EVANSTON — The Wyoming Department of Health announced on Friday, April 17, that two patients at the Wyoming State Hospital have tested positive for COVID-19. The news came just a day after Uinta County Public Health announced the four previous confirmed cases in Uinta County had officially recovered.
According to the press release from WDH, the two patients are adult females who were transferred to WSH from the Wyoming Behavioral Institute in Casper on Monday, April 13. Wyoming Behavioral Institute is at the center of a known COVID-19 outbreak in Natrona County.
The two transferred patients were reportedly quarantined at WSH pending test upon arrival, although the press release states the patients were asymptomatic when picked up in Casper by WSH transportation staff.
One of the patients remains at WSH in an isolation unit set up specifically for COVID patients, while the other has reportedly been transferred to an out-of-state medical facility.
Although it is not known why the individual in this case was transferred out of state rather than being hospitalized at Evanston Regional Hospital, and due to privacy concerns, healthcare providers are unable to comment on specific individual cases, ERH Chief Nursing Officer Angie Foster said.
“Evanston Regional Hospital is open, ready and safe,” she told the Herald. “Consistent with our existing protocols, our hospital can choose to transfer a patient whose acuity level would require a higher-level of care. This is not unusual, regardless of a person’s COVID-19 status.”
“We have been preparing for the possibility that the hospital might see coronavirus patients for quite some time,” said WSH administrator Bill Rein. “Both patients were attended by nursing staff who used personal protective equipment.”
“We were aware coronavirus had become an issue at the Casper facility before these patients were transferred and we were prepared,” continued Rein. “However, our role as a safety net facility for patients who need help continues during this pandemic.”
As to a rumor circulating on Facebook that WSH staff tried to refuse the transfers but were unable to do so, WDH Public Information Officer Kim Deti said that is not the case.
“After the issue at the Casper facility was made known,” Deti said, “WSH paused admissions for a brief time to review procedures. But, the safety net role of WSH remains important. After that pause, our department’s deputy director Stefan Johansson and Bill Rein together decided to allow transfers again. After these two positive cases, there will be another pause for further review.”
As with any other confirmed case in Uinta County, public health nurse manager Kim Proffit said contact tracing and risk assessments are being done to determine risks to anyone potentially exposed to the WSH patients.
Contact tracing involves a bit of detective work and retracing a person’s steps for several days to determine where an individual went and who that person was around. Proffit explained it involves backtracking to the date symptoms first started and then looking at activity for 48 hours preceding that date since the most recent scientific evidence indicates a person can be contagious prior to showing symptoms.
For a confirmed case in the general public, the tracing involves determining if a person went shopping, to work or to anyone else’s home, etc. There is some risk of exposure for anyone who may have been in the same aisle at a grocery store, for example, at the same time as an infected person; however, that risk is thought to be minimal. Those who may have been in close contact, meaning within 6 feet, of a contagious individual for at least 10 minutes are at significantly greater risk — so those are the contacts an investigation works to find.
Those individuals are then asked to quarantine. If a person begins to show symptoms during the quarantine period, that individual is presumed to be positive and may not actually be tested due to testing shortages and restrictions.
The process of contact tracing is similar within a healthcare facility like WSH, said Proffit. Infection control staff use a guidance document from the Centers for Disease Control (CDC) that contains a rubric or checklist to examine each individual who may have been exposed to a COVID positive patient to determine the level of risk, including transportation staff, healthcare workers, housekeeping and maintenance staff, food service employees, etc. For each individual, risk is assessed based on multiple factors, including whether staff were utilizing proper PPE (personal protective equipment) during any interaction.
Proffit said she understands the concerns of community members and especially staff at WSH due to the confirmed positive cases; however, she said she hopes it helps ease public fears to know that she feels staff and administration at WSH are taking the situation seriously.
“I can’t speak directly for them, but my experience is that they’ve been extremely concerned and are looking very closely at all possible exposures,” Proffit said.
She also emphasized that exposure does not necessarily mean a person is definitely going to become infected, since COVID is very contagious, but not at the levels of other viral illnesses, like measles, for example.
“In fact, in our county so far, nobody who has been quarantined due to contact tracing exposure has actually gotten it,” she said.
Although Proffit again said she cannot speak for WSH or WBI, she said it is possible the two patients were tested prior to being transferred and those tests came back negative.
“A false negative test can be tricky,” she said. “I could be exposed today and have a negative test tomorrow because there’s not enough of the virus being replicated yet for me to have a positive test.”
She said a negative test can sometimes give someone a false sense of security for that very reason.
A press release from WDH last week announced that CDC staff had arrived in Wyoming to help with efforts to control the COVID pandemic, including at mental health facilities. Proffit said she doesn’t know if that means some of those CDC staff will be coming to Evanston now but she hopes that is the case because she thinks it might help reassure an uneasy public that the proper steps are being taken to minimize exposure at WSH.
“It’s here in our community and we’re doing our very best to manage it and support people who may have been exposed,” said Proffit. “It’s scary and we understand that. Knowing that one of the patients was transferred means she’s sicker and that’s a scary thing. We understand people are scared and upset.”
As to the possibility of more patients being transferred to WSH from WBI, WDH Director Mike Ceballos said that is possible, especially when the new addition to WSH opens in June. Ceballos explained that mental health patients around the state are often temporarily housed in other facilities when no beds are available at WSH, including at WBI, which was the situation with these two patients. When beds do become available, it is the mission of WSH to care for the healthcare needs of Title 25 individuals.
Ceballos said nobody at WDH knew the two patients were infected when they were transferred; however, he reiterated they were placed in quarantine upon arrival, and after the positive test, the patient still at WSH was placed in isolation. He said he understands the concern and problems positive cases create in the community and said WDH is committed to ensuring WSH staff are protected, especially because healthy staff are necessary for the facility to function. He also emphasized the commitment to ensuring other patients are also cared for.
“We are taking every precaution we can to meet the mental health needs of our state while also protecting patients and staff,” he said.
Proffit asked community members to continue doing their part to slow the infection rate and keep fellow community members and healthcare workers safe. She said she understands people’s frustrations and economic concerns but asks that people refrain from gathering together in groups to protest closures.
“Local and state officials are also frustrated and concerned,” she said. “They have to balance lots of different factors and sometimes competing interests. I can assure you that nobody is willfully dragging this out any longer than necessary. I want to encourage continued cooperation. If we are able to avoid a crisis in our county, I would think we can attribute that to early action and intervention by Gov. Gordon.”