First local COVID-19 case confirmed

The above map of Wyoming provided by the Wyoming News Exchange shows the number of confirmed cases of COVID-19 by county. Officials confirmed the first case of the deadly virus in Uinta County Wednesday evening.

Local organizations say they're prepared for outbreak

EVANSTON — Uinta County Public Health announced the county’s first confirmed positive case of COVID-19 on the evening of Wednesday, April 1. The agency said the patient is an adult male who is isolated at his home, recovering well, and testing was performed in Evanston. County health agencies are tracking the patient’s contacts to identify anyone who may be at risk due to exposure.

As of the afternoon of Thursday, April 2, Wyoming’s total confirmed cases stood at 150 and the global case total surpassed one million, with more than 50,000 confirmed fatalities. Wyoming remained the only state in the country with no fatalities as of Thursday, although five patients in Fremont County were said to be in critical condition and on ventilators.

Although multiple people contacted the Herald on Wednesday, April 1, to express concern about a potential positive case in a newly transferred patient to the Wyoming State Hospital (WSH), Wyoming Department of Health (WDH) Public Information Officer Kim Deti stressed there were no confirmed cases at WSH. A patient was transferred to the WSH from the Wyoming Behavioral Institute (WBI) in Casper, where there have been confirmed positive cases in both patients and a staff member; that transfer was confirmed by both WDH and WBI.

WBI Director of Business Development Emily Quarterman-Genoff said the patient was quarantined after reaching WSH as a precautionary measure pending testing results, which she said was a decision made by staff at WSH. Deti confirmed the patient was quarantined in the APS building; however, she said staff at WSH were not made aware of the potential COVID-19 exposure until after the patient had arrived at that facility.

“Further review indicated that the exposure risk was not high for this individual, but appropriate precautions are being taken,” said Deti, who also said that a “handful” of other patients in the APS building were also being quarantined pending test results.

Now that Uinta County has its first confirmed case, and as the crisis and its attendant healthcare impacts continue to make headlines around the world, providers in Uinta County say they have taken and continue to take steps to meet the challenges presented by the coronavirus pandemic.

Deti said WSH staff have been preparing for the potential arrival of COVID-19 through the preparation of beds and rooms on a separate hall of the facility and through special training of staff members. She said WSH does have a supply of masks and other PPE (personal protective equipment), which has been kept on hand for quite some time as part of the facility’s emergency preparations. Patients who need to be either quarantined (for potential exposure) or isolated (for confirmed illness) will be handled according to guidelines from WDH and the Centers for Disease Control (CDC).

John Knopf, CEO of Mountain Regional Services Inc. (MRSI), said changes were made several weeks ago closing the day facility with the exception of essential staff, scaling back transportation, utilizing online grocery shopping and more. Knopf said MRSI staff are very concerned about potential PPE shortages as the pandemic continues, especially if COVID-19 becomes more prevalent in the community.

Nancy Bunot, administrator at Rocky Mountain Care (RMC), said that facility is in “good shape” in terms of both PPE and staffing and said they implemented CDC recommended changes several weeks ago in terms of restricting visitation, taking staff temperatures at the start of each shift and other measures.

Staff at Evanston Regional Hospital said multiple changes have occurred at the hospital due to the pandemic. Chief Nursing Officer Angie Foster said access to the hospital is now limited and patients and visitors must use the emergency department entrance. All people entering the hospital will be screened for symptoms prior to entrance. Additionally, ERH is now offering TeleHealth services to allow for virtual evaluations with healthcare professionals that people can use from home, as well as curbside screening in the emergency room parking lot. If a healthcare professional deems it necessary, COVID-19 testing can be done curbside.

Foster said testing in Uinta County is limited, as is the case statewide and nationally. However, testing has been conducted at ERH, with specimens sent to both the state lab and private labs, with an average wait time of 3-5 days for results.

Although many people with confirmed cases of COVID-19 will not require hospitalization and will be able to remain in home isolation, should individuals require hospital admission, Foster said ERH is prepared. She said the hospital has a fully equipped intensive care unit with negative airflow infection and isolation control requirements, including the capability to handle critically ill patients on ventilators.

Although local patients are at times transferred to Utah medical facilities for any number of issues, Foster said there are plans in place to treat patients locally and to increase capacity for any spike in cases. She said it is impossible at this time to predict what the situation will be for Utah hospitals grappling with cases, so the hospital is prepared to handle local cases. Additionally, ERH utilizes TeleICU services to work with specialists at the University of Utah remotely so that patients can receive specialist care without leaving their home community.

Foster said ERH currently has adequate supplies of PPE; however, she noted that restocking has become increasingly challenging. As for staffing, she said, “We are used to being on the frontlines of not knowing what may come in and scaling up or down to needs is part of what we do.”

Many prominent news stories regarding the pandemic are centered on major urban areas like New York City; however, Foster said rural communities have their own unique challenges at this time, including from a financial perspective.

“The loss in the ability to perform elective surgeries has been detrimental as patient utilization has declined,” she said. “Additionally, we will have to fight hard in the coming weeks to secure sufficient funding through the CARES Act in hope of offsetting some of the critical financial and workforce impacts we’ve felt.”

Foster, ERH CEO Cheri Willard and Dr. Richard Capener of Evanston all stressed the importance of social distancing and individuals following recommendations to stay home.

“Ideally, you should stay home if you are considered a non-essential employee,” said Willard. “But if you must go out, stay at least 6 feet away from others.”

Capener emphasized that COVID-19 is not like the flu.

“The vast majority of people who get COVID-19 do recover,” he said. “However, COVID-19 is to be taken seriously. This is not just like the flu. … Both COVID-19 and the flu are respiratory, viral illnesses. They both can be spread by an infected person for several days before their symptoms appear. Symptoms for both include fever, cough, body aches and fatigue. Social distancing is key for COVID-19. Experts agree that COVID-19 is more deadly than the flu and can attack the lungs, leading to shortness of breath and pneumonia.

“The sacrifices our community and nation are making at the moment are to save lives. Our understanding of this disease and how it spreads grows every day. But really what will save lives is behaviors — not a miracle drug or vaccine. These simple words of wisdom will empower you to stay healthy during the pandemic: Wash your hands with soap and water often. Avoid being around people who are sick. Stay home if you can,” Capener continued. “This is an effort to save lives and keep the healthcare system from being overwhelmed. … Without these social distancing measures in place, the CDC has predicted the U.S. would have seen 2.2 million deaths. With the social distancing guidelines in place, they predict 100,000 people will still die. Every person that stays healthy is a win for our community, state and country.”