Deadliest place in America: They shrugged off the pandemic, then their family and friends started dying – USA TODAY

QUINTER, Kansas — Sitting in the front seat of a red pickup as wind-whipped sorghum husks fly down Main Street like snowflakes, Ivy Charles fingers the white surgical mask slipped down beneath her chin.

“He was a puzzle piece who can never be replaced,” she says, tears welling into her tired eyes. “He was supposed to get better. We weren’t expecting him to die.”

Just over a month ago, the now-rampaging coronavirus pandemic tore through this rural town of 1,000 and surrounding Gove County, killing 20 residents. Among them was Charles’ father, Edward “Mac” McElhaney, 78.

Ivy Charles stares down Main Street in Quinter, Kansas, following the coronavirus death of her father.

Here, where most everyone knows most everyone else, the pandemic has killed farmers and their wives. The town’s unofficial historian. The beloved grandmother whose sour cream chocolate cake with chocolate fudge frosting was always the talk of the party. The mom whose piano-playing still echoes in the heads of her friends.

And it has drained the hearts of the survivors. Those who feel guilty that they recovered. The ambulance workers battling to treat their own relatives. The exhausted doctor who watched nearly half his patients die. 

“It was overwhelming and sad and you don’t think you have that many tears to shed,” says Charles, 46. “And you do.”

As of Thursday, coronavirus has killed a higher percentage of Gove County residents than any other county in the United States: One out of every 132 people has died.

Their intertwined stories illuminate the toll the pandemic has taken on communities across the country as emotional debates over how to control the infection have unfolded amid mounting losses.

Even today, mask-wearing remains controversialin Gove County, and friendships are being strained as authorities struggle to persuade their neighbors to follow basic public health guidelines, such as avoiding large gatherings.

President Donald Trump won the county with 88% of the vote in November, and many of the residents, including the farmers who raise up corn and sorghum, are deeply skeptical of government and public health orders, often echoing the language Trump has used about mask-wearing and the pandemic’s severity.

Conservative churches like the Dunkard Brethren — a Protestant faith brought over from Germany — help shape social life, and the Dollar General store is the biggest retailer for 50 miles in any direction. Quinter, the largest town, is 300 windswept miles west of Kansas City, and the paved streets surrounding it quickly give way to dirt roads.

Many young people move away when they can. Gove County’s median age is nearly 50 years old, a decade older than the national average. Among the 2,600 residents, coronavirus found easy targets, especially once it worked its way into the nursing home.

Starter

In August, just before the wave of positive cases began growing, Gove County leaders mandated everyone wear masks in public. They were forced to remove it two weeks later after a series of angry confrontations with their constituents. Around the same time, someone anonymously reported the county’s COVID-19 information Facebook page as spam or fake news, and it was temporarily taken offline just as public officials were trying to warn residents of the danger.

The first two deaths were reported on Oct. 7, setting off a wave of concern among public health officials and county managers. By Oct. 13, seven people had died, six of them inside the nursing home.

Some community leaders remain concerned their neighbors still aren’t taking the pandemic seriously.

“We are living through history right now, and I worry what the history books will say about us,” says Ericka Nicholson, 47, who helps run the town’s volunteer ambulance service and survived the infection.

EMTs Ericka Nicholson and Roy Litfin wheel a COVID-19 positive patient into their waiting ambulance for transport for a larger hospital from Quinter, Kansas.

Nicholson, 47, doesn’t want to be seen as criticizing her neighbors, but she’s often been the last familiar face the nursing home residents saw as she wheeled them, dying, into a strange hospital 50 miles from home. 

“We have to honor these people who passed so there is a story to tell about us in 50 years,” she says. “The people who died in our long-term care facility, they are our identity. They are why we are here. And they are dying.”

A mother’s death, a community’s loss

Sharon DuBois greets a longtime friend with a hug as the women step inside the cluttered second-hand shop she runs on behalf of the library. Children’s toys and Christmas decorations are piled high. Picking through them are a steady stream of women, some in the skirts and bonnets or head scarfs that mark them as members of the conservative Dunkard Brethren church. Most, but not all, of the women wear face coverings.

DuBois knows she shouldn’t hug: COVID-19 killed her mother inside the nursing home a month ago.

“I knew her time was coming close, but I still grieve her loss deeply,” she says. “I am thankful they are in the hands of Jesus. But I miss them. And I’m sorry we had to lose them in this way.”

Born in 1922, Margaret Lee Lewis met Winfred Inloes while she was teaching second grade in Quinter. She was the daughter of farmers, and she married Inloes, the son of farmers, during his boot camp leave just before Christmas 1944. After the war, the couple had five kids, including DuBois, raising them on a farm outside town.

Margaret Lee Inloes pictured on her 95th birthday. Inloes died of coronavirus on Nov. 6, 2020, after getting infected at the Gove County nursing home.

“From the time we could hardly walk, she’d have us in the kitchen stirring something,” says DuBois, 73. “We had things to do, whether it was harvest time or wintertime when you fed cattle or milked cows. It was just a simpler time.” 

After her husband died of complications from a brain tumor in 2001, Margaret Lee Inloes lived alone for a few years before eventually moving into the 42-bed Gove County Medical Center Long Term Care Unit. The nursing home very much felt like home to her: All around were neighbors who had also raised families and farmed the Earth, attended the same weddings and funerals and library bake sales.

“She wouldn’t dream of going to the dining room without her lipstick because these were important people to her— not just the staff, but the other people there,” DuBois says. “Even though her body and parts of her mind were wearing out, she was so grateful for all of the people around her. It was important for her to be proper in your presence. I always considered it a sign of respect. She wanted people to know she was respectful of that togetherness.”

Before she passed, Inloes was the one who remembered names, who always made time to visit sick friends in the hospital, who volunteered at the second-hand store to earn donations for the library and the school, who showed up to receptions with her renowned sour cream chocolate cake with chocolate fudge frosting. One wedding, DuBois says, her mother made nine different cakes.

Sharon DuBois, in the green mask, chats with an unmasked customer in thrift shop she runs, after her mother passed away from COVID-19 at the nursing home at the Gove County Medical Center.

“That was a big part of her life, to be a supporter of the community, an encourager. Much of her work, I’m finding, was done anonymously, at least to our family,” DuBois says. “I knew her time was coming close. But I still grieve her loss deeply.”

DuBois misses her mother, but she also mourns the community’s inability to collectively mark the COVID-19 deaths. DuBois counts herself lucky she was able to say goodbye in person; the doctors gave her permission to see her mom before she passed away.

That’s why she still hugs her friends, despite the risks. Because of the hurt. 

“As a community, we are used to making peace with someone’s departure from Earth. And we haven’t been able to do that,” DuBois says.

The gravestone of Margaret Lee and Winfred Inloes, which was recently updated with Margaret Lee's name following her death from COVID-19 in Gove County, Kansas.

Coronavirus claims town historian

After a lifetime of farming outside Quinter, Daniel Albert “D.A.” Crist knew just about everybody in the area, including Margaret Lee Inloes. In the twilight of their lives, both were living at the nursing home, maintaining social bonds built through worshipping at the Quinter Church of the Brethren and having kids the same age.

Most days, DA’s son, Dan Crist, would pick him up from the nursing home and drive him back out to the family farm, where the two men restored old tractors and steam engines of the kind that once provided power before electricity arrived. As COVID-19 precautions tightened at the nursing home, Dan Crist stopped picking his father up, but would still visit regularly.

D.A. Crist was Gove County’s unofficial historian. Born in 1930 on the family farm, he lived away for a few years after college, running an orphanage for 20 homeless boys in the early 1950s with his wife, Carole. He learned to fly a biplane and in 1954 moved back to Quinter to work his father’s cattle farm until he retired. 

D.A. Crist, the unofficial historian of Gove County, Kansas, sits in the front seat of a right-hand drive 1915 Pierce Arrow car being driven by his son Dan, with Dan's wife Janice in the back seat, in this undated photo. D.A. Crist died of coronavirus Oct. 12, 2020.

He was born the year Mickey Mouse made his first appearance, when astronomers discovered Pluto and workers started building the Hoover Dam. He lived through both world wars, Korea and Vietnam, watched farming move from horses to tractors, saw the first humans land on the moon. 

“Up until the virus hit he was sharp as ever,” says Dan Crist, 67. “He was just fine and then they called at 2:30 in the morning and said he died. I was shocked.”

Adds DuBois: “He could name the dates, the times, the people. Already people are saying, who are we going to ask now? D.A. had a way of telling the stories that you just wanted to listen.”

Like many Gove County residents, Crist hoped believed the rural county’s isolation would insulate them from the worst. But Interstate 70 runs through the northern portion of the county, and lots of travelers stop to gas up or grab lunch at the Dairy Queen. Crist says he’s also disappointed that wearing masks — as recommended by doctors — has become so political.

“We were kind of hoping it wouldn’t get here. And it sure did,” Crist says. “Dad was able to trace family trees back many generations to when his ancestor Crists came to America from Austria in 1747, seeking religious freedom. He was often asked how folks were related, and could recall dates of events without a moment’s hesitation. We often asked Dad to share his stories so we could record them, but his stories were spontaneous. Now that historian is no longer with us.”

A sign on the Gove County Medical Center's nursing home reminds the public to wear a mask. Workers there painted the sign after a COVID-19 infection rampaged through the facility, killing 17 people.

He was ‘the rock for our family’

Charles, who works at the hospital and nursing home, tears up when she thinks of Crist, Inloes and the 15 other residents who died, many of whom had no chance to say goodbye to their families. 

Today, there’s an eerie emptiness at the nursing home: vacant seats at lunch tables, familiar faces missing from the window, voices silenced. The facility has essentially been locked down for months, so family members still can’t regularly visit the remaining residents. Perhaps more than anyone, Charles has shouldered the most grief: She lost her own father and the 17 nursing home residents she saw daily.

“It’s not just that everybody knows everybody, it’s that everybody cares about each other,” Charles says. “It was like losing 18 family members in a two-week period.”

Charles’ father, “Mac” McElhaney, was living at home with his wife, her mom, when the two got sick. Her mother was hospitalized eight days after her diagnosis, Charles says, but her father seemed fine.

“He was at Day 12 and we pretty much thought he had beaten it,” she says. “He called me about four hours later—  I still have the voicemail. He said ‘I just don’t feel right.'”

Born in October 1942, McElhaney joined the Air Force in 1962, retiring 22 years later after he and his wife, Ruth, had three kids, including Charles. The family moved to Boulder, Colorado, and then to Quinter in 1994. He joined the Gove Community Bible Church, and unofficially ministered to community members the way his father and grandfather had. Charles played the mobile phone game Words with Friends with him every day. After he died, she discovered he’d been playing with many other people, strangers who sent her money to pay for his funeral.

Edward "Mac" McElhaney beams with pride as his granddaughter, Andrea Charles, kisses him in this undated family photo. McElhaney, 78, died of coronavirus on Oct. 24, 2020, after getting infected in Quinter, Kansas, where he lived.

“He’s always been the rock for our family— Biblically and overall,” she says. “You think he’s just a retired old guy who goes fishing and drinks coffee and doesn’t do anything but in reality he was still out there touching lives.”

As McElhaney’s condition worsened, doctors decided he’d have a better chance of survival at the bigger regional hospital in Hays, Kansas, 54 miles east along Interstate 70. Working with other EMTs, Nicholson loaded him into “Big Red,” an ambulance designed to keep the virus from reaching the driver’s compartment.

“She told him she promised him pie when he got better,” Charles says. “He just thought that if he went on the ventilator, he’d never come off. And ultimately that’s what happened.”

‘The last piece of Quinter’

Coronavirus isn’t done with Gove County. Residents are still being driven to Hays or other bigger hospitals for specialized treatment, and cases are increasingly popping up in the smaller towns of Grainfield, Gove and Park.

The county’s sheriff, Allan Weber, remains hospitalized 300 miles west in Denver, where he was flown by medical plane on Oct. 18. Weber, 64, was reelected to his post from his hospital bed at Swedish Medical Center in Denver on Nov. 3. He first tested positive Sept. 28.

“The hardest part has not being able to see him. It’s been pure hell. I cry every day,” says his daughter, Andrea Dinkel, 40.

Dinkel says too many people are refusing to do their part to protect the elderly from COVID-19. 

“To sit there and say they are old that they will die of something,” she says, “Well, they wouldn’t have died of the flu. My dad wouldn’t have been in the hospital for a month if this was the flu.”

Despite the efforts of local public health officials and experts, many residents aren’t taking the deadly pandemic seriously. Bearded farmers stride defiantly down Main Street past signs requiring them to wear masks. School is still in session and churches are open. Someone threatened to blow up the home of a pro-mask county commissioner.

Nicholson, the ambulance worker, is also co-owner of a restaurant and brewery on Main Street, and she’s had customers swear they’ll never come back after she reminded them to wear a mask when picking up food. She doesn’t want to wade into the middle of a political dispute. She just wants her neighbors to live.

“When we take people to another hospital, I think, are we the last piece of Quinter, of Gove County, they will ever see?” she says. “These people contributed to who I am, and when I have to load them into an ambulance and they can’t breathe, it’s just so hard.”

This undated photo provided by their families shows Margaret Lee Inloes and D.A. Crist inside the Gove County Medical Center's Long-Term Care facility. The two attended the same church with their families, and died less than a month apart after becoming infected with COVID-19 inside the nursing home.

‘A false sense of security’ gripped residents

Amber Hargitt still remembers the feeling of dread as the deaths began. A former care assistant at the nursing home who often worked overnights, Hargitt, 30, now works for a local florist making and delivering arrangements, including funeral flowers. She still regrets not returning an unexpected late-night call from one of the residents who passed away a few days later. 

“I had a feeling of impending doom, honestly,” she says. “There was one day where we had four names come to us. Either way, you look at it, it seems like it was all at once.”

Hargitt says she knew many of her neighbors would oppose wearing masks because, well, that’s just how they are. Across Gove County, the frontier ethos that prompted many conservative Christians to settle and remain there despite struggles dating to well before the Dust Bowl of the 1930s has left many residents with an attitude ranging from skepticism to outright hostility toward government. The county on Nov. 24 passed a new mask mandate that is only lightly enforced, and the people who wear masks feel the need to explain themselves to outsiders.

Sharon DuBois poses for a photograph on Main Street in Quinter, Kansas.

“There’s also a significant part of the population that you cannot tell them what to do; they won’t wear a mask, that it’s not worse than the flu,” Hargitt says. “The flu is around every year and we don’t lose half the long term care facility from it. This is clearly not the flu.”

Hargitt says she wishes her neighbors who dismiss concerns about the virus would see the toll it’s taking on the community and respond accordingly.

Hargitt’s own father, she says, refused to wear a mask until the burials began mounting at the Quinter town cemetery that he helps manage.

“A lot of us are just going through the motions trying to do life as best we can,” she says. “It’s not fair. It’s all so much at once. It’s hard for us all to process.”

For many Christians here, there’s a widespread acceptance that God takes you when it’s your time. The Rev. James Thomas, who oversees Gove County’s Catholic parishes, said he’s telling his parishioners to stay home if they’re sick, but few people have been wearing masks while they’re singing and celebrating Mass. 

A sign on the Dairy Queen in Quinter, Kansas, asks customers to wear masks if they have them. At the time the photo was taken, the county required masks in public places, but many people ignored the protocol.

“In our retirement home, the people who died were aged and had underlying health conditions,” says Thomas. “They had various health issues. That’s the main reason.”

Carol Kinderknecht, 71, owns the Christmas Castles store in Quinter, selling nativity scenes, plastic angels and gingerbread houses. Her son is an optometrist in town, and she said she believes wearing a mask can give people carbon dioxide poisoning or contribute to eye infections. 

She says most of the people who’ve gotten sick with COVID have recovered.

“One thing they don’t tell you is that a lot of those people are in their 80s and 90s and are in the nursing home and are already sick,” she says of the dead. “In a small community, you’re going to know everybody. And you also know they’ve been in the nursing home for a long time.”

Dr.  Scott Rempel, the county’s health officer, shakes his head at how quickly and callously some community members write off the dead from the nursing home. Rempel, 30, is also a staff doctor at the hospital and serves as the nursing home’s medical director. He and his staff struggled to save the lives of people who would otherwise be alive today, but for the virus.

David Caudill, the CEO of the Gove County Medical Center and a member of the county's Emergency Operations Center, talks to a representative of a local store after receiving complaints people inside were not following the county's mask mandate, as Mike Haase, the Gove County Emergency Manager, assists.

He said the pandemic’s late arrival in Gove County gave residents time to grow tired of the public health warnings, especially when early statistics showed Black, Latino and indigenous Americans are four times more likely to be hospitalized for COVID-19 than white Americans, and are more than 2.5 nearly times more likely to die from it. Gove County is 93% white. Nursing home residents account for about 40% of all COVID-19 deaths, according to the Kaiser Family Foundation.

“Rural America has always been insulated to some degree to the problems that plague more urban areas,” Rempel says. “I think that gave some people a false sense of security. I think there was maybe a public perception we would be OK. But if you had asked any of the healthcare providers, we were all worried.”

Rempel says it’s likely a staff member brought COVID-19 into the nursing home. During the worst of the crisis, he and his staff struggled to find bigger hospitals  — the closest is 50 miles away — to which they could send the sickest patients from Gove County, a challenge that federal health officials had been warning of for months.

The Gove County Health Department has little practical authority to require county residents to wear masks.

‘The town wasn’t really ready for it’

Charles, the nursing home worker, misses her dad every day, from the sweet texts he’d send each morning to the “I love yous” and kiss he offered her mom each night. The rock of the family, “Mac” was the one no one ever thought would get sick. She was at her son’s football game when the doctors called to say her father was dying, and she rushed down the interstate to be with him.

“He was the one who held everyone up during bad times,” she says, choking back tears.

Like many Gove County residents, Charles isn’t one to tell her neighbors how to live their lives. But looking back, she wishes the community had taken coronavirus more seriously, wishes people had taken to heart the warnings from health experts.

“When that first case happened, the town about shut down because everyone freaked out. But when it really hit, the town wasn’t really ready for it,” she says. “You even hear the high school kids saying, well, it’s just old people dying. But they were part of somebody’s life. They were part of the world. Some people say, well, if it’s your time to go, it’s your time to go. But COVID pushed that along.”

USA TODAY reporter Matt Wynn contributed to this story.

EMT Ericka Nicholson dons a protective gown in preparation for transporting a COVID-19 positive patient from Quinter, Kansas, to a larger hospital for treatment, assisted by fellow EMT Roy Litfin.

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