Finding, isolating COVID-19 cases helps protect high-risk residents

Infectious disease experts say people can have COVID-19 and not know it.

Testing and rapid identification of people who show no symptoms of COVID-19 but are nonetheless contagious can help reduce the possibility in Lincoln County of “a silent epidemic” of the respiratory disease, said Dr. Brad Black, the county’s medical officer.

Black has been emphatic for weeks about how vital testing is to regional efforts to characterize the scope of COVID-19 in Lincoln County and to lessen its spread.

As of the morning of April 9, seven people had tested positive in Lincoln County for coronavirus. One person, Jim Tomlin, 77, died March 26 from complications of COVID-19.

Black told members of the Lincoln County Board of Health during an April 6 emergency meeting that the county had sufficient supplies on hand, including 400 nasal swabs, to begin testing people without symptoms. When the county launched a drive-through testing site March 24, the primary focus was on residents with possible coronavirus symptoms, followed by people in high-risk groups.

Now, said Black, “We’re encouraging people to call up and come in.” The number to call is (406) 293-6295.

For the time being, there are two potential hitches to testing people who show no symptoms.

The county has followed Centers for Disease Control and Prevention recommendations that people who have been tested need to self-quarantine afterward until the results return. That’s been taking two to three days. Black and other county health officials realize that some of the asymptomatic people they hope will come in for testing, including workers in grocery and convenience stores and emergency responders, cannot take time off work to self-quarantine.

There also is uncertainty about whether people who are asymptomatic and agree to testing might end up with a bill for the process.

Black said the county hopes remove these potential barriers.

The county’s testing capacity will improve if and when it has the supplies and materials on hand to process test results locally, Black said.

The Margolis Center for Health Policy at Duke University says the capacity to conduct rapid diagnostic testing for everyone with COVID-19 symptoms and for those with exposure or higher risk for exposure is a key component of containing disease spread and will help the nation move beyond “the extreme and disruptive physical isolation measures in place across the United States.”

Lincoln County is home to a population that includes people especially vulnerable to respiratory diseases like COVID-19. The region’s history of vermiculite mining and associated exposure to asbestos contamination have left many residents with asbestosis and other lung diseases.

In June 2009, the EPA declared a Public Health Emergency for the Libby Superfund Site because of the serious health hazards of the asbestos contamination. It was the first and last time EPA ever made such a declaration and it remains in effect.

The Lincoln County Board of Health cites this declaration in a letter to Montana’s U.S. senators.

“We are unlike any other county in America facing this COVID-19 threat given an extremely high population of ‘high risk individuals,’” the letter reads.

“Just testing the symptomatic persons is chasing the virus whereas random testing will allow us to catch it, isolate it and keep it from our high-risk populace,” the letter reports.

Lincoln County officials plan to alert U.S senators Steve Daines and Jon Tester that the county needs to perform 1,300 tests monthly. The county said it has the infrastructure to perform the testing but not the supplies.

“We currently need 600 test swabs for the next four weeks and 1,300 monthly to sustain an appropriate surveillance operation,” the county said.

An April 8 regular meeting of the Board of Health included discussion of the draft letter and board members suggested a few changes, including placing a greater emphasis on being outfitted with the supplies and apparatus to process test results locally instead of sending them off to a private lab.

Separately, the health department has reached out to Stimson Lumber Company and a contractor whose workers are in the region doing tree planting to provide information about steps to take to avoid transmission of COVID-19. Similar outreach occurred with maintenance workers for BNSF who have been lodging in Libby motels.