There are currently no reported cases of the new coronavirus in Montana. This, however, may only be temporary. State public health officials say they’re preparing for the worst.
The COVID-19 virus continues its steady march. One by one, more countries are reporting new cases. At the time of this recording, California Governor Gavin Newson says at least 33 people have tested positive for COVID-19 and that state is now monitoring over 8,000 others.
That's in contrast to Montana where state health officials say a total of 24 people returning from mainland China have been monitored for coronavirus exposure. Nine are still being monitored; the rest are cleared and healthy.
So far, so good. That, however, could change on a dime.
"A single case of something like this, right now, based on what we know, would be very disruptive and would be hard to deal with," says Jim Murphy, who leads the Montana Health Department’s Communicable Disease Bureau.
Murphy says even one COVID-19 diagnosis would require an extraordinary amount of resources
"[Resources] To isolate a person for a fairly long time until their illness resolves and they clear the virus. And then the investigation that would go along with that, identifying who is at risk and monitoring those people under quarantine -- and that would be a strict quarantine -- would require a lot of resources than even the largest health jurisdiction in Montana."
Ellen Leahy is Director of the Missoula City-County Health Department. Last spring an outbreak of whooping cough had Leahy’s staff scrambling to keep pace. The department hired extra public health nurses to help chase down leads. Leahy says the response to a hypothetical coronavirus epidemic would dwarf that effort.
"Because it’s a novel virus – a new virus – theoretically, and probably in reality, the majority of people are susceptible. With pertussis at least you had folks who had some immunity. But with a new virus you have to theoretically consider that your whole population could get it."
Montana’s public health officials are gathering around tables and connecting via teleconference to wargame COVID-19 strategies.
COVID-19 is caused by a member of the coronavirus family that’s a close cousin to the SARS and MERS virus that have caused outbreaks in the past.
Leahy says they’re closely monitoring the current outbreak to glean any information about its spread and incubation period. Her Missoula team is already preparing a basic incident command structure.
"So we have an incident commander, an infectious disease specialist. We have a public information officer. We have someone assigned to just researching the literature and keeping us all apprised."
That kind of pre-planning is critical, according to Montana Communicable Disease Bureau chief Jim Murphy.
"A single case in Montana would have a lot of attention from our federal partners at the Centers for Disease Control. The state health department would be heavily involved. But at the end of the day the local jurisdiction would have an awful lot of responsibility. They would be the lead on the investigations that would identify other people that may be at risk. They would be the lead on implementing quarantines, for instance."
Murphy says Montana’s local health agencies, overseen by health boards have broad authority to issue mandatory patient isolation and quarantine orders.
"Our law does allow us to use law enforcement options if we have to. If we think somebody is going to be noncompliant, or we think the risks will be too high, we can be a little more strict with those orders."
But Murphy says he believes most sick Montanans would never intentionally endanger anyone else and would voluntarily comply with isolation or quarantine order.
How could COVID-19 affect school schedules? Missoula health official Ellen Leahy says that would be a tough call, and one made on a case-by-case basis.
"When you close schools you’re trying to balance between how likely is it that people have been exposed at school and they’re going to get it, versus how likely if you take the children that perhaps were not infected or exposed and you send them home or to daycare or somebody else’s house – have you really, really cut down contact? That’s a hard question to answer."
And for the time being Montana health officials say they don’t have all the answers.
The COVID-19 virus is not in Montana yet – and they want to keep it that way.
While there is no vaccination or cure, experts say knowledge truly is power. Public health officials urge Montanans to lean on credible sources of information during this public health emergency; to resist the urge to fall for baseless rumors, conspiracy theories and get-rich-quick scams.
"The medical guidance on this is going to be critical," says Rich Rasmussen, president and CEO of the Montana Hospital Association. "Don’t just pick up an ad you might see in your social media feed, but actually do some research, look at what the Department of Public Health has put out on their [coronavirus] site. Look at what the Centers for Disease Control has put out on their site. Those are the most credible sources and that’s who we should be looking to and listening to as we try to protect ourselves and our families."
Federal health officials say the immediate health risk of COVID-19 is low.