Past emergency declaration seen as way to secure resources

A regional public health emergency declared in 2009 by EPA could yield tangible support for Lincoln County residents and healthcare workers as they respond now to the potential for disease tied to the novel coronavirus.

That’s the hope, anyway.

A respiratory disease that quickly attacks the lungs poses troubling risks for residents of Lincoln County affected by the region’s history of vermiculite mining. The vermiculite mined near Libby contained asbestos fibers that can embed in lung tissue and cause asbestosis as well as mesothelioma and other cancers.

In 2009, the EPA declared an unprecedented public health emergency for people in Libby and Troy whose lives had been affected, and sometimes ended, by asbestos-related disease. Today, many residents live with damaged lungs.

That reality has raised the stakes for ensuring the region is adequately equipped for testing that can identify and isolate people who have COVID-19, the disease caused by coronavirus, identify their direct contacts and initiate quarantining for them too.

Dr. Brad Black, Lincoln County’s health officer, has emphasized repeatedly the key role testing can play in limiting the spread of COVID-19. That testing has been challenged at times by a lack of adequate supplies, including a shortage of swabs used to collect mucous for analysis, and by the long turnaround time between testing and receiving results from a private lab.

Now, Black and others hope the federal government — specifically the Food and Drug Administration — will respond to the region’s unique vulnerabilities and help equip medical staff with test kits that could be processed by the lab at Cabinet Peaks Medical Center.

“It’s important to have a test for which you can have results in an hour or so in order to isolate and determine contacts [for positive cases],” Black said.

This is especially important, he said, in a community where a disproportionate number of people have lung disease tied to the mining of vermiculite.

“We need to be testing now,” he said. “We need to stay ahead of this.”

Black said there’s been an improvement in the stock of testing supplies and that the private lab that is currently handling samples from Lincoln County seems to have the ability to process more testing.

“We at least have the capacity to expand testing,” he said.

But that could change, Black said, once other communities with similarly improved supplies begin testing more aggressively.

The private lab could get overwhelmed, Black said, which is another reason to develop the capacity to process tests locally.

The current turnaround ranges from two to four days, he said.

Does Black believe the federal government will be able to help Lincoln County?

“It’s too early to speculate,” he said.

A recorded phone call Monday between Gov. Steve Bullock and President Donald Trump featured a conversation in which Bullock told Trump about a looming shortage of test kits. Trump said he hadn’t heard concerns expressed about testing shortages for weeks.

In recent weeks, as more information emerged about the novel coronavirus and COVID-19, local officials and residents began to worry about Lincoln County’s many vulnerable residents.

As of April 1, six individuals in Lincoln County had tested positive for the disease. One, a 77-year-old man who lived at Bull Lake was the county’s first positive case and the state’s first fatality tied to COVID-19. He had retired from teaching in Washington and there was no suggestion that his death was asbestos-related. He suffered though from Parkinson’s disease, his family said.

During a March 23 special meeting of the county’s Board of Health, resident DC Orr referenced the EPA’s 2009 public health emergency. He wondered whether Lincoln County ought to inquire whether that declaration could be relevant to the new battle against COVID-19.

Soon after, Mark Peck, chairman of the Lincoln County Board of Commissioners and a member of the Board of Health, reached out to the offices of U.S. Sen. Ted Daines, R-Montana, and U.S. Sen. Jon Tester, D-Montana, to see what the federal government could do for Lincoln County because of the risk posed by COVID-19 to people with damaged lungs.

“We are getting very good support from our congressional delegation,” Peck said in late March.

Daines hosted a “town hall” conference call April 1 to talk about COVID-19. He said he understands the importance for Montana communities of local testing.

George Jamison, a member of the Board of Health, said during one of the board’s special meetings that the county and its healthcare providers should be prepared to provide a list of specific needs in case the federal government responds to the community’s unique vulnerabilities.

The EPA noted in June 2009, “Over the past years, hundreds of asbestos-related disease cases have been documented in this small community, which covers the towns of Libby and Troy.” And investigations by the Agency for Toxic Substances and Disease Registry found that the incidence of asbestosis in the Libby area was “staggeringly higher than the national average for the period from 1978-1998.”

That Superfund-related public health declaration, the first and only of its kind, remains in effect.