely.

But while face coverings were required at schools, local leaders still hadn’t approved a mask mandate, so face coverings were optional in other public areas. That meant more chances for the disease to spread from outside the schools to inside.

And it did.

A picture of Comanche Middle School in Dodge City, Kansas.

Between Sept. 1 and Dec. 1, more than 370 school district students and staff tested positive for COVID-19, Baker said. The football team cancelled its last game of the season after three players tested positive and six others were in quarantine.

Sabrina Frerichs — an elementary school teacher for the district — was among the many victims of the second wave to hit Dodge City.

Frerichs awoke in the middle of the night on Oct. 29, freezing cold and with a fever. It came out of nowhere, she said, as had the pain in her stomach that had been bothering her for days.

Within a week of testing positive, Frerichs said, she could barely eat or drink. She grew weaker, and her blood oxygen levels were falling.

The 39-year-old was admitted to the hospital, where she stayed on oxygen for four days. When she came home — still exhausted and aching badly — she needed to use an oxygen machine.

Frerichs’ husband and three daughters also came down with less serious cases of COVID-19. Only Frerichs’ 14-year-old son has avoided the illness so far.

“I fear in regards to the burden financially that is going to tackle my household,” she mentioned, including she has been planning faculty classes whereas recovering at residence. “Insurance will not cowl the whole lot. I fear in regards to the long-term results on my well being.”

When it comes to the mask mandate, Frerichs keeps her opinions to herself because of the divisiveness in the community over the issue.

But since being diagnosed, Frerichs has continued to battle after-effects of the disease, including tremors in her hands, intermittent tingling in her hands and feet, rapid heart rate, palpitations and shortness of breath.

Even brushing her hair or getting dressed has been exhausting.

“I never thought covid did all of this,” she posted on Facebook on Nov. 27. “Stay healthy and safe please.”

FILE – In this May 20, 2020, file photo, Kansas National Guard member Jessica Pal collects a sample at a drive-thru COVID-19 testing site in Dodge City, Kan. Doctors and nurses treating those sick and dying from the coronavirus said politics around social distancing and the lethality of the virus are complicating treatment efforts.

The first symptom for Karyn Garcia, a 29-year-old teacher’s aide in the school district, was blinding migraines. She thought it was stress, so she took Tylenol and continued working and caring for her two kids.

Two weeks later exhaustion set in, along with shortness of breath, body aches and fever. A test at the local expo center confirmed she had COVID-19.

Garcia immediately went into quarantine with her children, neither of whom got the virus.

This isn’t like just any other virus, she said. The bone-crushing weariness, the up and down fever — it just feels different, she said.

“It’s scary, to be sincere,” Garcia said.

COVID patients fill hospitals

While Frerich has a doctor nearby, many rural communities and small towns suffering the most during the current COVID-19 surge don’t have hospitals or even medical clinics, forcing people to drive long distances to get care or discouraging them from even trying.

Hewlett, with the University of Nebraska Medical Center, said tests can be hard to come by in rural areas and the turnaround time for results can take a week. By then, if people aren’t quarantining, the disease may have spread.

“Our social bubbles are bigger than we think,” Hewlett said.

Wellhealth is the new organization testing for COVID-19 at the Western State Bank Expo Center, sent to Ford County by the Kansas Department of Health and Environment.

Medical professionals in rural America are exhausted, she said. They’re working multiple shifts and are worn down from wearing gowns, gloves and N-95 masks for hours on end. Meanwhile, doctors in private practice are helping carry the load by picking up shifts at the hospital, Hewlett said.

Dodge City’s Western Plains Medical Complex has only 10 ICU beds and six ventilators, but officials say they have not been at capacity — yet.

Kansas National Guard member Roy Manns, from Topeka, Kan., writes down results as he runs samples through an Abbott COVID-19 testing machine at a drive-thru testing site Wednesday, May 20, 2020 in Dodge City, Kan. Kansas Army and Air Force medical guard units have tested 100-200 people daily since setting up the testing site nearly a month ago in an attempt to stem the spread of the new coronavirus.

Southwest Kansas counties have a total ICU capacity of 22 beds at 18 hospitals for the region’s roughly 143,000 residents, state officials report.

On Sept. 1, those hospitals reported 17 ICU patients, including nine hospitalized with COVID-19. By Dec. 7, 18 of the 21 ICU patients were being treated for COVID-19 and only one staffed bed remained open. Another 63 people with COVID-19 filled other in-patient beds.

The state is sending ventilators to hospitals throughout Southwest Kansas because they are seeing so many COVID patients, Norman said. Thanks to that effort, state figures show the region has not yet been close to running out of ventilators this fall.

Some hospitals have run out of beds and are transferring people to Denver or other cities in Kansas, though the state doesn’t publicly track those numbers. The ability of those larger hospitals to accept new patients could run out as case numbers rise locally and in surrounding communities that rely on metropolitan facilities for critical care.

“I don’t know how you can be a COVID-19 denier all the while the hospital in your own community is filling up and case volumes are going up dramatically,” Norman said. “It doesn’t make any intellectual sense. I don’t understand it.”

‘What’s next?’

On Nov. 16, Dodge City residents filed into city hall, where officials were set to vote on the mask mandate.

Among them was Ford County physician adviser Dr. R.C. Trotter, who in April urged residents to wear masks on a Kansas radio program. This time, he was urging commissioners to take action.

Just one infected person affects everyone around them, he said. And there can be long-term effects from the disease, such as damage to the brain, lungs, heart and circulatory system.

Dr. R.C. Trotter is the Ford County physician’s adviser for Ford County, Kans. who is one of three doctors practicing at Family Practice Associates of Western Kansas in Dodge City.

“It’s not an invasion of your rights, no more so than you can’t drive as fast as you want on the road, and you can’t drive without your seatbelt and you can’t smoke in this room,” he said.

Outside the commissioner’s room, about a dozen protesters decried the proposed mandate.

Most residents who testified said that the mandate would be an infringement on their rights, that it would be hard to enforce or that children were being psychologically traumatized by having to wear masks.

Casey Fitzgerald told commissioners the pandemic had been overblown.

“I’ve been in the community for 12 years, served in the military 21 years, still serving,” Fitzgerald said. “You all know this is the land of the free. So I’m asking you to allow everyone here to remain free and make the choice whether to wear a mask or not”

Dodge City residents wait outside of Dodge City City Hall to speak before the Dodge City Commission regarding the mask mandate for the city on Nov. 16.

A few residents encouraged commissioners to follow the advice of medical professionals.

Laura Williams — who has multiple sclerosis and has quarantined herself three times after possible exposures to the virus — encouraged commissioners to impose the mandate. Nobody wants a mask mandate or a shutdown, she said. But the virus needs to be controlled.

“If you don’t know somebody who has been tested positive, who’s been hospitalized, who’s been ill, or, God forbid, died, you’re lucky,” Williams said.

Dodge City commissioner Joseph Nuci, who was the sole vote against the mandate, agreed that masks, handwashing and other safety measures help slow the disease. But the mandate was a step too far.

“If we do that, then what’s subsequent?” Nuci mentioned. “Not permitting folks to journey? Forcing folks to scrub their palms as quickly as they enter a restaurant?”

On Nov. 18, Gov. Kelly again ordered a statewide mask mandate. Counties across Kansas were allowed to opt out of it, though, because the Republican-led state legislature granted them the power to do so in their summer session as part of a compromise negotiated with Kelly.

Some, including Ford County, opted out. The three Ford County commissioners, all Republican, walked into their meeting on Nov. 24 and unanimously rejected the mandate.

Ford County is now in the minority of Kansas counties without a mask mandate. As of Dec. 2, 66 of 105 counties had a countywide mask mandate, although a quarter of them specified they would encourage compliance but not enforce it, according to a USA TODAY review of information compiled by the state Division of Emergency Management. Another 14 counties have passed resolutions recommending, but not requiring, mask use.

The mixed messages from local leaders makes life more difficult for business owners like Larry Cook, 64, co-founder and brewer at Dodge City Brewing on 3rd Avenue. He said he wished local leaders would do more. Cook said he worries every evening about patrons who ignore the prominently posted signs requiring customers to wear masks.

In the lead up to the Dodge City Commission voting on its mask mandate on Nov. 16, residents were allowed inside the lobby area of Dodge City City Hall to speak to commissioners. As the residents went in to speak they had to wear a mask when speaking to the commission.

“I had one customer come in the other day, not wearing a mask, and I told him he had to,” Cook said. “He just stared at me. I stared at him. And then he said, ‘I don’t eat in commie establishments’ and left. It wears me out. I’m just exhausted all of the time.”

While some in Dodge City proceed about their lives as if the pandemic didn’t exist, life has modified dramatically for some who have already struggled with COVID-19. Many, like Karyn Garcia, have already totally recovered and returned to work. Others are nonetheless affected by lingering results of the virus.

Frerichs is coping with neurological issues from the sickness. She has had bother strolling and speaking at instances. She sleeps simply 4 or 5 hours an evening due to physique ache. She nonetheless wants oxygen. Sometimes, her left arm and proper leg twitch involuntarily.

She simply needs the whole lot to return to regular.

“I believe most individuals sick this lengthy surprise if it can ever finish or if they are going to ever be nicely once more,” Frerichs mentioned. “Well, I’m wondering.”

Norman, the state well being secretary, mentioned he’s hopeful that the Dodge City masks mandate will assist include the unfold within the broader county. But he worries that as the vacation season reaches its peak and other people proceed to dwell near-normal lives, Kansas’ rural communities and small cities will see extra darkish days.

“Those communities and counties that have not chosen to put in what I’ve called ‘anti-contagion measures,’” he mentioned, “are just denying reality.”

Dodge City Globe Editor Vincent Marshall, USA Today investigative reporter Jessica Priest and USA Today information reporters Dan Keemahill and Dian Zhang contributed to this story.

This article initially appeared on USA TODAY: A small city dragged its ft on masks mandates. Thousands acquired sick.

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