Jean Allais mug

Dr. Jean Allais, MD

Albany County health officer

Wyoming is currently ranked ninth nationally and is in the “red zone” for new COVID-19 cases, meaning we have had more than 100 new cases for every 100,000 residents in one week. Over the past couple of weeks, there are new records in the State for number of new cases in one day, number of hospitalizations, and number of deaths. Albany County ranks highest in Wyoming with over 3900 cases per 100,000 population. That’s twice as many compared to Laramie County and Natrona County. Albany County has consistently had the highest number of active cases in the state over the past two weeks.

Aren’t the increased numbers just because we are testing more? Total number of cases, and cases based on population do not tell the whole story. The most important metric is percent positive cases — the percentage of coronavirus tests done that are positive. Percent positive is an indication of how widespread infection is in the community tested. The higher the percent positive, the more concerning. The thresholds most often cited, recommend keeping that number below 3%, and closer to 2%. At 5%, the community is considered a “hot spot.” The two-week rolling average for Albany County is currently 4.4%. For comparison, Laramie County is at 10.4%, and Natrona County 16.6%.

The current numbers reflect what happened two weeks ago. What we are doing now will be reflected in our numbers two weeks from now. If we do nothing different, our cases will continue to escalate. In Casper, which is in Natrona County, Wyoming Medical Center, has activated “Code Orange,” which set several emergency protocols into place. They have opened a COVID-19 ward and are now starting to cohort two patients per room. They are making double rooms in the non-COVID areas of the hospital. They are housing admitted patients in the Emergency Department because there are no beds available on the wards. Our goal throughout this pandemic has been to not overwhelm our healthcare system. Unchecked, Albany County will be in the same situation Natrona County finds themselves in now. Ivinson Memorial Hospital not only serves the residents of Albany County, but many tourists, who will stress its capacity. Excess strain on IMH resources will impact its availability not just for COVID-19 patients, but also for other members of the community in need of medical care.

COVID-19 is a highly contagious disease that spreads person to person by droplets that are formed when someone who is infected coughs, sneezes, or talks. Each person who is infected can infect two to three more people. When someone tests positive, they are isolated to help break the chain of spread. Then why doesn’t isolation of infected people stop this outbreak? We know that the virus can be passed on to infect another person even when the infected person does not have symptoms. Transmission can occur two days before someone develops symptoms and they don’t even know that they are sick. It can also be spread by someone who is infected and doesn’t develop symptoms at all.

Studies have shown that consistent and correct use of face coverings can reduce spread of Coronavirus by 85%. Albany County School District No. 1 is doing a great job. They have a mandatory mask policy, and although there have been cases of COVID-19 in students, as well as in faculty and staff, there has been no transmission of the virus in the classrooms. According to a study by the University of Kansas Institute for Policy and Social Research, Kansas counties that had a mask mandate had a 50% reduction in the spread of COVID-19 when compared to those without. Vanderbilt School of Medicine found that in Tennessee, hospitals that predominantly serve patients from areas without masking requirements see the highest rate of hospitalizations compared to areas with mask requirements.

With hope of preventing more death and disease from COVID-19 in Albany County, a Public Health Order that requires people in Albany County to wear facial coverings in certain public settings has been issued. It is effective 5 p.m., Friday, Nov. 6. After consultation with Community Partners, including business professionals and public officials, as Albany County Health Officer, I requested this be implemented. It has been approved and signed by the State Health Officer, Dr. Alexia Harrist. It is modeled after orders already issued for Laramie County and Teton County. The order requires face coverings for everyone who is inside or in line to enter a retail or commercial business, as well as county and municipal buildings and healthcare operations. Everyone who works or volunteers in these places must also wear a face covering when interacting with the public or working in a space visited by members of the public.

Minors three years and older are encouraged to wear face coverings in these settings. There are exceptions for medical conditions and disabilities. Face coverings are not required while eating or drinking in an establishment, or actively exercising in a gym. The person shall wear a face covering while entering, exiting, or otherwise moving about the establishment. The full health order can be found at: www.CityofLaramie.org/masks

As of Wednesday, Nov. 4, the Wyoming Department of Health reported COVID-19 related death in 105 Wyoming residents. Six were residents of Albany County. They need to be more than a statistic. They were grandparents, mothers and fathers, aunts and uncles, brothers and sisters, friends and neighbors. This is a public health emergency, and as County Health Officer I cannot in good conscience do nothing. I need community support of this, so that some day we can get some normalcy back into our lives. In the meantime, we need to wear face coverings in settings where physical distancing measures may be difficult to maintain. It will slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.

Jean Allais, MD, is the Albany County Health Officer.

(4) comments

Brett Glass

Finally! But alas, probably too little, too late. We need to shut down bars, indoor dining, in person classes, gatherings of more than 8 people. The virus doesn’t care about your political views, and with winter setting in it will be deadly.

WYO1

Just wanted to point out that nobody seems to talk about the death rate. Just doing the math from what is posted online that the death rate looks to be about ~.007 which is less than 1% . I got the numbers from the Casper Star-Tribune today. Seems pretty low to me, less than the flu..now, this is for Wyoming, not sure about elsewhere. I just don't like the issue being cases, the death rate is the major issue to me.

geo

Yes, the Albany County death rate is currently fairly low and is much lower than the US death rate, which, going by numbers from Johns Hopkins, is 2.4% as of yesterday. However, cases have only recently started to rise in Albany County, and we can expect more deaths here since they lag several weeks behind the positive case increase. The fact is at least 235,000 Americans have died so far and this is totally unacceptable. Models project upwards of 300,000 by the end of the year and half a million by February. The seasonal flu has a mortality rate of much less than 1% (on the order of thousandths of a percent). COVID is absolutely much worse than the seasonal flu going by death rate.

jbrionez@live.com

@WYO1, thank you for pointing out the fact the mortality rate is low. Another also important outcome of COVID-19 is, according to Dr. Andrew E. Budson, chief of cognitive & behavioral neurology at the Veterans Affairs Boston Healthcare System, the potential for cognitive impairment in people who survive it.

Dr. Budson wrote, "COVID infection frequently leads to brain damage — particularly in those over 70. While sometimes the brain damage is obvious and leads to major cognitive impairment, more frequently, the damage is mild, leading to difficulties with sustained attention."

While surviving COVID-19 is exceptionally likely, the adverse outcomes to our cognitive functioning due to the virus are not. A mask mandate and other practical measures in our county are a useful and albeit uncomfortable response to this virus. - Julio

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