Nurses have long been educated about the need to prepare for a possible future pandemic, it seems the future is now. During times of public health or natural disasters people who have the resources have historically fled cities to more rural locations. With this highly contagious COVID -19 virus, rural area health resources may soon be stretched to the limit. Meit, Kennedy, and Briggs (2007) wrote about the potential rural population surge during a future pandemic scenario and the problems the burdens this could cause in rural health care systems. Those passing through rural areas may unknowingly spread a virus if the stop for fuel, food or temporary lodging. Survey data (Meit, Briggs, & Kennedy, 2008) estimated that about 25% of an urban population may evacuate the more urban areas during a pandemic, even when the government is asking them to shelter in place (p.16). The potential for urban evacuation is more likely without any government recommendation.Early rural hotspots such as ski areas in Colorado saw transmission from both domestic and international visitors before travel bans were put into place. Rural areas that are vacation spots are more likely to see earlier COVID -19 cases than more difficult to access or less popular rural places. However, those who think the pandemic will not reach their rural community are most likely mistaken. The surge may be later or smaller than in highly metropolitan areas, but it will take fewer numbers to quickly overtake the capacity of the rural health care system. Since 2010 the University of North Carolina Sheps Center for Health Research (n.d.) have been reporting about the increasing number of closures of rural hospitals. As of 2019 104 rural hospitals had closed in the past decade (Fahs, 2019); with eight more closing in the first few months (pp. 437-446).