The peace and the quiet that encompasses Block Island in the middle of the winter are what keeps lifelong resident Sue Millikin on this 7-mile stretch of land off the New England coast.
One of a small handful of cab drivers here, the 63-year-old resident spends her days crisscrossing the island helping people get to where they need to go. Tourists flock to Block Island in the summer months, but during the winter, only about 1,000 full-time residents remain here.
But while this summer safe haven is seemingly cut off from the world, it is not cut off from COVID-19.
"[Everyone] has been very cautious, very cautious, because we don't have a hospital," Millikin explained.
Since the start of the pandemic, Block Island has reported 72 total COVID-19 cases. Many happened during the summer months, as tourists and renters come to the island looking to escape from the mainland.
Dr. Thomas Warcup serves as the medical director for the island's only medical clinic. He and his staff of about 10 people have been working nonstop to make sure residents on Block Island get their COVID-19 vaccine. Like most small communities nationwide, they've had to take vaccination efforts into their own hands.
"We have to take care of it for our community so that way we know it gets done," Dr. Warcup said.
Getting vaccines to Block Island is a major, grassroots undertaking. There's no FedEx or UPS to help deliver the vaccine vials. Instead, every few weeks, the emergency management director from the island drives his own personal car to the mainland and picks up a box of vaccines. The boxes are then transported back to the island on a ferry, a process that takes about four hours.
The biggest factor health officials here can't control, though, is the weather. It's not uncommon, especially during the winter, for the ferry service to be shut down for a day or two at a time, meaning delivery of the vaccine would have to be rescheduled. So far though, Mother Nature has cooperated.
"You’ve learned to do for yourselves because it’s a unique scenario that’s easily understood by large policymakers," Dr. Warcup added.
For communities across the country whose economies rely on seasonal tourists, there's another push right now. Many are trying to get year-round residents vaccinated before visitors and the virus return for the summer. The average age of full-time residents on Block Island typically skews much older than other places in the state of Rhode Island.
Just 1,000 people call Block Island home year-round. While it is an island, it's also part of this nation's larger patchwork of rural communities.
About 57 million Americans call rural areas home.
Alison Warfel is the COO of Block Island's Medical Center and her concern for health care for residents who live on the island has become personal.
"Rural communities represent a large part of our population, but they are often the most underserved when it comes to health care," Warfel said explained about the vaccination efforts.
Like health officials in smaller communities nationwide, Warfel and her colleagues are trying to remove as many hurdles as possible when it comes to inoculation efforts.
"If someone has to drive three hours or take a ferry in our case, it’s another barrier and another reason why they might not," Warfel added.
As for Sue Millikin, she's already gotten her first dose of the vaccine, "I carry a lot of seniors in my cab, so I just wanted to get it done early."
There are small victories in this country's fight against COVID-19 and out here on Block Island, there are some sunnier days finally within view.