Texas rural towns hit with economic, health care toll

Trish Choate


A look at how the coronavirus pandemic is affecting a rural North Texas community.

Wichita Falls Times Record News

OLNEY, Texas – The people of Olney believed their small town in rural North Texas was fairly sheltered from the COVID-19 pandemic. Until April 10.

The country miles seemed to insulate the approximately 3,100 residents on the mesquite-dotted prairie from the highly contagious virus strafing the Lone Star state’s urban areas. It’s almost an hour’s drive north from Olney to mid-size Wichita Falls and about two hours southeast to big city Fort Worth.

Dr. Mark Mankins said the initial feeling was the pandemic wasn’t going to have much impact on the town.

“But as time goes on, it sure affects people. At least, they’re thinking about what’s going on,” Mankins, chief of staff for Olney Hamilton Hospital, said.

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Olney Hamilton Hospital ER director Colter Garrett, RN and Samantha Isbell, MSN, look over a patient’s case. Olney, Texas has seen four positive cases and one death from COVID-19 at this time. (Photo: TORIN HALSEY/TIMES RECORD NEWS)

Confirmed COVID-19 cases generally haven’t been widespread in Texas rural communities of less than 5,000 like Olney, where residents look to self-reliance to get by. While social distancing poses little challenge, these rural communities are weathering the economic toll of the pandemic and the vulnerabilities of already spotty health care systems.

Olney residents have mostly followed the Young County Judge Jim Bullock and Gov. Greg Abbott’s instructions to curb the spread of the novel coronavirus. 

They have been flying red Cubs flags in their yards while the kids take online school, welcoming the new Cubs Chicken N Fish restaurant serving to-go orders in the pandemic and attending the First Baptist Church of Olney’s drive-up Sunday service if inclined.

Pandemic or not, Olney didn’t stop being the kind of place where people know a lot about and care a lot about each other.

“It’s a real close-knit town. It’s like one huge family. Everybody knows everybody’s business typically like a lot of small towns,” Mankins said, adding, “Olney’s got a spirit of giving and sacrificing for others.”

Hunkered down during stay-at-home orders, Olney felt like a ghost town to some. Then on April 10, emergency personnel were dispatched to a home for an unresponsive 75-year-old man.

“An officer responded and found a man that wasn’t breathing laying on the bed, and he pulled him off the bed and started chest compressions,” Olney Police Chief Conny Clay said.


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The man, whose name was withheld for privacy reasons, died at the home in the city’s first confirmed COVID-19 case. It was also the first fatality from the virus in Young County, population about 18,000.

Olney residents suddenly became aware COVID-19 could kill anywhere. Since then hundreds of county residents have been tested to limit community spread of the virus.

Residents were shaken.

“I think that when that happened, everyone’s eyes opened a little bit and (they) said, ‘OK, this is real, we need to be careful. We’ve got to pay attention,’ ” Holly Bailey, owner of Hometown Coffee and Tea, said.

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Holly Bailey, left, owner of Hometown Coffee & Tea in Olney, Texas, helps her employee, Jae Montgomery, fill a large order to go. Her business has done well despite the economic downturn of the pandemic. (Photo: TORIN HALSEY/TIMES RECORD NEWS)

The 75-year-old became ill in New York where he lived, and his family brought him to Olney to better care for him, Dr. Jared Mataska of GMA Health in Graham said.

Bullock, a point person for pandemic information in the county, said the man had been in the county less than a week when he died. Autopsy results confirmed the death was related to the coronavirus. 

When local police learned about the test, the officer who attempted life-saving measures had to be quarantined in an apartment by himself for five or six days.

“In the meantime, the other officers had to pick up his shift,” Clay said. “It puts a strain on a small department, things like that.”

The five-officer police department took a big hit, showing tiny rural towns have limited resources to slow a pandemic. Members of the medical community braced themselves.

“Up until then, we didn’t have any cases, so it brought it home,” Olney City Administrator Neal Welch said. “It made it real.”


Hebbronville, a town of about 4,000 people in Jim Hogg County, doesn’t have a town doctor let alone a hospital. This is how they are fighting COVID-19

Corpus Christi Caller Times

Taking extra precautions

Jim Hogg County is one of many rural areas in Texas where folks may have little choice but to look to a tradition of rural independence to curb the spread of the virus.

Tucked in a remote pocket of South Texas 100 miles west of Corpus Christi and 60 miles east of Laredo, Jim Hogg is one of only two Texas counties with no incorporated cities or towns.

“We’re at a disadvantage as far as medical facilities. We’re at a disadvantage as far as medical professionals,” county Judge Juan Carlos Guerra said.

The nearest hospitals are more than an hour away, and the only medical clinic is operated by a physician’s assistant commuting from Laredo.

“That is why we have to take extra precautionary measures,” Guerra said. “If this spreads like wildfire the way it has in other communities, we’re at a disadvantage.”

He wasted no time issuing a stay-at-home order in mid-March, followed a month later by a mandate that masks be worn in public.


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At the time, there were no reported cases among the county’s estimated 5,200 residents. But caseloads were mounting in population centers where residents go for business or entertainment.

Guerra and the school superintendent lead a six-member emergency management team to stop or contain any spread of coronavirus that by mid-May had infected nearly 44,000 Texans and pushed the death toll to over 1,200.

“We’ve been pretty fortunate that the community has understood that this is in the best interest of all of us – the safety and well-being of our citizens,” Guerra said in an April 28 interview a few days after the county reported its first case of COVID-19.

The second and third case followed almost immediately.

“No mask no service” is seen at outside of Chatitos Snacks, Wednesday, April 29, 2020, in Hebbronville, Texas. The county required masks for every person after cases in Laredo increased.  (Photo: Annie Rice/Caller-Times)

The first case was a sheriff’s deputy hospitalized in Laredo. Two others, who came into contact with the officer, also tested positive and were recovering at home.

The cases, Garza said, have demonstrated to the community that its remote location and sparse population do not immunize it from the fast-spreading virus.

 Phyllis Adams runs the Jim Hogg County Feed Store that sits on part of a 100,000-acre ranch and is adjacent to her home.

Adams said she’s among those taking the threat seriously.

“I order most of what we need online,” said Adams, adding that it breaks her heart that her grandchildren cannot come for a visit. “If I do have to go to the store in town, I wipe down the cart with disinfectant.”

Father Evencio Herrera puts on his mask in the empty Our Lady Guadalupe Catholic Church, Wednesday, April 29, 2020, in Hebbronville, Texas. “I hope this collaboration will continue because that’s the way God wants for us to work together,” Herrera says.  (Photo: Annie Rice/Caller-Times)

The pandemic hit just after the busy season for the feed store and ranch, which offers hunting.

“Out here, we are used to being isolated,” Adams said. “And given what’s all going on right now, that is just fine with me.”

Fort Hancock and Hudspeth County, the third largest county in Texas in terms of area, have so far dodged it all. No one there has tested positive. It’s among 35 of the state’s 254 counties that had no confirmed COVID-19 cases by May 14.

Fort Hancock, population 1,750, is an hour southeast of downtown El Paso on Interstate Highway 10 but feels much farther in some ways.

“So far everything has been very calm,” Hudspeth County Judge Thomas Neely said from his office in Sierra Blanca. “I’ve been happy with people. There has been no major outcry. Everyone has been very calm.”

Cookie Grajeda delivers food to Lorena Grajeda during the coronavirus scare in Fort Hancock, Texas, Friday, May, 8, 2020. The town has yet to see a case of coronavirus. (Photo: Mark Lambie / El Paso Times)

As for social distancing, Hudspeth County is a natural. Hudspeth has more square miles — 4,572 — than it does people — just under 3,500.

“It is a little weird, an eerie feeling,” resident Mondo Aguilar said. “There are hardly any kids running around. Usually you see kids. People are a little worried, but it’s not bad here so far.”

Count Frank Saldana as one of the locals deeply impacted by the schools shutting down. He’s the athletic director and football coach, still hoping the Mustangs crank back up in the fall.

In the meantime, he said everyone is holding together well.

“People are doing their part,” Saldana said. “I think everyone understands that some things can wait.”

Fort Hancock resident Cruz Gonzalez takes a walk in his mask Friday. Hudspeth County has yet to see a positive coronavirus case. (Photo: Mark Lambie / El Paso Times)

‘The invisible enemy is really impacting us.’

In mid-March, Michelle Boyd went from operating a small sit-down cafe to running a to-go restaurant, a market and a bakery in Caldwell, population 4,300.

Boyd belongs to a special breed of entrepreneur gutsy and hardy enough to set up shop in small-town Texas.

Her staff of seven was scaled back to herself and her daughter. Together, the two have been working long hours to keep the family business, The Garden Spot Cafe, afloat.

“I thank God every day I live in this little town,” Boyd said, standing where dining room tables used to sit in the cafe.

Caldwell is around a half-hour drive from Bryan-College Station. As of May 16, there were 18 confirmed cases in Burleson County, where Caldwell is the county seat.

The town has two major grocers — a Brookshire Brothers and a Walmart that share the same parking lot, fast food chains and dollar stores for dining and shopping.   

The oil industry is also a large contributor to the town’s economy, and the latest bust has hit hard.

“The oil field has pretty much left us, and then you put this coronavirus on us, and the invisible enemy is really impacting us,” Caldwell Mayor Norris McManus, a business owner himself, said. “We’re hurting.”

On the town square, where shops outline a courthouse building, some businesses had signs marking closures.

Shelly Spivey owns the restaurant Daisy Dukes in Caldwell, Texas. (Photo: Eleanor Dearman)

A sheet of white printer paper hung in the window of the Mainstreet Gym, letting people know they couldn’t exercise there.   

A soap-making business, The Humble Life, perches on the corner of the square. A sign reading “Small Family, Small Business, Small Town, Big Love” is on the edge of the artisan shop’s window display.

Retail businesses in the county could start operating May 1 with capacity limits. But Taylor Locke, co-owner with wife April, was holding off to see how the roll out went before re-opening to in-shop customers.

“We’re not in a rush to go back yet,” he said.

Other business owners in town are eager to reopen, including Boyd, owner of The Garden Spot Cafe.

Attorneys Lina Burns and her husband Jeff Burns have been using their legal knowledge to help those in Caldwell, Texas interpret orders related to COVID-19. (Photo: Eleanor Dearman)

“We’re excited to see our locals,” Boyd said. “We’re excited to see our friends.”

The place to eat in Fort Hancock is Angie’s Restaurant, a Mexican food establishment right off Interstate Highway 10. In better times, Angie’s lures road trippers to take the unincorporated town’s only exit, Spur 148.

It is one of the few places in the small town hit by the statewide stay-at-home order.

“Oh, we can’t wait to open up,” proprietor Thelma Lujan said, part of a two-person staff with her daughter in late April.

“We’ve been doing to-go orders, and the people in town have been keeping us in business,” Lujan said. “They are probably 80 percent of our business.”

Per Gov. Greg Abbott’s orders, the few restaurants in Hudspeth County can operate at 50 percent capacity since there hasn’t been a positive test for COVID-19. Angie’s was  reopening May 1 knowing it wouldn’t be business as usual. 

“It will be different. We won’t have as many tables full,” Lujan said, adding, “We have to keep going. That’s what we do.”


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Anson General Hospital has been feeling the economic brunt of the pandemic.

Patient volumes are essentially gone at the small hospital in Anson, population around 2,300, about a half hour’s drive northwest of Abilene.

“We have seen, not 100 percent, but I’d say an 80 percent to 90 percent decrease in volume,” Nathan Staggs, the hospital’s chief executive officer, said. “That’s killing us.”

Like most hospitals, Anson General relies on outpatient services, such as X-rays and lab tests from clinics and physicians’ offices, he said.

“We don’t have any reserves,” Staggs said. “We have no volume, and so our cash flow is starting to dry up.”

Anson General is among rural hospitals still holding on while financial woes have shuttered others. With health care becoming less available, rural residents must at times travel for medical attention, shelling out for hotels and meals on top of everything.

Texas has 157 rural hospitals, more than any state, said John Henderson, president and chief executive officer of the Texas Organization of Rural and Community Hospitals.

“They were vulnerable and struggling before the crisis, and this has only accelerated the problem,” Henderson said.

Michelle Boyd is the owner of the Garden Spot Cafe in Caldwell, Texas. (Photo: Eleanor Dearman)

But in May, they received a much-needed influx of federal stimulus funding, he said.

“I was worried we were going to have a dozen closures, and I think we’re going to avoid that at least in the next couple of months,” said Henderson, former chief executive officer of Childress Regional Medical Center.

Texas Agriculture Commissioner Sid Miller announced May 8 that 393 rural health care providers in Texas were receiving $634 million.

Each rural facility is getting $1 million, and a formula will funnel more money to them from the federal Health and Human Services Provider Relief Fund.

But money can’t buy everything during a pandemic.

For instance, Anson General’s access to testing supplies has been limited, Staggs said.

Making certain enough personal protective equipment is on hand has also been tough.

“We’re okay right now, but we did have some challenges a few weeks ago,” Staggs said.

Supplies dwindled to “10 or 12 N95 masks” before the hospital acquired some from the state, he said.

Anson General placed its own orders for masks, face shields and hand sanitizer from vendors.

“But we still haven’t gotten them,” Staggs said. “They’re being stopped, or I don’t know what’s happened. Nobody knows what’s happened to them.”

Henderson said COVID-19 has turned the normal supply chain upside down.

TORCH staff members have transformed their Austin-area office into a kind of procurement shop for PPE. 

“We’re sending hand sanitizers, gloves and gowns and masks all over the state, and that’s not normally what we do,” Henderson said. “But we’re just trying to meet the members’ needs.”  

As businesses reopen, Staggs hopes people will keep in mind that the ever-decreasing restrictions still imposed are there for a good reason.

“We’re trying to limit this from the health care provider side,” he said.  

For small towns, heading off the spread of the new coronavirus become more important as the pandemic grinds on.

Looking at patterns, starting at Abilene and going toward Amarillo, rural communities were the last ones to get COVID-19, cases, so they’ll likely be among the last to see them fade, Staggs said. It will hit everywhere at some point.

“We’re struggling with the financial part like everyone else,” he said. “But I don’t want it to be something where we have to go through this again or even worse.”

Reporters John Moritz in Austin, Elly Dearman in El Paso, Bret Bloomquist in El Paso, Brian Bethel in Abilene and visual journalists Annie Rice in Corpus Christi, Torin Halsey in Wichita Falls and Mark Lambie in El Paso contributed to this report.

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