Why So Many COVID-19 Cases Have Been Confirmed In Teton County

Apr 10, 2020

Despite putting in place restrictions before anyone else, Teton County's numbers continue to jump. It's consistently ranked as one of the top two or three places in the state with confirmed positive tests. Although health care providers also say it's a place where lots of testing has taken place. Wyoming Public Radio's Kamila Kudelska spoke with Teton County Health Officer Dr. Travis Riddell who joined us from his home in Jackson. He said he knew the area would get hit hard by the coronavirus.

Dr. Travis Riddell: I would say yes, absolutely. We anticipated that our community could be a place where we saw higher numbers of coronavirus. We're looking at other Mountain Resort communities around the West places like Blaine County, Idaho, which is Ketchum and Sun Valley, Park City, Utah, Vail, Colorado, they all saw coronavirus early and often and compared to those communities we're actually fortunate. It's hitting us a little bit later. And that's given us some time to prepare. That knowledge is really why we worked hard with the state to get more restrictive measures in place in our community. It's hard to put too much value into the reported positive test numbers. We know very clearly that that's really the tip of the iceberg. And that the true number of cases out there are much higher. That's because we are not testing all of the symptomatic people out there. We just don't have the resources to do that. And we also know that folks who are not symptomatic also have coronavirus. And so maybe our numbers look high because we're testing more. We don't have the data to answer that question either.

Kamila Kudelska: Right now there are about 40 confirmed cases in Teton County. That seems like a lot of numbers for the area in Wyoming, since there is only one other county ahead of Teton. But I wonder for you as the county's public health officer, is that a lot?

TR: Yeah, so one, one way to look at that is prevalence, meaning number of cases per population, and that's a number that's reported on various sites that are charting the coronavirus outbreak. Generally, it's reported as the number of cases per 100,000 population. And by that measure, we are several times higher than anywhere else in Wyoming.

KK: So Teton County and Jackson Hole is one of the few areas in Wyoming that has actually put an order to stay at home. Do you think that's going to make a difference in the future?

TR: Yeah, I think that people in Teton County are taking this really seriously. Obviously, people are making a lot of choices voluntarily. And I think that has been and will remain the most important factor in controlling this outbreak. We all control our own act, our own actions and our own activities. And the decisions that we make on a daily basis are the most important factors. But our order certainly is more restrictive than other places. And I felt that was important because of the risks that we face. Teton County, Wyoming compared to the vast majority of the rest of the population of our country is very much on par. I think it's the rest of Wyoming that's the outlier in terms of restrictions that may or may not be in place.

KK: What can you tell us about the cases you've seen so far in Teton County?

TR: Oh, we've had the whole spectrum. I would say our data probably is slightly biased towards more severe cases, because those are the people who we are actually able to test. Last I checked, we had five cases which required ICU level care and which have been transferred out of our community to higher level care facilities.

KK: How is the hospital prepared? It sounds like you can transfer the patients now.

TR: Currently, yeah, we're able to transfer critically ill patients to other hospitals. One of the things we're worried about is that may not continue to be the case if we see the communities where we transfer patients for us that's Salt Lake City and Idaho Falls. If they are overwhelmed themselves, they may close to transfers which would really leave us on an island here. And it's an island that would also be sort of a catchment area for some of the other communities. We often have patients coming in from Lincoln County, Sublette County, Fremont County, as well as areas in eastern Idaho. I think that given the limited resources and in our setting here, we've done absolutely everything we can with the resources we've got.

KK: What would the plan be if we can't transfer patients anymore since all of the hospitals are at capacity,

TR: We would keep them here if we needed to. And that would mean using the resources that we have, obviously, our resources are finite, just like any other hospitals. But we will, you know, we will use them to the best of our capability. Like a lot of other facilities, we have convened our ethics committee, we started to talk about ways in which we might triage care, triage use of ventilators. Those are horrible decisions to have to make as a health care provider and I think we are all hoping above all hope that we don't have to make those sorts of decisions. But I think it's important to be thinking ahead and starting to think about those scenarios.

KK: What are some challenges ahead that you're looking at?

TR: I think the number one challenge is managing that surge when it happens, and that's what all of our work so far has gone into. We're not surprised that our efforts and restrictions were not successful in keeping coronavirus out of our community. That was never really the goal. The goal is to as they say, flatten the curve and to slow the spread of the virus such that when we do get the surge it doesn't overwhelm our health systems.

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