Dr. Desmond Wah is used to being the only physician tending to patients during his shifts at Margaret Mary Community Hospital in Batesville, Ind., population 6,500, where at least half of the 25 beds are usually empty. But he was hardly prepared for the weeklong shift he started on March 20, when the two counties Batesville straddles became one of rural America’s worst coronavirus hot spots.

By the end of the week, most of the hospital’s beds were filled with patients who had either tested positive for or were suspected of having the virus. Six were on ventilators, two of which had been lent hastily by a local emergency medical services unit.

With limited staff, equipment and medicine, Dr. Wah and a handful of nurses and respiratory therapists had to scramble. They had only five intensive care beds, and no experience with caring for multiple patients on ventilators at once. They ran out of propofol, the drug they normally use to anesthetize patients and had to urgently consult with an anesthesia team at a big Cincinnati hospital about alternatives.

“We were trying to manage them on a ventilator with limited support, burning through our sedation protocols, having to use sedatives we never typically use,” Dr. Wah said. “We were just cobbling stuff together.”