Virus taking hold in rural, old plantation region of Alabama

HAYNEVILLE, Ala. (AP) — Sparsely populated Lowndes County, deep in Alabama's old plantation country, has the sad distinction of having both the state’s highest rate of COVID-19 cases and its worst unemployment rate.

Initially spared as the disease ravaged cities, the county and other rural areas in the state are now facing a “perfect storm:” a lack of access to medical care combined with poverty and the attendant health problems, including hypertension, heart disease, lung disease, kidney disease and diabetes, that can worsen the outcomes for those who become sick with the coronavirus, said Dr. Ellen Eaton.

“I think a lot of people fell into this idea that we were immune because we’re not in tight spaces like in New York and New Jersey, and we’re in wide-open areas,” said Eaton, who specializes in infectious diseases at the University of Alabama at Birmingham.

But no longer. Lowndes and nearby poor, mostly black counties in rural Alabama are facing an increase in confirmed infections. Their outbreaks are also affecting urban areas, since many of the sick need to be transferred to city hospitals.

Less than 30 miles (50 kilometers) from the white-domed Capitol in Montgomery, Lowndes lies along the highway where the Rev. Martin Luther King Jr. led voting rights marchers from Selma to Montgomery in 1965. Today, it has a population of 9,700, and 220 have now tested positive for the virus.

The surge in Lowndes and neighboring countries may be inextricably linked to their demographics — and thus their history as home to plantations where slaves grew the cotton that fueled the Confederacy. About 75% of Lowndes' population is African American, and nearly 30% live in poverty. Its jobless rate has surged to 26% as area manufacturing plants closed during the pandemic.

The problem can also be seen elsewhere in...