031820 Doug Dodge and Karen Wandel

Doug Dodge, Jefferson County’s director of emergency services, and County Public Health Supervisor Karen Wandel, at a special meeting of county officials on March 16 to plan the county's response to COVID-19. 

On March 13, Montana reported its first four known coronavirus cases, confirming the presence in the state of the virus that has spread quickly around the world since appearing in China’s Wuhan province in December.

None of those known cases are in Jefferson County. But the risk of contagion is high, and the county’s public health department is working to help prevent the spread. Karen Wandel, the department’s supervisor, spoke with The Monitor on March 14.

Have you experienced anything like this before?

I’ve been a public health nurse for 19 years. I worked through the H1N1 virus in 2009; that was a big one. I remember SARS, but we didn’t have any activity. And then MERS, which was similar to the coronavirus, but it wasn’t as efficient at spreading.

But this is the first time it’s actually hit where it seems there’s a lot more concern about the severity for certain populations. With H1N1 in 2009, we were getting geared up for a 1918 Spanish Flu situation, and that didn’t happen. Because of that, I’ve heard several people say this time that the Swine Flu was going to be a big deal and it wasn’t – so this is going to be the same. But it looks like the severity [with the coronavirus] for some people is going to be much worse. So, it’s really important for us to protect older adults and people who have chronic medical conditions.

A lot of this is about which population is susceptible. Often people will have a little bit of an immunity, because your system remembers a similar-looking flu. With the 2009 flu, the older population may have had some immune memory from being exposed many years before to a similar virus – but it was hitting pregnant women, the obese, and children, a different demographic. With this one, you don’t know for sure, because you have pretty much the whole population whose immune system hasn’t seen this virus before.

The question on everyone’s mind is: How serious is this? And the answer seems to be something between “very” and “we don’t know.” Can you help guide us?

That’s a good way to put it. But the other side is, they say that 80% of people who get this virus won’t notice the difference between this and a regular bad cold. They won’t need any special attention, they’ll just need take care of themselves at home. Most people are going to manage it just fine. There’s a small percentage who will be more serious; all these preventative measures are efforts to protect those people, and to slow down how quickly people get infected.

The first four Montana cases, which were announced Friday night, were really spread out. What does that mean?

To me, it means that the virus has dispersed already. It’s not just one cluster in Bozeman or Missoula. There was a case in Lewis & Clark [since corrected to Broadwater] County, but not in Jefferson. I was very relieved.

How is testing happening?

It might change, because things have been evolving so quickly. But for now, if someone who thinks they have the virus goes to their doctor’s office – and they’re supposed to call ahead – they’re masked immediately and put in private room. If the provider wants to get them tested for COVID, they call the county health department. The state wants to verify that there’s a risk: Do they have symptoms that are consistent with the virus, have they been anywhere where they could have been exposed? In those cases, the health departments have been saying, go ahead. We call the state and tell them we’ve had a report. And the provider sends the specimen to their lab; if the lab doesn’t have test kit, and most of them still don’t, then it’s forwarded to state Montana Public Health Lab in Helena. The turnaround is really fast. If you can get specimen in by 11 am, you can get results by the end of the day.

Is being in a rural community a good thing, because we’re more spread out?

It is, without a doubt. But we still have to be careful. If we actually stayed in our communities and didn’t travel outside the area, it would be an even greater benefit. But a lot of people do shopping, and Costco and Walmart are crowded places right now. The state basketball tournaments are this weekend, so you have big crowds there; I’m glad that’s almost over.

Lewis & Clark County declared a state of emergency on Friday. Will Jefferson do the same?

I’m not sure. [County officials] will be meeting on Monday afternoon, and I’m sure we’ll discuss that. And there’s no word yet on schools. My concern there is about working parents, because for those smaller kids someone is going to be home.

We’ve started to see public events and activities being canceled. Is that the right decision?

It probably is a good thing. Right now, they’re saying that some things that can help slow the spread are basic hygiene and regular cleaning – but also, community measures for avoiding crowds. So, the ones that are canceling, they’re thinking about how contagious this is and trying to limit the number of people who may be exposed in one setting 

What has your team’s day to day been like the last few weeks? How are you spending your time?

We’re answering a lot of calls now. It’s mostly the “worried well” — people asking, “I’ve got this symptom, or I was on a plane a week ago, should I get tested?” There’s been a lot of that. We’re talking a little with the schools, and with health care providers asking where we’re at, what are the protocols, reviewing that with them.

And then we’re doing some messaging about what’s happening and preventive measures. We’ve gone to Facebook, where we can put things up more quickly. We’re going to try to set up a dedicated phone line with basic information, and where we’ll check messages. People also can call the state information line at 1-888-333-0461, or email question to covid19info@mt.gov.

We don’t learn anything before anyone else. Every Friday, I get an update from the state Department of Public Health and Human Services. We have one conference call each week with the state, and we’ve jumped on some of the Centers for Disease Control media calls. And we get e-mailed information from both the state and the CDC. My biggest gripe is, we get layers of new information on top of old, 10-page reports. It’s hard to stay on top of what’s new.

What’s the most important thing people can do right now?

A lot of this is about basic hygiene and cleaning. Stay at home if you feel even mildly sick. Wash your hands regularly with soap and water; don’t touch your face; cover your coughs and sneezes. And keep high touch surfaces clean.

We’re going to get through this one way or the other. But we’ll get through it better if everybody has the mentality that we’re here to help each other. If they know someone they think is going to struggle through this, mentally or physically, be there for them. If you have resources to help people buy groceries, or you have a little stockpile of supplies you can share — soap, maybe, or hand sanitizer — then share.

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