High levels of distrust undermined the country's pandemic response and possibly caused half a million deaths. Distrust continues to erode health care, diminish access and give old diseases a chance.

Transcript

AILSA CHANG, HOST:

Has sharp political polarization cost lives in the U.S.? Well, a lack of trust in government during the pandemic arguably led to hundreds of thousands of COVID deaths. As Frank Morris of member station KCUR reports, health care workers are still grappling with this lack of trust.

FRANK MORRIS, BYLINE: In Fredonia, Kan., a remote town of about 2,000, Dr. Jennifer Bacani McKenney is treating Madelyn Rindle (ph), a bright-eyed older woman with a big, fresh scar on her knee.

JENNIFER BACANI MCKENNEY: Let's start with your poor knee. I see that thing.

MADELYN RINDLE: Actually, they said I'm doing really good.

BACANI MCKNNEY: OK.

RINDLE: But they worked me out today...

BACANI MCKNNEY: Yeah.

RINDLE: ...In PT. And they said, you need to get some pain pills.

MORRIS: It's a friendly, empathetic exchange.

RINDLE: But my other thing is I don't want to go all the way to Walgreens.

MORRIS: The closest Walgreens is 30 miles away. If the hospital in Fredonia weren't here, Rindle would be driving at least that far for basic health care. That's typical in rural parts of the country, and it's likely to get worse. The Center for Healthcare Quality and Payment Reform figures that about a third of rural hospitals face closing this decade. But during the pandemic, many rural residents turned on their hometown doctors, even Dr. McKenney.

BACANI MCKNNEY: That was the first time in my career that I had people say, no, we don't believe you.

MORRIS: At a county commission meeting in the fall of 2020, people like Patti Timmons (ph) and Donovan Hutchinson (ph) framed McKenney's mask and social distancing recommendations as part of a dark conspiracy.

(SOUNDBITE OF MONTAGE)

PATTI TIMMONS: Once our freedom of choice is taken, they will come after more.

DONOVAN HUTCHINSON: After our guns, after our kids. Is this America?

MORRIS: Some residents stormed out of the meeting. A sheriff's deputy insisted on escorting McKenney home to protect her from people she'd known her whole life.

BACANI MCKNNEY: I'm like, what do you mean? And they're like, well, there's some angry people here. And so I was like, oh. Like, but this is my hometown. What do you mean, you know? And I thought, oh, my gosh. This is, like, the first time I didn't feel safe in my hometown.

MORRIS: She was afraid for her kids and took steps to protect them as online abuse piled up on her feet. And this kind of thing happened in lots of places. Tom Bollyky says the pandemic exposed the threadbare social fabric in much of the country.

TOM BOLLYKY: People don't like to feel like they're being taken advantage of. And to the extent they don't believe others are doing the right things, they resist doing the right things themselves.

MORRIS: Bollyky directs the Global Health Program at the Council on Foreign Relations, and he says distrust helped drive U.S. COVID rates higher than those in most wealthy countries.

BOLLYKY: This pandemic has been less about the microbe spreading around and more about the people to which it's spreading. It's about us and how we feel about each other and how we hang together as a community.

MORRIS: Some states are doing a lot better than others. In New Hampshire, for example, people express the highest level of trust in the United States, and New Hampshire's COVID death rate was the second lowest. Bollyky says his research shows that if all Americans were as trusting and cooperative as New Hampshirites, half a million COVID deaths would have been prevented. Brock Slabach is chief operations officer at the National Rural Health Association, and he says this trust issue - it's the most vulnerable Americans.

BROCK SLABACH: We're already behind the eight ball because we have higher poverty, lower rates of education and less access to quality health care. And now through the pandemic, we've added this issue of mistrust in the very professionals that, for centuries, we've valued as an important source of information for health and health care.

MORRIS: Vilifying health care professionals hasn't made it any easier to recruit doctors and nurses to small towns. Slabach says you can add that to the lasting damage caused by the pandemic.

SLABACH: And then to add insult to injury, we have lower rates, for example, of childhood immunization that directly come out of the pandemic and the mistrust in vaccines generally now. And so we're going to start seeing childhood diseases that we thought we've eradicated returning.

MORRIS: And that's not the worst of it. Slabach, Bollyky, Dr. McKenney all agree. The United States is now less prepared, less capable of dealing with another pandemic or other major disaster because there's no sign that people inclined to suspect the worst of government or their neighbors are any more trusting now than they were in January 2020. For NPR News, I'm Frank Morris. Transcript provided by NPR, Copyright NPR.