Jean Allais

In the beginning of the COVID-19 pandemic, if you had mild symptoms and were able to recover at home, you were not tested. Nobody had testing in place for several reasons. Because it was a new virus, a test had to be developed. Then there were problems obtaining the supplies needed for testing. There were not enough tests. Tests were reserved for people who were at higher risk of severe illness. Moving into the new phase of starting to reopen the economy, Public Health wants everyone who has symptoms to get tested, and now there is the capability to do that. Knowing what is going on locally helps us to control outbreaks and prevent spread in our community.  

How can the economy be reopened safely? To understand, let’s go back to the beginning. The Coronavirus was a new virus, and everyone was susceptible to it. Remember those graphs with the steep curves? Those were based on the doubling time of infection of the virus. Let’s say the doubling time is 2 days. If there were 5,000 cases on Monday, on Wednesday there would be 10,000 cases, and on Friday 20,000 cases. Social distancing keeps that curve flat. Stop social distancing, and there will be a rapid resurgence, a steep curve. That would occur in two weeks, the incubation period of the virus. The challenge as the economy begins to reopen, is how to deal with the fact that there can be a rapid rebound? 

There are two public health response strategies. One is mitigation, in which the goal is to keep health care systems from being overrun. Governor Gordon declared a state of public health emergency on March 13. Gatherings of 10 people or more were prohibited, schools were closed, and people were asked to stay home. In addition to this social distancing, increased hygiene measures with frequent hand washing and sanitizing procedures were recommended. The goal with containment is to reduce numbers such that cases can be contact traced and isolated. It is a much more aggressive strategy, as we try to identify everyone who has COVID-19 and their close contacts. Public Health is moving from a mitigation strategy to a containment strategy as the pandemic evolves. 

Does social distancing work? Yes, significantly reducing contacts dramatically reduces the infection rate to a more manageable level. We as a community succeeded in flattening the curve and preventing a big spike in infections that threatened to overwhelm the healthcare system. But it was never expected to wipe out the virus completely, or to thoroughly contain it. Now that flattening the curve has succeeded, it offers the opportunity for many people to go back to work, or other activities, under carefully controlled conditions, so that we can keep the curve relatively flat. Those conditions continue to include social distancing, good hand hygiene and sanitizing procedures.

Albany County Public Health, working with community leaders and the Wyoming Department of Health, is following a stepwise approach to easing of restrictions. There will be continued attention to social distancing, hygiene measures as well as use of face coverings. Initially the restrictions are being lifted in areas that are of least risk, like places that rely on one-on-one encounters, such as hair and nail salons and barber shops. Gyms have been able to open with limits on number of people in an area, and increased space between exercise equipment. On Friday, May 8, restrictions were eased on bars and restaurants and other food and beverage establishments in Albany County. Tables must be at least 6 feet apart, and there will be less contact between waitstaff and patrons.  Sanitizing between customers will be increased. 

As these changes are implemented, we are watching our data in Albany County, surrounding counties, and the state. That data includes number of new cases of COVID-19, percent of tests that are positive, amount of community spread, number of hospital beds available, particularly ICU beds, and availability of personal protective equipment (PPE) and other equipment.  There also must be capability of widespread testing. Testing is our early warning system. Public Health must have the capacity to contact trace, isolate and quarantine people. 

It is a balancing act, and the balance so far has been tipped towards restrictions. As we move to loosen restrictions, the balance is starting to be reset. Testing is a key piece to the reset. Testing has the potential to move us away from the widespread closures and restrictions and move us towards a set of disease control measures. We want to diagnose as many people with COVID-19 symptoms as possible. What will be the response to those tests? Pretty much the same as now. Those with mild symptoms will be isolated. Those with severe symptoms will receive medical treatment. We want to test everyone who has symptoms of COVID-19. We will be much better able to trace contacts and quarantine people who have been exposed, so we can keep that curve flat. The test that determines if you have active infection is the viral test. Currently, antibody tests are not reliable enough to use as a basis for reopening strategy.

If you have symptoms of fever, cough, or shortness of breath, or think you have COVID-19 call your health care provider. Stay home except to seek medical care and to get tested. More severe symptoms include trouble breathing, persistent pain or pressure in the chest, confusion, or inability to stay awake and you should call the emergency room right away. Be sure to call ahead first to let them know you think you have COVID-19 symptoms. More information can be found on the Albany County Public Health website: publichealthlaramie.org, the Wyoming Department of Health: health.wyo.gov, or the Centers for Disease Control: cdc.gov

Dr. Jean Allais is the Albany County Health Officer. 

(19) comments

Brett Glass

We have nowhere near adequate testing, nor do we meet any qualified epidemiologist's criteria for easing restrictions. We must not "reopen." If we do, we'll follow in the footsteps of other countries and provinces, such as the Japanese island of Hokkaido, which have seen huge spikes in sickness and death during even partial relaxation of social distancing constraints.

TheReplacement

"We must not "reopen." If we do, we'll follow in the footsteps of other countries". Like Georgia USA which opened two weeks before WY and saw their cases DROP!! Dr. Jean is probably a nice lady but she just carrying water for our disaster of a governor who put this entire state into a depression and ruined thousands of lives.

Brett Glass

False. Every place which has attempted "reopening" has seen an increase in infections. Either you have been watching too much Hoax News or - more likely - you've got a vested interest in lying. No wonder you're hiding behind a pseudonym!

TheReplacement

You just can't keep from lying can you. Now go back to hiding under your bed.

https://www.zerohedge.com/health/georgia-covid-hospitalizations-drop-after-state-reopens

Brett Glass

Oh, and in case folks are interested in the actual stats from Georgia, and the predictable disaster that is already resulting from its unwise "reopening," see

https://www.forbes.com/sites/alexandrasternlicht/2020/04/29/georgia-coronavirus-deaths-surpass-1000-forecaster-says-will-double-by-august-with-reopening/#6297cdcd4353

TheReplacement

How many $Billions in bailout cash did oligarch Steve Forbes get for publishing this garbage?

Brett Glass

Ignore the troll, folks. There's a good reason s/he is hiding behind a false name. For more on Georgia in particular, see https://www.theatlantic.com/health/archive/2020/04/why-georgia-reopening-coronavirus-pandemic/610882/

TheReplacement

Ignore the fear mongering peddler of fake news with the fake name and the fake life. For Georgia see here: https://www.zerohedge.com/health/georgia-covid-hospitalizations-drop-after-state-reopens

Brett Glass

Also, for information on the disastrous "reopening" on the Japanese island of Hokkaido (which led to a second lockdown after a startling increase in infections and deaths), see https://time.com/5826918/hokkaido-coronavirus-lockdown/ Note that because the incubation time of the virus is as long as 14 days, they realized their mistake only after they had a huge problem on their hands.

TheReplacement

Have you just flown back from Hokkaido? If not then dispense with your drivel.

Brett Glass

Dispense with your gaslighting.

TheReplacement

Dispense with irrelevant, off-topic and unverifiable comments.

Brett Glass

Research has now also shown that areas lacking proper social distancing experience 35 times the amount of coronavirus spread. See https://www.nbcnews.com/health/health-news/live-blog/2020-05-14-coronavirus-news-n1206776/ncrd1207406

TheReplacement

For once you are spot on. Social distancing plus washing hands. That's why Sweden wins hands down. Cloth masks are both useless and dangerous. That are used for virtue signaling only, any medical practitioner not owned by the med cartel or big pharma will tell you that.

Brett Glass

Sweden has lost... hands down. It has had the worst track record of any European country. Seehttps://www.forbes.com/sites/davidnikel/2020/04/14/sweden-22-scientists-say-coronavirus-strategy-has-failed-as-deaths-top-1000/#6f8f72057b6c

TheReplacement

How pathetic it is to still be referencing fake news from bailed out oligarchs.

Brett Glass

Masks work, just as they did during the 1918 influenza outbreak. When masking ordinances were lifted, cities such as San Francisco suffered massive resurgences and thousands of lives were lost.

TheReplacement

Cloth masks are both useless and dangerous. The next round of COVID illnesses will strike the cloth mask wearers.

Brett Glass

Again, displaying your ignorance. The purpose of cloth masks - and they have PROVEN to be effective - is to protect others, not you. So we should all not only wear them but insist that OTHERS wear them.

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