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WDH explains case reporting policies
As new orders go into effect that will further reduce the restrictions imposed on Wyoming’s businesses and citizens, and the legislature announces progress from its two-day special session, the state recorded three more deaths from the novel coronavirus this week.
The first of the three reported deaths occurred in Fremont County over the weekend. The older, hospitalized woman was described by the Wyoming Department of Health (WDH) as having existing conditions that put her at higher risk of serious illness related to the virus.
Two more deaths were reported on Monday, but neither were recent. One occurred in March and the other in April and took place in Colorado, which WDH stated in a press release meant they were only reported very recently to Wyoming and had not been previously included in the case count.
“When Wyoming residents pass away in another state from a disease such as COVID-19, it is a widely accepted practice to track those deaths based on the location of the person’s permanent residence,” said Guy Beaudoin, deputy state registrar with WDH.
“In Wyoming, we have instructed medical certifiers such as attending physicians and coroners that COVID-19 should only be reported on death certificates when the disease caused or contributed to a person’s death. So if someone who happens to be positive for COVID-19 died due to an automobile accident, their passing would not be counted as a coronavirus-related death.”
The state has appeared over the last few days to be experiencing a minor spike in recorded cases, with the usual single-digit daily tally increasing to 12 new laboratory confirmed cases reported on Friday, 18 on Saturday and 11 on Monday.
A portion of these were attributed by WDH to a small outbreak in a long-term care facility in Washakie County, where five cases among staff members and four among residents were identified. It is unclear how the virus was introduced to the facility.
WDH is now encouraging anyone with symptoms related to COVID-19 to get tested. According to state health officer Dr. Alexia Harrist, testing is significantly more available now than it has been previously during this pandemic.
New Orders
The dashboard being used at the state level to dictate decisions about restrictions and health orders remains unchanged this week. Only the number of new cases is currently considered to be a concern.
The other five metrics are said to be stabilizing: percent of cases attributed to community spread, percent of all tests that are positive, admissions reported by hospitals, hospital bed availability and total ICU bed availability. Given these metrics, said Governor Mark Gordon last week, it has been possible to ease restrictions further.
“We will continue to focus on safety with these new orders. These orders contain detailed social distancing requirements,” he said, noting that COVID-19 is “still capable of wreaking havoc”.
The first change to the statewide health orders allows restaurants to resume indoor and outdoor service under operational guidance. Face coverings, social distancing, increased sanitation, fewer tables, stocking of personal protective equipment and screening of employees will all be required, Gordon said.
“I want to thank the restaurants and bars for their patience as we’ve worked through this,” he said.
Meanwhile, movie theaters, concert halls and music halls must limit groups of customers to six and maintain a six-foot distance between groups, while gyms may offer classes up to 20 as long as they follow the six-foot distancing rules and daycares may now host up to 25 children and providers with an increase of hand washing and sanitation and a limit on parents being in the facility.
The second adjustment to the state orders increases the maximum number of people who may gather in one place from ten to 25, with an exemption for establishments where more than 25 people would normally be present, such as theaters.
Churches may have more people as long as the six-foot rule is followed and with proper sanitation. Gordon thanked spiritual leaders across the state “for taking the care of their congregations so seriously” and suggested a continuation of online services where possible for the sake of vulnerable populations.
The third adjustment removes the provision that there can be a maximum of nine people in a room or confined space. Businesses such as hairdressers and tattoo parlors may now have additional clients in the building at one time as long as they maintain a six-foot distance between stations.
Yellowstone and Grand Teton National Parks re-opened with limited capacity on May 18, with the only access through the south and east entrances in Wyoming. Mitigation plans are in place, said Gordon, “and I support this slow approach, which is being conducted in a safe and prudent manner”.
The goal is to prevent these destinations from being overwhelmed while also reawakening the economy, the governor said. This will of course mean more traffic in the state and more people.
This is “not a hold-my-beer moment,” said Gordon. While it is an exciting time for Wyoming, it is also a time for caution.
Mitigation Efforts
Mitigation strategies will continue to be important, Governor Gordon said. The state will continue to allow employees to telework wherever possible, though conversations have begun about bringing some employees back in; Gordon encouraged private employers to also allow staff to continue teleworking where possible.
Meanwhile, he said, around $15 million of the funding directed to Wyoming via the federal CARES Act has been allocated to the WDH to increase testing and contact tracing capabilities.
“These will be essential as we move forward,” he said, because the state will be able to identify cases more quickly and act to prevent further spread.
The Wyoming Department of Homeland Security has also received $2 million to purchase and distribute personal protective equipment to non-healthcare entities.
According to Dr. Harrist, a new drug has been received that is thought to be beneficial for COVID-19 patients. At present, its use is only authorized for seriously ill and hospitalized patients due to the limited supply, with further shipments hoped for in the near future.
“We’ve taken some big steps forward in the last weeks,” said Harrist. The state is pleased, she said, but the measured approach must continue.
Harrist said she believes Wyoming has prevented the danger of being overwhelmed, as has happened in many other places around the country.
“I know this has been difficult and I hear from people every day about their frustrations,” she said. However, we cannot go back to doing things as we did as social distancing will remain critical.
The new restrictions will encourage safe operations, Harrist said, and the state is not allowing for large events yet because, “More people means a higher chance that someone who is there is infected and may not know it.”
It’s not possible to predict every outcome in a situation like this, Harrist said.
“Viruses don’t play fair, they are tricky and sneaky,” she stated. And while that’s generally true of every virus, she pointed out that this one is even trickier because it’s new, which means there is no baseline immunity in the general population, no treatment and no vaccine.
“Please know that we don’t make these tough decisions without knowing they have real consequences,” she said.
Caution Ahead
Governor Gordon warned last week that there is still a possibility the situation can change, and the state retains the right and ability to roll back the advances made on easing restrictions. The responsibility for making sure that does not happen rests with the citizens, he said.
“It is only you who can prevent the kind of rollback that we might require,” he said, emphasizing once again the need for every person in Wyoming to practice social distancing, regular hand washing and other precautionary measures.
“Above all, think about all of Wyoming’s citizens in your behavior,” he said.
Speaking to the growing unrest around the state, with a number of people feeling that it’s time to get rid of the restrictions altogether, Gordon suggested that the reason the state appears to have overreacted is precisely because the measures have worked to prevent unchecked spread of COVID-19.
“With the benefit of hindsight it’s easy to say that we’ve done too much. I would say we’ve done what we should,” said Gordon.