The number of positive cases of the coronavirus in the United States has grown to over five thousand, and the death toll stands at ninety-seven. These cases are spread over forty-nine states, the District of Columbia, and America’s assortment of territories. There is one place however, that hasn’t had a single reported case of the coronavirus: West Virginia. But that doesn’t mean the state isn’t preparing for the virus.  

“We know it’s here,” said West Virginia Gov. Jim Justice. “I mean, let’s be real. It has to be here. We just haven’t found it yet.”

Eighty-four residents of West Virginia have been tested for the disease and eighty tests have come back negative. Four are still pending confirmation. These are just eighty-four tests issued to a population of 1.8 million. 

“Where we are is just plain simply this: We’ve got a monster that’s looming,” Justice continued, explaining that his state was still taking the same precautions taken by infected areas. “There’s times in life where you got to stare down the monster. That’s all there is to it.” 

On Friday, the governor announced that all public schools in the state would close for an indeterminate amount of time. He also placed a travel ban on state employees and issued a recommendation for other residents that they preclude any nonessential travel. 

Justice’s belief, shared by other West Virginia lawmakers, is that the coronavirus is already in the state. This belief stems from the deficit of testing that has been done on people who are feeling flu-like symptoms. Since the beginning of the pandemic, a lack of testing has handicapped the U.S. response. The state’s commissioner for public health announced that they only have enough testing kits on hand for a maximum of five-hundred people. 

This scarcity has led to public officials making judgment calls based on assumptions and predictions, such as extrapolating how many positive cases might be in an area based on just a handful of sick individuals.  

Geography might be West Virginia’s greatest defense against a major outbreak. The state is predominantly rural and mountainous, with its population practicing social distancing through necessity. This remoteness makes it difficult for the virus to spread as it has in major urban centers.  

What puts the state in danger, however, is its high-risk factor population. As summarized by the New York Times, West Virginia has the highest share of tobacco smokers in the nation, along with the highest death rate from diabetes. It also has one of the top percentages of death rates from cancer, heart disease, and chronic lower respiratory disease. All of these ailments are increased risk factors for complications deriving from the coronavirus. The state’s heavy use of mining and the respiratory damage it causes to miners could also prove to be fatal. 

Hunter DeRensis is the senior reporter for the National Interest. Follow him on Twitter @HunterDeRensis. 

Image: Reuters