In the past week, Jefferson County joined the rest of the planet in playing out a classic civic dilemma pitting public safety against economic well-being. It’s worth exploring what happened to better understand the forces at play, decisions that were made and not made, and the potential impact of resulting policy.
Executive summary: There’s no easy answer.
Some background: Montana state law requires every county to employ a health officer whose job is to advocate for public health and to make independent decisions when threats emerge. Specifically, the law empowers the health officer, in collaboration with federal, state, and local officials, to “take steps to limit contact between people in order to protect the public health from imminent threats, including but not limited to ordering the closure of buildings or facilities where people congregate and canceling events.”
Jefferson County’s health officer is Joan Van Duynhoven. You will only hear about her at moments like this, when bad things are happening. Until her recent retirement, she was a certified nurse midwife at the Butte-Silver Bow Health Department.
I spoke with Van Duynhoven last Wednesday, March 18. The first COVID-19 cases had emerged in Montana, including patients in three neighboring counties. The state had already ordered all public schools to close. Things were happening very quickly.
In an announcement released that morning by the County Health Board, Van Duynhoven had recommended that county businesses take steps to prevent the disease’s spread. Among others, “bars, breweries, distilleries, casinos, restaurants, and gyms are strongly encouraged to voluntarily suspend operations.”
Importantly, there was no order for those businesses to close — and some wondered why not. “Maybe time for Jefferson County Commissioners to step up to the plate and close places where 10 or more gather,” John Stangland wrote on Facebook. When it was noted that this wasn’t the Commissioners’ call, Betty Ellis responded: “Whoever’s jurisdiction it is, please just do it.”
Van Duynhoven told me that she had weighed stronger measures. “I was ready to close businesses,” she said. But she felt that, with no active COVID-19 cases, the county had “breathing room.”
And she added: “I’ve lived in Jefferson County for over 40 years. I personally feel like I have to take into account what our culture is, and who’s going to be hurt. It’s our families, when you do something like close businesses.”
This was the tension that defined discussion throughout the week as the county shifted into emergency gear. Officials took the health risk seriously – but they weighed the profound risk to the area’s locally owned companies of a prolonged shutdown. And they wondered: Can’t this wait?
County Commission Chair Leonard Wortman said later that, although it wasn’t his decision, he personally had supported keeping businesses open. “The economic well-being of citizens is not equal to the health and safety of people. But to me, well, we had our [restaurants and bars] open when everything else was closed, and we don’t have any cases so far.”
Here’s the thing: The brief, dizzying history of COVID-19, and that of previous pandemics, tells us that forceful actions earlier in the game can limit spread of the disease. It took three weeks after an initial outbreak in Lombardy for Italian officials to declare a mandatory shutdown of the region; now, Italy has the most active cases in the world, with an astoundingly high death rate.
China, on the other hand, has apparently stopped new cases by locking down 780 million people for a month. But experts worry that, as long as the pandemic rages everywhere else, the disease will reemerge in China the instant restrictions there are lifted. “I don’t see the long-term plan for those locations. Are they going to just cycle, just down one month in every three months? Because that’s extremely destructive to the economy,” Dr. Ben Cowling, who leads the World Health Organization’s Collaborating Center for Infectious Disease Epidemiology and Control at Hong Kong University, told Business Insider.
So, back to Jefferson County: Officials here faced a no-win decision in the face of rapidly changing information and limited visibility. Shutting down businesses surely would help lessen the risk that COVID-19 could spread. But doing so earlier than was necessary – whatever that means – would damage the area’s economy, possibly for a long time. Past experience shows that economies eventually return to vitality after pandemics, but it can take years.
Van Duynhoven chose the more moderate course. And for two days more, many of the county’s restaurants and bars stayed open. In Boulder, The River Pizza & Subs kept its grill and its dining room open, though owner Greg Hughes called off his Friday night buffet to reduce crowding. “Stay safe and see everyone at The River,” he wrote.
And then, finally, Governor Steve Bullock shut down the party. On March 20, he directed that restaurants, bars, cafes, gyms, movie theaters, and casinos, among other establishments, close by 8 p.m. that evening, though take-out and delivery service would still be allowed.
Was it the right decision? Montana’s COVID-19 patient count has grown in the days since, but its total is still relatively low. As of this writing, there are still no cases in Jefferson County.
Wortman isn’t convinced. The state, he says, “targeted small businesses, because people congregate there. But what are you going to do later this month when you have 100 cases [in the state]? You won’t open those businesses back up. You can’t, until this thing is under control. How long is that going to be? Three months? Six months? I bet we’re going to have businesses that aren’t going to come back.”
Like I said: No easy answer.