Looking to the future while facing a pandemic

GALLATIN CITY-COUNTY HEALTH DEPARTMENT AND BOZEMAN HEALTH DISCUSS THE LOCAL PLAN

Using the words of a friend, Gallatin City County Health Officer Matt Kelley described the Treasure State’s efforts to confront COVID-19 as a kind of public health barn raising.

He cautioned during a press conference on Friday that although the heavy lifting may be done for now, this remains a time of vigilance. In essence, the walls are up, but the foundation is a bit shaky. The populace should keep washing their hands, wearing masks and social distancing.

The likelihood of sporadic outbreaks is high. Describing it with another analogy as a “marathon, not a sprint” he noted that while it may be tempting to celebrate and socialize with Phase 1 of Gov. Steve Bullock’s plan to reopen initiating, the task is not done and the parties should not commence – if over 10 people are involved and social distancing cannot be practiced.

This stance was reiterated on Monday, when Gallatin County reported its first loss to the virus – a male over 60 years old.

It’s important to note that we have a long way to go with this pandemic, Kelley explained.

“With this reopening, we are likely to see more cases. That is just simple math. As people come together there is going to be more opportunity for the virus to spread,” he said. “The goal is not to get back to our old normal, but to find a new normal.”

The sustained reduction of new cases over the past couple of weeks is promising, and was a marker for the governor’s plan to be set in motion.

Still, Kelley provided cautionary tales from hot spots around the nation: spread at a meat packing plant in South Dakota that brought a community from zero to 1,400 cases in two weeks, a Grand Forks wind turbine factory that produced a couple hundred cases in a few days, not to mention the slew of assisted living facilities that have been struggling with widespread COVID-19 cases and fatalities.

“Protecting them is one of our highest priorities and biggest vulnerabilities,” he said. Those facilities will continue restricting visitors.

The health department will be working closely with area businesses on best practices and procedures to protect employees and the public.

As this all transpires, the goal is to do a “phased reopening, to allow economic recovery and reduce risk to community health” as well as hospital surge.

There is a chance we will have to stay in Phase 1 and a chance we will have to go back and do closures again, he pointed out.

Obvious markers: cases, hospitalizations and deaths will help make that determination. Another interesting – and cutting edge – marker: wastewater. A project between the GCCHD and Montana State University has had researchers analyzing wastewater samples to measure the viral load for COVID-19 in order to test its current impact on a community. Using that method, Bozeman saw a decrease of COVID-19 in wastewater in early April. That study is being expanded to other communities in the county, but does come with significant cost.

Phased reopening of Bozeman Health

John Hill, Bozeman Health president and CEO recently addressed members of the press to discuss the health system’s plan for reopening.

“Three weeks ago, Bozeman Health began planning for a surge of patients that we believed would peak yesterday, and would last eight weeks,” he said on April 28. Quick action at the state level and efforts by local health departments helped avert that surge, he said.

“There is still a possibility that significant Covid surges may occur,” he said. “We are not yet through this community health crisis.”

The community and its leaders allowed for time – to plan, to prepare.

Onsite COVID-19 testing, additional Personal Protective Equipment (PPE), increased hospital and medical center capacity – strides have been made in these essential areas. With business closures lifting, the health system’s priorities are to protect the safety of its workforce and the public, continue preparing for a surge, support the efforts of local and state elected officials and help the local health department continue to flatten the curve.

With all that in mind, Bozeman Health now has a detailed readiness and reopening plan.

“As we’ve designed our readiness and re-opening plan, we’ve carefully considered how to move appropriately towards full operational capacity to meet the health needs of our community while continuing to be ready for widespread or clustered COVID-19 surges
as stay-at-home orders and business closures are lifted,” Lauren Brendel, system director, Marketing and Communications for Bozeman Health said.

A re-opening preparation phase will take place until May 3 in which the hospital will continue operating at 25% capacity, which allows for 75% of hospital beds to be available in the case of a surge.

Phase 1 (50% capacity) begins May 4 and goes through May 17. Phase 2 is expected to begin May 18 and extend through May 31 – open to 75% capacity and Phase 3 will occur June 1 and onward, in which the hospital will be at full operational capacity.

Indicators will be reviewed throughout the re- opening sequences that will guide decisions toward the progression to the next phase.

These markers include:

Monitoring for a continuous reduction or no significant increase in confirmed new COVID-19 cases in Gallatin County; ensuring the availability of COVID-19 testing for approximately 100 tests per day for 30 days; achieving and maintaining a 30-day PPE supply; maintaining staffing levels to provide high quality and safe patient care delivery; and sustaining hospitalization capacity, meaning that we will maintain available beds, ventilators, and essential equipment.

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