Mitigating the COVID-19 surge
Gov. Steve Bullock urges cooperation and local enforcement
This last week, Gallatin County saw the largest spike in COVID-19 case totals since the pandemic began. Other counties in Montana are seeing similar increases, as noted during Governor Steve Bullock’s Tuesday afternoon press call. In fact, 31 other states have seen spikes.
Billings recently earned the notoriety of being the 18th highest in COVID-19 cases of metropolitan areas across the entire United States. Mitigation efforts by local public health officers were discussed and Dr. Hollsmer, the State’s Chief Medical Examiner said the largest hospitals in the state have daily meetings, analyzing their surge plans and establishing protocols to help each other when the time comes. Some care workers in the state are under quarantine after community spread, which further complicates efforts – the discussion is ongoing.
“Hospitals in some areas of our state are reaching or are already at capacity due to an influx of COVID 19 cases,” Gov. Bullock said. This should be cause for concern and make all Montanans want to rally behind an effort to stop the spread, so that hospitals are not overrun as they have been in other states, he explained.
Dr. Greg Holzman, State Medical Officer with the Department of Public Health and Human Services cited studies by the Centers for Disease Control in other parts of the nation that emphasized the importance of social distancing, masking and sanitization efforts.
“We have the data. We don’t really need to wait and see it happen here and then respond,” he said. He noted Montana’s unique opportunity to learn from other states.
“Montana is not immune to this reality just as we are not immune to this virus,” Gov. Bullock said before stating that Yellowstone County just initiated greater restrictions, limiting gatherings to 25 individuals without regard to social distancing and without regard to whether the event is held inside or outside.
Flathead City County Health Department is considering following suit by increasing restrictions. The Hill County Health Board is seeking input from health officials and tribal communities are under stay at home orders or other phase back approaches.
In light of the surge of cases, the governor has been fielding questions about enforcement.
“Montana’s public health laws anticipate the kind of crisis that we’re facing in our state. These laws permit state and local health officials to issue orders that address the spread of communicable diseases. The same law empowers county attorneys to enforce public health orders,” he said.
He said some counties are having success with enforcement and outlined the usual process: Many compliance issues are resolved when the health department conducts an informal call or visit; an industry specific inspection usually does the trick but the health department provides education to the establishment owner if the compliance issue persists. If the business continues to not comply thereafter, then the health department issues a health officer order. In those rare circumstances where a compliance order is not followed, health departments can refer to county attorneys to pursue civil enforcement action.
“In normal times, officers certainly can’t issue speeding tickets for every speeding violation that occurs on the road, but if drivers know that there are no officers on patrol, they can certainly speed with impunity,” he said. “Likewise, there’s no expectation that every single violation will be or should be remedied through enforcement, but our public health officials find themselves helpless to combat the virus if they don’t receive the support that Montana law guarantees them.”
The large counties that have taken civil enforcement action against some of the “most egregious bad actors” now have much lower rates of transmission.
“My administration is offering support to county attorneys by providing education on the process and if requested also making state legal resources available for consultation. On top of the day to day responsibilities, we will also work with counties on making available relief dollars to help increase capacity to investigate and enforce violations of health orders,” he said.
A shared goal of helping support healthcare workers should be a priority, he said. Things like masking, avoiding large gatherings, washing hands, staying home when sick, and quarantining, working “together in good faith” can help “prevent our mainstreet businesses and schools from having to shutter, but only really if we roll up our sleeves and work together.”