Major construction projects moving forward along the U.S. borders with Canada and Mexico are raising fears that the coronavirus could race through temporary camps and workers could spread it to nearby rural communities that would not be able to handle an outbreak.

Despite a clampdown on people’s movements in much of the U.S., groups of workers travel every day from camps in New Mexico to build President Donald Trump’s border wall.

Along the northern border, TC Energy says it will start work this month on the disputed Keystone XL oil pipeline, which could bring thousands of workers to rural communities in Montana, South Dakota and Nebraska.

Residents, Indigenous leaders and state officials have warned that the influx of outsiders could make problems worse in rural areas with little or no medical infrastructure capable of dealing with a surge of infections. Both the border wall and pipeline are exempt from stay-at-home restrictions intended to reduce the spread of the virus.

Faith Spotted Eagle, an environmental activist and member of the Yankton Sioux Tribe in South Dakota, said she’s reminded of her grandmother’s stories about the tribe’s struggles to survive small pox and the Spanish flu.

Cities have borne the brunt of the virus so far in the U.S., but rural areas are expected to be hit as well.

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