The Sierra Nevada towns that dot Alpine County, Calif., have no hospital. Nor do they have a single doctor's office or clinic.
In this region of small unincorporated towns, the workers who comprise its fellowship of coronavirus first responders look a bit different from their counterparts in metropolises a few hours away. They're a mix of civic-minded locals serving as volunteer firefighters and EMTs, and ambulance contractors who come when called from neighboring counties.
Until the coronavirus outbreak, a nurse practitioner ran the county's only health care facility, but she recently left to help in an Army clinic in Texas. Now, residents must go out of the county, in some cases across the state line to Nevada, for health care, or call 911.
That's why health and law officials in the least populous county in California -- and other nearby rural counties that draw anglers, backpackers and skiers -- have united in a single message to tourists who can't seem to keep away: Stay home.
Alpine County Sheriff Rick Stephens issued a blunt plea in late March to anyone considering a trip to the county.
"I, myself, haven't seen my children or grandchildren in over two weeks," he said in a statement. "My staff is isolating themselves on their days off so that we may be here to serve you. Lately, they had to respond to calls that were unnecessary due to visitors not following the advice given by the CDC and our local public health officer. You will be putting my staff and their families in danger from unnecessary exposure."
Dr. Richard Johnson, the Alpine County public health officer, agreed there's no medical care to treat visitors who fall ill with COVID-19.
"There's no way we would even have ground or air resources to get them out," Johnson said. "It's a dangerous assumption that you can come and look at us as a safe haven. It is an unsafe haven."
Remote California counties in recent weeks have seen waves of tourists hoping to escape their cramped apartments and stay-at-home orders in cities such as San Francisco and Los Angeles. In Alpine County a few weeks ago, visitors snapped up all the gas and food at one of the area's few convenience stores, leaving shelves bare, tanks empty and residents without other options, Johnson said.
The county, which locals dub the "California Alps," had just one confirmed coronavirus case among its 1,100 residents as of last week, which officials said may give visitors a false sense of security.