'We need to remain vigilant'

As has been the case since March, the Board of Carbon County Commissioners (BOCCC) received an update on the novel coronavirus (COVID-19) from Public Health Nurse Manager Amanda Brown on May 5. During that discussion, the BOCCC praised the ongoing response from Carbon County Public Health while expressing frustration with communication from the State of Wyoming.

Brown informed the county commissioners that, as of May 5, Carbon County Public Health had been monitoring nearly 70 individuals with symptoms similar to COVID-19. Of those, 43 individuals had been tested and 20 had not been tested. The 20 who had not been tested, Brown clarified, had been during the time period in which testing supplies had been scarce throughout the country.

“As of right now, we are testing anyone with COVID-like symptoms,” said Brown.

According to Brown, of the individuals that had been monitored since the onset of the pandemic, 41 were considered recovered and 26 were still sick. She added that Carbon County was seeing an eight percent hospitalization rate of the individuals being monitored.

“Right now, we have diagnosed nine positive cases in Carbon County, four of those being out-of-state residents. So, they did not count as Carbon County numbers but we are still monitoring them,” Brown said. “Five of those are still ill and not recovered. So, four of the nine have recovered.”

Commissioner Travis Moore, who serves as the BOCCC representative to the Carbon County COVID-19 Incident Management Team, asked Brown if the State of Wyoming had determined the availability of hospital beds within the state and in surrounding states.

“Carbon County, for example, if we had a bunch of people that were seriously ill, I know that we utilize surrounding hospitals, the Wyoming Medical Center, Cheyenne, a couple hospitals in the Front Rage. Has the State really looked at that in terms of that medical capacity because, I know, once we can’t send anybody out anymore, that’s when we’re looking to get in trouble,” said Moore.

Brown replied that, if the State had determined medical capacity outside of Wyoming, Carbon County Public Health had not been informed. She added that public health had been using a program called HAvBED to monitor the availability of Intensive Care Unit beds throughout the state and that the hospitals within the state had their own lines of communication.

“Being that they’re the ones that set-up the data points, that one would appear to be very critical for counties to make decisions and they haven’t released the data to do something,” Moore said. “It’s troubling to me that the State determines the metric and then does not release the data for people to interpret said metric to make decisions. That’s the main trigger point that all the counties are waiting for.”

Brown informed the BOCCC that while there was still a lot of data and information still needed for a more complete picture, she was working on compiling what data sets she had into a usable format.

“We will be looking at the hospital beds, the ICU bed, the percentage of tests we are doing compared to the test percentage of the people sick, the positives. All of those metrics will be monitored at the local level and then the State kind of lets us know how many tests are done to reference labs because we don’t always have access to that information,” said Brown.

Following Moore’s line of discussion, BOCCC Chairman John Johnson asked Brown if Carbon County and Wyoming had been able to avoid overwhelming medical facilities. This had been the stated purpose of the health orders issued by Governor Mark Gordon beginning with the closure of various businesses on March 20.

“It did get a little close at the state level. In the last few weeks, the ICU in Casper was at capacity, so they started their surge planning but, as far as locally, we have not,” Brown said.

Returning to the discussion on available data, Moore stated that the State of Wyoming kept information on medical patients rerouted to different hospitals in the state during large events such as Cheyenne Frontier Days. It appeared to be Moore’s suggestion by examining that data, the State of Wyoming could be able to develop a trigger point that could then be relayed to the counties throughout the state.

“I know that data exists. If there’s a discussion to be had with State Health, would you please ask them to do that to accelerate this process,” said Moore.

Finally, Brown informed the BOCCC that Wayne Couch, Carbon County Health Officer, was working on a series of variances to be submitted to State Health Officer Alexia Harrist. Those variances were approved on May 8 and allowed for a number of businesses and churches in Carbon County to operate on a limited capacity. This led to a question from Johnson about variances that would open up everything in Carbon County currently closed by the health orders.

“We still need to be vigilant so we don’t end up seeing a spike in cases. We still want to maintain safety for our Carbon County residents,” said Brown. “We don’t want to lose the ground that we’ve already made. If we open up too quickly, it may backfire (on) us, it may not, we just don’t know. I think taking more of a conservative approach to opening may be wise but we don’t want to be too conservative and keep everything down. It’s a balance between supporting our economy and opening back up and still protecting the health of our residents.”

Several of the commissioners informed Brown that, in recent weeks, they had heard from business owners and residents throughout the county who were frustrated with the effect the health orders were having on the economy. They were quick to add, however, that they understood the caution that Brown and Couch were showing and were not being critical of either individuals’ performance during the process.

“We’re just trying to make this as simple as possible. I know everybody … wants their sector to be open but we’re trying to just look at the essentials first and kind of ease into it,” Brown said.

The next meeting of the Board of Carbon County Commissioners will be at 9 a.m. on May 19 at the Carbon County Courthouse in Rawlins.