The firsthand pandemic experiences of rural health-care providers—who were already burdened when COVID-19 hit—raise questions about the future of public health and health-care delivery.

This volume comprises the COVID-19 pandemic experiences of Appalachian health-care workers, including frontline providers, administrators, and educators. The combined narrative reveals how governmental and corporate policies exacerbated the region’s injustices, stymied response efforts, and increased the death toll.

Beginning with an overview of the SARS-CoV-2 virus and its impact on the body, the essays in the book’s first section provide background material and contextualize the subsequent explosion of telemedicine, the pandemic’s impact on medical education, and its relationship to systemic racism and related disparities in mental health treatment.

Next, first-person narratives from diverse perspectives recount the pandemic’s layered stresses, including

• the scramble for ventilators, masks, and other personal protective equipment
• the neighbors, friends, and family members who flouted public-health mandates, convinced that COVID-19 was a hoax
• the added burden the virus leveled on patients whose health was already compromised by cancer, diabetes, or addiction
• the acute ways the pandemic’s arrival exacerbated interpersonal and systemic racism that Black and other health-care workers of color bear
• not only the battle against the virus but also the growing suspicion and even physical abuse from patients convinced that doctors and nurses were trying to kill them

These visceral, personal experiences of how Appalachian health-care workers responded to the pandemic amid the nation’s deeply polarized political discourse will shape the historical record of this “unprecedented time” and provide a glimpse into the future of rural medicine.

Contributors: Lucas Aidukaitis, Clay Anderson, Tammy Bannister, Alli Delp, Lynn Elliott, Monika Holbein, Laura Hungerford, Nikki King, Brittany Landore, Jeffrey J. LeBoeuf, Sojourner Nightingale, Beth O’Connor, Rakesh Patel, Mildred E. Perreault, Melanie B. Richards, Tara Smith, Kathy Osborne Still, Darla Timbo, Kathy Hsu Wibberly

Wendy Welch is the executive director of the Southwest Virginia Graduate Medical Education Consortium and the author, coauthor, or editor of six books, including Fall or Fly: The Strangely Hopeful Story of Foster Care and Adoption in Appalachia (also from Ohio University Press). She advocates for social justice in health care and other critical areas of development across Appalachia.