No abstract

Rural communities with predominantly older adult populations could be especially vulnerable to poor outcomes from COVID-19 due to lacking intensive care unit (ICU) capacity. Our objective is to describe the scope of the problem by summarizing population totals of older adults in rural America and their community’s ICU bed availability. We performed a review of peer-reviewed literature, in addition to hand searching non–peer-reviewed and governmental/non-governmental agency reports, using the Kaiser Health News data report to assess the number of ICU beds in 10 predominantly rural states with the highest older adult populations. We found that while 19% of the U.S. population lives in rural counties, these counties contain only 1% of the ICU beds in the United States. Counties particularly at risk for inadequate ICU capacity include Crittenden, Arkansas; Cass, Minnesota; and Sagadahoc, Maine. Solutions include building new delivery systems, reopening previously closed rural hospitals, and calling on local businesses to create medical supplies. In summary, the 10 million older adults in rural communities in the United States may face challenges with obtaining critical care treatment due to the increased need of ICU beds during the COVID-19 pandemic.

Tagging is essential for many types of ecological and behavioural studies, and it is generally assumed that it does not affect the fitness of the individuals being examined. However, the tagging of birds has been shown to have negative effects on some aspects of their lives. Here we investigate the influence of tagging on apparent survival. We examined the effects of flipper bands and injected transponders on the apparent survival of adult Little Penguins by comparing the survival probabilities of 2483 Little Penguins marked at Phillip Island, Australia, between 1995 and 2001 in one of three ways: with bands, with transponders or with both. The design of the study and our method of analysis allowed us to estimate tag loss and ensured that tag loss did not bias the survival estimates. Birds marked with flipper bands had lower survival probabilities than those marked with transponders (with apparent survival probabilities in the first year after tagging of 75% for banded birds and 80% for birds fitted with transponders, and in subsequent years of 87% for banded birds and 91% for birds fitted with transponders). We estimated both band and transponder loss probabilities for the first time, and found that transponder loss probabilities were substantially higher than band loss probabilities, particularly in the first year after marking when the tag loss probability was 5% for transponders and 0.7% for bands. Survival probabilities were lower in the first year after marking than in subsequent years for all birds. Studies of penguins that have used flipper bands to identify individuals may have underestimated annual adult survival probabilities, as banded penguins were likely to have lower than average survival probabilities than those of unbanded birds. The higher annual survival probabilities of individuals marked with transponders indicate that this should be the preferred marking technique for Little Penguins. However, future studies will, like ours, need to consider the higher rates of transponder loss when estimating survival, possibly by double-tagging some birds.