BRISTOL, Florida – The calls haven’t stopped.
For the last week, paramedic Melissa Peddie has fielded them back-to-back for cases of COVID-19.
Peddie runs the only ambulance in Liberty County, a sprawling, sparsely populated community in Florida’s rural Big Bend, where as of last week just 23.9% of residents were fully vaccinated. The county has seen a dramatic surge in COVID-19 cases during July, mirroring other communities across the nation where many people have not gotten the shot.
Peddie, 51, is among the small minority. For her, vaccination was a “no-brainer.”
“I knew I would get the vaccine,” she said. “Every day I climb in the back of that truck is a risk."
As the highly contagious delta variant rapidly spreads, Liberty County is a hot zone in a state on fire. Florida leads the nation in new cases, recording more this week than California, Texas, New York and Illinois combined. And like elsewhere, the unvaccinated make up nearly all of the hospitalized and the dead.
With the lowest population of all 67 Florida counties according to Census Bureau estimates, Liberty's rate of new COVID-19 cases during the week ending Thursday is in the state's top 15 highest, alongside four other rural Big Bend counties, Florida Department of Health reports show.
That includes neighboring Calhoun County, where vaccination rates last week were similarly low, at 23.6%. It's seeing an even bigger surge, with the fourth highest rate of new cases in the state. With two ambulances and a population of about 14,000, the county saw its number of new COVID cases jump in three weeks from four to 19 to 62.
“This mess is crazy,” Peddie said. “It’s not if – it’s going to spread.”
Peddie and other paramedics often must transport patients to larger, better equipped hospitals. The closest is an hour-drive away, in the state capital, Tallahassee. A worsening or prolonged surge could further strap the counties' one small hospital and emergency staff.
“I am concerned with the resources and what we’re going to do if it continues in the route it’s heading now,” she said.
The ambulance director hasn't had time to replenish essential supplies amid the nonstop calls. On Wednesday afternoon, a rare day off, Peddie was at the office ordering airway kits and disinfectant when her daughter-in-law texted. The unvaccinated mother of three was exposed to the virus by a cousin at a gathering.
“This surge is bringing back a lot of fear in people,” Peddie said. “And it should.”
'Turn a blind eye'
Low vaccination rates aren't the only thing putting the counties' residents in danger of COVID-19. Widespread chronic conditions threaten severe complications from the virus that causes the disease.
Bristol, Liberty’s county seat, has one grocery store, the Piggly Wiggly. Between Liberty and Calhoun, there are only three groceries, making nutritious food hard to access in the vast rural counties. A new Dollar General is under construction.
State health department data shows more than a third of Liberty and Calhoun residents suffer from obesity, a major risk factor for COVID-19 complications.
Dr. Laura Davis is a fifth-generation resident of Blountstown, Calhoun's county seat. She grew up in the country town and returned to practice there as a family physician at a Tallahassee Memorial HealthCare Physician Partners clinic.
Many of her patients have chronic kidney disease, which often accompanies high blood pressure and diabetes, making them vulnerable to the virus and complications.
Davis has dealt first-hand with the frustration of people avoiding the shot, and seen the consequences.
“We're a small community. We all know people who passed away from COVID. When someone passes away, it’s people we know,” Davis said. “But I still don’t feel like that overrides what people have seen on social media.”
Davis has heard it all – from the myths that the vaccine will turn people magnetic to the virus being a hoax. She ties to quell fears, countering the false claims with research and data but patients often shut the conversation down.
She recalled one who was angry staff tested for the virus, upset the health department would "have his information" and he'd have to quarantine.
"It’s frustrating when sometimes people don’t seem like they care, and not that getting the vaccine is them caring, it’s just the, ‘We’re going to turn a blind eye,'" Davis said. "In some aspects, it feels like we’re exactly where we were a year ago."
The county's numbers are on par with those of last summer, before vaccines were available.
Edna Francois, 42, of Bristol, was one of those infected before. Last week, she again tested positive for COVID-19. This time she and her whole family fell ill. She said they're all having trouble breathing, and it "knocked" her out.
“I feel terrible because I do think I gave it to my mom," Francois said by phone, her voice raspy and breathless. "The elderly are so vulnerable. It's really hard to know that I possibly gave it to my mom."
Her mom has chronic health problems and on Thursday remained hospitalized but Francois said the unvaccinated woman is expected to be "fine." Only about 58% of seniors in Calhoun and 63% in Liberty were fully vaccinated as of last week.
Francois said her family – mother, sister, brother, boyfriend – are all “on the same team” and still don't want the shot.
“I don't regret not getting the vaccine,” Francois said, pausing to calm her fussing 4-year-old grandson, who isn't eligible for a shot. “The vaccine hasn't been around long enough and I don’t know what they put in it and everything. I want to know more about it.”
Health care workers wary of shot
On Burns Avenue in Blountstown, Calhoun Liberty Hospital is the only hospital serving both counties, where about one in five residents live in poverty, and about 80% voted for Donald Trump in last year's presidential election.
The small 10-bed facility is tucked off a curving road lined by once dense forest decimated by Category 5 Hurricane Michael in 2018. It’s a few miles past the Trammell Bridge, which stretches over the winding Apalachicola River that separates the two counties where many livelihoods are linked to the nearby state prison and area psychiatric hospital, as well as agriculture, timber, retail and construction.
Housed in a 60-year-old building that's seen few improvements over the years, the hospital almost closed after a controversial patient death in 2015, embezzling by its former CEO a few years later, then severe damage from the hurricane. It had just begun to turn things around when the pandemic hit.
The lone hospital is one of the counties' few health resources. It had one ventilator at the start of the pandemic. Recently, it received two more.
On Wednesday morning, chief nurse Paige Tolley received a call from the clinic across the street, where Davis works, about rising COVID-19 cases.
"Are y’all seeing multiple daily, too?" Tolley said on the phone. "Keep sending them if y’all need to. We'll be here."
Tolley said cases have "really picked up in the past couple weeks," mostly among unvaccinated people.
“I hate to see the infection rate like it is,” she said.
She and her staff print information on the vaccine from the CDC to give to patients. She encourages them, especially those with health conditions, to get vaccinated "if they think it’s the right thing to do."
She empathizes with those who refuse. "I’m not going to push anything on anybody," said Tolley, who hasn't been vaccinated.
“I don’t know what the virus would do to me, I don’t know how it would affect me, because everybody’s different," she said. "I also don’t know what the vaccine would do.”
Her coworker, risk control nurse Janna Martin, a mother of three, also hasn't gotten a COVID-19 vaccine. She's afraid of unforeseen fertility ramifications. While experts say such claims are unfounded, Martin said her doctor suggested she hold off.
Tolley said she knows the pros and cons of the vaccines authorized for emergency use by the Food and Drug Administration but considers them "just experimental right now."
“And I don’t know that I’m comfortable with that yet," she said. "But I think it’s great, and it (the vaccine) does make a difference."
'I just want it to go away'
A mile across town at Fiddler's Oyster Bar, where the heads of two alligators caught in nearby rivers decorated the counter, unmasked diners, including health care workers in scrubs and local law enforcement officers, filled the booths during the lunchtime rush.
Sitting at a table in the bar area, owner Randal Martina recalled how one of his kitchen workers almost died from COVID-19 last year. But he too remains leery of the shot.
"I'm not vaccinated. I'm not getting the vaccine," he said. "It was made too quick."
Martina said his wife, a nurse for 14 years, told him the vaccines hadn't been studied enough. "She hasn't taken it either."
Patti Brake, 58, is manager of the Calhoun Liberty Ministry Center thrift store. She's had several family members and friends infected with the virus who've “pulled through it.”
“Some barely. Some OK,” she said, hanging up colorful second-hand women’s clothes on wire racks. “I just want it to go away.”
Brake, who hasn't gotten a shot, said she read about the increasing cases and the area's low vaccination rates in the morning's newspaper but remained skeptical of vaccine's effectiveness. She and others pointed to recent reports of breakthrough infections among the vaccinated as another reason to avoid the shot.
“There’s just so much misinformation out there that you really don’t know what to think," she said. "They tell you one thing, they tell you something else.”
Even as COVID-19 cases rise, Brake has no plans to be vaccinated.
“I’m a fairly healthy person,” she said.
Her husband, Billy Beck, 59, and her 18-year-old daughter, also aren’t vaccinated. Beck said the barcode detector on the phone of his stepdaughter's friend lit up after the friend got a shot.
His wife called across the store asking if was true that they knew older folks who'd gotten vaccinated.
“Yep," Beck replied. "I say, ‘In a few years from now y’all going to be dead.’ And they say, ‘No, you’re the one going to be dead.' "
Beck said he prays, and remains optimistic the virus won't hurt him.
Brake, who started volunteering at the thrift store shortly after her former husband died in 2007, said faith is her anchor.
“Not too much scares me,” Brake said, her eyes brimming with tears. Crying, she recited the 27th Psalm.
"'He is my strength and my rock. Of whom shall I be afraid?'"
The virus included, she said.
Data editor Mike Stucka contributed to this report.
This article originally appeared on USA TODAY: Florida COVID case surge: in spiking rural areas vaccine fears remain