Reported COVID-19 Numbers Are The Floor, Not The Ceiling

May 1, 2020

Credit Alissa Eckert, MS, Dan Higgins, MAMS

At the end of March, Curtis Harnish started getting sick.

"I had what seemed like a really sore throat and chest tightness," said Harnish, a resident of Laramie. "It felt like someone was sitting on my chest. Like it wasn't hard to breathe, but taking a deep breath was very taxing and when I did it, I had a cough."

As he started feeling worse, he realized his symptoms were aligned with COVID-19. When he had a temperature he finally decided to call his doctor.

"I say, 'Hey, these are the symptoms I'm feeling,' and she's like, 'Well, it definitely sounds like you have it [COVID-19]. But I can't test you. We don't have a test. And if we did, we wouldn't use it on you,'" said Harnish.

Harnish was told to quarantine for two weeks and go to the emergency room if the shortness of breath got worse. But luckily it didn't.

"Once I stopped having a fever, my energy started coming back, and I started feeling a lot more normal," he said.

After about 12 days of quarantine, Harnish was on the mend and he feels good today, but he's now sceptical of the number of COVID-19 cases by county that the Wyoming Department of Health provides.

Wyoming is one of the states with the fewest number of COVID-19 lab confirmed cases. That's good news. But officials say the state still needs to be careful to not fall into a false sense of security that could cause a second wave and end up being more disastrous to the health and economy of the state.

"I think that it's important that people be aware that there are likely more cases than we've diagnosed," said the Wyoming Health Officer Dr. Alexia Harrist. "And really take that into consideration going forward."

Harrist stressed that even if a county has zero or one case, it does not mean you're safe.

So, why do we not have the accurate numbers of COVID-19 cases in the state? There are a couple of factors. First, Park County Health Officer Dr. Aaron Billin said there's a possibility that the COVID-19 test could be giving false negatives.

"I can think of a handful of cases in Park County that were tested and were negative, and we're thinking they were a false negative because they had the contact and they had the symptoms," said Billin.

Second, for a couple of weeks the state didn't have enough tests to test everyone, so only those on the Department of Health priority list were being tested. Those were people over 65 and others that had risk factors. So Billin agreed with those who think the numbers are off.

"We suspect cases in most communities in Park County that haven't been diagnosed yet," he said. "We anticipate more diagnosed cases in Park County as we approach the peak."

The Wyoming Department of Health is trying to improve things by keeping track of people who have been in contact with a confirmed case and developed symptoms- whether or not they've been tested. The department is calling these probable cases. And some counties are keeping track of one more thing.

"A possible positive is somebody who's symptomatic, but has not been tested and has not been deemed a close contact of an actual positive person," said Campbell County Public Health Director Jane Glaser.

Possible cases are recommended to self-quarantine. Glaser said keeping track of possible cases helps people realize that there's probably more COVID-19 cases in their community.

"We just have found it's a really good way to help alleviate some fears within symptomatic patients," she said.

All of this to say, people shouldn't fall into a false sense of security if their county has few coronavirus cases. State Health Officer Dr. Alexia Harrist said people should be especially aware of this as the state starts reopening the economy.

"All of the social distancing, wearing face covering, staying home when you're sick, can help prevent transmission in the cases that we may have not diagnosed because they didn't have access to a test," she said.

But Harrist said widespread testing is critical, and the state is working to increase that. During a recent press conference she said easing restrictions has to be slow.

"Our first steps forward must be smaller steps that involve lower risk and fewer people. [...] We need more time to see how this disease may progress overall and how each of our moves forward will affect Wyoming," said Harrist.

If the state starts seeing more cases, there is a chance that they would have to close some things down again. Gov. Mark Gordon said that would be more devastating to Wyoming than it is now.

Have a question about this story? Contact the reporter, Kamila Kudelska, at kkudelsk@uwyo.edu.