He reflected on one patient who began struggling to breathe. Aware of his hospital’s lack of resources, Chad said he knew full well that he needed to move the man to another facility. So he began to call medical centers across the state.

“There I am: Can’t get the guy in any hospital,” he said. “And If that guy stays here, he’s gonna get a tube, but I can’t wash his lungs out — I can’t do any of that s—. If he stays here, he’s gonna die.”

He was finally able to get the patient moved to a larger hospital in Tupelo, more than 150 miles to the northeast. A family member of the patient told him a few days later that the person had got control of his breathing and was getting better.

The next morning, Chad woke up to a text that the man had died.

“He just had this black-green gunk all over his vocal cords, and of course I know it’s all in his lungs and that’s why we couldn’t get him to oxygenate,” he said. “It just killed me because we got him there. He was getting better over four or five days, reading on his own even, and then I wake up to that message.”

Both Dowells said their hospital is not equipped to deal with the standard of care many patients require, adding that it’s particularly scary in a region of the state facing massive health inequities and outcomes. The Mississippi Delta has the highest rates of heart disease, diabetes, hypertension, obesity and stroke in the country — all conditions that can make someone particularly vulnerable to COVID-19 — according to the Centers for Disease Control and Prevention.

The two doctors said they are tired, morale is low at the hospital and some have had to take pay cuts because of the low number of patients. Seeing people in their community not wear masks or practice social distancing amid the outbreak only makes things worse.

Some locals have even mentioned herd immunity to the Dowells, dangled casually as a solution on the horizon — a concept particularly popular among those who aim to dismiss the size and the scope of the disease’s outbreak. Experts say relying on herd immunity could lead to millions of deaths.

It’s a point of view that even the Mississippi governor has pushed back against. Reeves, a former banker, used his finance and mathematics background to explain why Mississippians shouldn’t depend on herd immunity in a series of tweets that went viral, warning that the state would need to increase its worst single-day number of infections threefold every 24 hours for a year to get anywhere close to herd immunity.

That ignores the fact that the state’s hospital system is already overwhelmed, he said.

But Singh does not have much faith that the Mississippi Delta, the state or the country will be able to pivot in time to stop the spread of the infection, especially as the response to the virus has become politicized within the region’s white community.

The epidemiologist said that because of the resistance here to masks, social distancing and staying home, many will undoubtedly die and hospitals will be overrun.

“That’s why we may end up with herd immunity” he said. “Only the strong — or the people who take it seriously — will survive and many, many others will perish. I hate to say it, but we’re almost at natural selection at this point.”