First COVID-19 case confirmed in Lincoln County

The Lincoln County Health Department reported March 25 that it had received notice of the county’s first confirmed case of COVID-19.

“The individual is in their 70s and had engaged in domestic out-of-state travel,” the health department reported in a news release.

The patient is male and hospitalized, health officials said.

Kate Stephens, a spokeswoman for Cabinet Peaks Medical Center, said the patient had been ground transported to higher level care.

Lincoln County is home to many residents especially vulnerable to the infectious disease because of lungs damaged by exposure to asbestos in vermiculite mined near Libby.

The county’s COVID-19 Task Force said it was pleased with the response of the community’s medical and emergency service teams.

“At this time, all indications are that our EMS and hospital personnel were well prepared for this event,” said Dr. Brad Black, the county’s health officer. “We feel confident that our medical personnel used appropriate personal protective equipment and were able to minimize potential exposure.”

The health department said it is investigating the case and will provide more information when available.

Black said earlier in the week that testing confirming a case of COVID-19 will be followed by isolation of the patient and inquiry about his or her contacts. Tracking and quarantining of the patient and recent contacts will help lessen community spread of the disease, he said.

Black said patience to ride out social distancing restrictions will pay off in the end.

Mark Peck, chairman of Lincoln County’s board of commissioners, has said several times that a positive case in Lincoln County was both inevitable and cause for concern because of the region’s vulnerable population. He has also said it won’t be worthy of panic.

He said Thursday that the confirmation of a case “allows us to move on now that we know it’s here and really take it seriously.”

On March 24, the health department, staff from the Center for Asbestos Related Disease and regional medical providers teamed up to launch a drive-through testing site in Libby for people with symptoms potentially indicative of COVID-19 or those considered high risk for complications.

The Central Testing Site was set up in the parking lot of the CARD Clinic on East Third Street. Sky-blue and white canopy tents lent the scene a festive air that contrasted with the seriousness of the site’s mission and the healthcare workers clad in medical masks, face shields and gloves.

Around 11 a.m. on day one, two vehicles were the first to pull through. Each driver wore a baby blue mask covering their nose and mouth.

Miles Miller, a certified physicians assistant, and Dr. Lee Morrissette, both with CARD, prepared that morning to perform the testing.

Jennifer McCully, Lincoln County’s public health manager, said the drive-through site is intended to relieve testing pressure on clinics and the Cabinet Peaks Medical Center. It is not open to the general public.

“There are two ways to access testing at the Central Testing Site,” she said. “Providers can refer to the site to preserve their PPE [personal protective equipment] and to limit possible exposure in their clinics. People can also call the health department information line to be triaged based on symptoms, risk level and risk of exposing others.”

The plan is to operate the site Monday through Friday, from noon to 3 p.m.

McCully said this schedule could change if supplies run short of PPE and testing kits.

She said the site tested 14 people on day one and 17 on March 25. Test results would likely not be known for about three days, she said.

In a March 24 news release, Black addressed the importance of testing.

“Increasing testing allows public health to identify and track any cases and establish any contacts to slow the spread of disease,” Black said.

The Lincoln County Board of Health held special meetings on March 23 and 25.

Black said during Monday’s meeting that a key focus should be expanding testing to identify people who have the virus.

“We’ve hardly touched the population with testing,” he said then.

The March 25 meeting focused at times on the potential shortage of key supplies for personal protection equipment and testing.

Stephens said Cabinet Peaks Medical Center has four ventilators on hand and four non-invasive medical devices that can be converted to ventilators.

“Based on our current daily staffing plans, we cannot run all eight ventilators,” she said. “However, if the need should arise to use all eight ventilators, additional staff would be called in.”

Stephens said a plan is in place for such circumstances “but it would be difficult to sustain for a long period of time with the number of staff we have at our facility.”

Peck said this reality is playing out in small communities nationwide where small hospitals often transport patients who need specialized intensive care to hospitals in larger communities.

He said he anticipates Lincoln County would be able to transport such patients unless receiving hospitals reach capacity.

During the public comment portion of the health board’s March 23 meeting, resident DC Orr noted that the unprecedented public health emergency declared in 2009 by the EPA might provide some leverage to help the county acquire supplies to help protect its vulnerable residents.

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.”

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

Peck said March 26 that he has been in touch with 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. The senators’ staff members are working on the issue, he said.

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

George Jamison, a member of the board of health, said during the board’s special meeting Wednesday 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.

Meanwhile, rumor mills in small communities tend to churn during times of crisis.

Pam Winter, office manager for the Libby Clinic, said the clinic has received several inquiries from people who believed it and other clinics in town were closing temporarily.

Not true, she said.

In reality, she said Libby Clinic is trying to do its part to see patients who might otherwise strain the resources of the emergency department at Cabinet Peaks Medical Center.

It seemed clear this week that a return to anything approaching normalcy remains a distant hope.

Gov. Steve Bullock announced on March 24 a directive extending public school closings until April 10. The same extension was ordered for dine-in food service and alcoholic beverage businesses, along with health clubs and similar businesses.

Both measures were described by the governor as tactics meant to slow the spread of COVID-19 in Montana.

“The obligation to control the spread is on each and every one of us, each and every day,” Bullock said during a news conference.

The governor noted that concepts such as “social distancing” were essentially unknown to him and many other Montanans just two weeks ago.

His directive prohibited “non-essential social or recreational gatherings of individuals outside of a home or place of residence greater than 10 people…if a distance of at least six feet between individuals cannot be maintained.”

The health department emphasized the importance of practicing social distancing, avoiding unnecessary travel and avoiding visits to public places.

Peck said it’s vital during the period of limited access to many local businesses to support them as much as possible.

People with questions about COVID-19 or the Central Testing Site should call the Lincoln County COVID-19 hotline, McCully said, at (406) 293-6295.