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Wyoming Lands In Middle Of Ranking For Best, Worst States For Health Care

in Health care/News
Doctor Shortage in Wyoming; “Almost Impossible to Recruit”

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By Ellen Fike, Cowboy State Daily

Wyoming landed right around the midpoint in a recent ranking of the best and worst states for health care in the nation by personal finance site WalletHub.

Wyoming was ranked 31st in the list, just between Indiana (30) and Oregon (32). It ranked lower due to a near last-place ranking for its number of doctors per capita (coming in at number 50, just above Idaho), and having some of the highest average monthly insurance premiums, tying at number 48 with Vermont, Iowa and West Virginia.

However, Wyoming did rank third when it came to having the most dentists per capita, just behind the District of Columbia and Vermont, respectively.

Massachusetts was considered the best state for health care, while Georgia was considered the worst.

To determine where Americans receive the best and worst health care, WalletHub compared the 50 states and the District of Columbia across 44 measures of cost, accessibility and outcome. According to the website, the average American spends more than $11,000 per year on personal health care.

According to a study by the Kaiser Family Foundation, the U.S. lags behind several other wealthy nations on several measures, such as health coverage, life expectancy and disease burden, which measures longevity and quality of life. However, the U.S. has improved in providing healthcare access for people in poor health and healthcare cost growth has slowed somewhat.

“Most buyers of health insurance tend to focus on identifying health plans with the lowest price; and typically, are not concerned with the level of coverage,” Virginia Commonwealth University professor R. Timothy Stack told WalletHub. “My recommendation is to pay the extra premium for a health plan that offers a broad network coverage of providers. Consumers, especially younger ones, believe they would not experience a life-threatening medical condition during their life whereby accessing a medical expert is critical. This type of coverage could benefit them medically as well as financially. “

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One Unexpected (And Stupid) Result From the Coronavirus: More Smoking

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Perhaps the stupidest development to result from the coronavirus a smoking resurgence in the country.

Wednesday’s Wall Street Journal reports that although the national smoking rate hasn’t increased, the decrease in cigarette sales have slowed from a projected decline of 4% to 6% to a decline estimated at 2% to 3.5%.

The reason, according to the maker of Marlboro cigarettes, is a combination of fewer opportunities for people to congregate outside the home and the arrival of government stimulus checks.

“Fewer social engagements allow for more tobacco-use occasions,” said Altria Chief Executive Billy Gifford on an earnings call Tuesday.

More tobacco-use occasions cost money.  In Wyoming, smoking-caused health care costs $258 million per year and smoking-caused losses in productivity cost $202.4 million per year.

The news that some recipients of government stimulus checks are spending the money on cigarettes could be depressing for many reasons.

One, people would use stimulus checks for cigarettes. Two, smoking is bad for your health. Three, COVID-19 is a respiratory illness.

The University of Maryland Medical System reports that smoking not only increases your risk for complications if you get the virus, it can also make you more likely to contract the disease in the first place.

“The Centers for Disease Control categorizes smokers as “immunocompromised,” which means having a weakened immune system,” they write. 

“This puts smokers in the same group as those receiving cancer treatments or who have HIV. The CDC cautions that people who are immunocompromised are at risk to get more severe COVID-19 symptoms,” they said.

In 2017, 18.7% of adults in Wyoming smoked. Nationally, the rate was 17.1%.

In 2017, 5.7% of adults in Wyoming used e-cigarettes and 9.1% used smokeless tobacco.

In 2015 (the latest data available), 29.6% of high school students in Wyoming used electronic vapor products on at least one day in the past 30 days. Nationally, the rate was 24.1%.

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Wyoming Hospitals Offer Quicker Coronavirus Testing

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By Wendy Corr, Cowboy State Daily

Since the coronavirus emerged as a real threat to Wyoming residents in March, the only testing option for many counties was a process that involved sending swabs to the state health office.

But last week, it became possible for both Cody and Powell hospitals to run tests in their labs and produce results within a day, according to Doug McMillan, CEO of Cody Regional Health.

“At the state, the turnaround time is, I think, three to five days,” he said, “and the average can take longer. We’re working with Abbott, the company vendor that we work with, and they provided software to update four or five of our existing machines, and the state did provide us with one additional machine.”

Jeanine Brus, director of the lab at Cody Regional Health, said the accuracy of Park County tests have been corroborated at the state level.“We sent at least a hundred tests in tandem to the State,” she said, “and we got the exact same result that the State did.”

Brus said Cody Regional Health can can conduct up to 50 tests per day. The hospital is also conducting drive-through testing in its parking lot.

“It’s now open from 8 (a.m.) to 11 (a.m.) every day, and we’re testing asymptomatic patients (individuals who do not have symptoms),” he said. “Patients are getting calls that day, or no later than the next day, so we’re really excited about that.”

And McMillan said the same-day testing option is drawing people from beyond the Big Horn Basin.

“A family member was driving from Bozeman to come to Cody to get their test, because they’d been told it’s going to take 10 to 14 days to get the results back in Bozeman, Montana,” he said.

McMillan added that with the increase in tourism – and in the number of cases – as the summer goes on, this type of service is invaluable to locals and to visitors alike. 

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Wyoming Department Of Health Not Implementing Meningitis Vaccine Requirement (Yet)

in Coronavirus/Health care/News
Doctor Shortage in Wyoming; “Almost Impossible to Recruit”

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By Ellen Fike, Cowboy State Daily

Due to the coronavirus pandemic, the Wyoming Department of Health is withdrawing a proposed addition to the state’s list of required vaccinations.

In 2019, the department proposed changes to require the meningococcal vaccination for students to enroll in school as one of several recommended updates to the state’s vaccination policies. Other changes included clarifying other school vaccination requirements and clarifying provider agreement requirements for the immunization information system.

The department determined a portion of the rule changes could have presented a challenge to its school partners at this time. However, in a news release, the department said it expects to implement the new rules at some time in the future.

Two vaccines are recommended to prevent the meningococcal disease, any type of illness caused by the neisseria meningitidis bactera.

Meningitis is an inflammation of the protective membranes covering the brain and spinal cord. While a bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling, injuries, cancer, certain drugs and other types of infection also can cause meningitis.

Meningococcal disease can include meningitis and bloodstream infections.

The Centers for Disease Control and Prevention recommends all 11 to 12-year-olds get the meningococcal conjugate vaccine, with a booster dose at 16. Teens and young adults (people 16 to 23) may get a serogroup B meningococcal vaccine.

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Wyoming Department Of Health Now Allowing Visits To Long-Term Care Residents

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By Ellen Fike, Cowboy State Daily

The Wyoming Department of Health has issued new guidelines to allow in-person visits to long-care facilities, three months after all such facilities barred in-person visits due to the coronavirus pandemic.

But the visits will have to be outdoors and under strict guidance. Visits can happen in a designated outdoor space and no more than two people can visit a resident at a time.

Visitors will also have to undergo a health screening before every visit. A facility staff member trained in patient safety and infection control measures must remain with the resident at all times during the visit.

Staff and residents must wear surgical face masks and visitors are required to wear face coverings.

“We recognize how challenging this pandemic has been for Wyoming’s aging population and their families,” Gov. Mark Gordon said in a news release. “Isolation can be debilitating for our seniors. I’m glad we are able to take this step to make in-person visits possible in a safe manner.”

The decision to allow visitation rests with individual facilities, which are encouraged to consider local conditions when making visitation determinations.

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Harrist Believes Early Action Stopped Significant Coronavirus Spread

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By Ellen Fike, Cowboy State Daily

Dr. Alexia Harrist can remember the morning she checked one of the infectious diseases websites she regularly follows.

It showed a strange outbreak of pneumonia in Wuhan, China, a city Harrist had never even heard of.

As a trained epidemiologist (someone who studies and analyzes the distribution, patterns and determinants of health and disease conditions in defined populations), it was fascinating to see this pop up, but she didn’t think much about it.

Just a few months later, that strain of pneumonia turned out to be the coronavirus, a newly discovered virus that would cause a pandemic.

As Wyoming’s state health officer, Harrist has been thrust into the spotlight over the last three months, regularly providing updates to the state about the coronavirus and health orders stemming from it.

She loves her job, but admitted she never expected to become such a public figure when she took over the role as health officer.

“I know my role is to protect public health,” she said. “Dealing with a pandemic like this is something I never imagined would have to be done. I’ve been a part of making decisions I never expected. But thankfully, I’m not alone and I have a ton of support from my team at the Department of Health.”

Harrist has been the state epidemiologist with the Wyoming Department of Health since March 2017 and officially became the state health officer in late 2018. She’d been filling the role as the interim officer since the summer of 2017 when Dr. Wendy Braund left the position.

Originally, Harrist is from the Boston area, growing up there and attending college in the region. She went to Philadelphia for graduate and medical school, but fell in love with Wyoming when she spent two years at WDH for a medical fellowship.

“I’m an outdoors person, so I just loved the mountains, the skiing, mountain biking, all of it,” Harrist said. “I also loved being at the Department of Health, so when I got the chance to come back as state epidemiologist, I took it.”

As the state epidemiologist, Harris’t job is to oversee disease control and surveillance. She and her team track diseases that have public health significance and prevent further transmission.

In her role as state health officer, Harrist is more involved in health policies surrounding disease prevention and control. She also advises and provides input for numerous activities taking place in WDH regarding disease prevention.

While Harrist didn’t expect to take on the role of state health officer when she joined WDH in 2017, she found that she enjoyed working through policies and a broader variety of activities.

But since March, she and basically every other county health officer and health care provider across the state have been inundated with the coronavirus.

“We’ve all been working long hours, because the virus doesn’t care what day it is or what time it is,” she said. “I already knew my team was great, but to see them come together and step up to this challenge, it’s been incredible.”

Harrist touted her team’s work doing contact tracing, where they find a person infected with the virus and find everyone that person has recently been in contact with. She also praised the state’s Public Health Laboratory, which has been kicked into high gear to get test results out quickly and efficiently.

While she is saddened by the 17 deaths Wyoming has seen due to the virus, Harrist feels that by taking early action with health orders, the state was able to prevent many more coronavirus cases and deaths.

However, she doesn’t believe the state, country or world is anywhere near to being out of the woods when looking at the virus. She urged caution moving forward, noting that wearing face coverings and continuing to social distance will likely be a part of everyone’s lives for the foreseeable future, at least until a vaccine or treatment for the virus is created.

“The pandemic isn’t over,” she said. “We expect to see more cases and more deaths. But I do think we’ve had success in slowing the transmission and we’ve prevented more people from dying.”

In the last few months, Harrist has learned that tough decisions have to be made when it comes to people’s safety, something not everyone appreciates.

She knows there have been detractors, those who don’t like the orders she issued with Gov. Mark Gordon that closed some businesses and restricted some activities, such as large gatherings of people.

But she praised Wyoming citizens for their vigilance, saying that they’re the real reason the coronavirus didn’t spread throughout the state as originally expected.

“I’ve learned that if you make a right decision for public health, there are people who will support those decisions,” she said. “In terms of public health, these are absolutely some of the hardest decisions we have had to make. You have to look at the possibility of deaths, the severe illnesses we’ve seen and the knowledge that people’s livelihoods would be affected. I think we did the right things, but time will tell.”

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Wyoming Department Of Health Sees ‘Alarming’ Vaccine Decline

in Coronavirus/Health care/News

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By Ellen Fike, Cowboy State Daily

The Wyoming Department of Health has seen an “alarming” decline in the number of administered immunizations since the start of the coronavirus pandemic.

In a news released issued Tuesday, the WDH pointed to a decline in immunizations given by providers enrolled in the department’s Immunization Unit’s Vaccines for Children and Wyoming Vaccinates Important People programs.

The Wyoming Immunization Registry showed state providers administered 42% fewer vaccines in April compared to April 2019. The total number of vaccine doses ordered by these providers has dropped about 25% compared to April 2019.

“It appears the pandemic’s uncertainty and challenges have resulted in the postponement of routine well-child visits, which typically include immunizations,” Jude Alden, Immunization Unit manager with WDH, said in the release. “While we recognize the reasons for the decrease, we also want to encourage families to stay on track and to schedule appointments to make up any immunizations that may have been missed.”

The Centers for Disease Control and Prevention (CDC) published data earlier this month that confirmed the trend of lower vaccinations during the pandemic is being experienced nationwide and not just in Wyoming.

Alexia Harrist, state health officer and state epidemiologist with WDH, is concerned postponing routine visits and immunizations could put Wyoming families at a higher risk of contracting vaccine-preventable diseases, including measles and whooping cough.

“It is critical for infants, young children, pregnant women and people with chronic illnesses to continue maintaining routine immunizations during the pandemic to help prevent further outbreaks,” she said in the release. “We definitely do not want outbreaks of other dangerous diseases to unexpectedly grow in Wyoming while we are still dealing with the coronavirus pandemic.”

Alden said clinics across Wyoming are using strategies to help ensure safe access to their patients for routine visits, such as:

  • Designating specific entrances, hours and exam rooms;
  • Checking in patients outside of the clinic and allowing them to wait in the parking lot until appointment times;
  • Allowing one caregiver to accompany a child to the clinic;
  • Cleaning and disinfecting exam rooms between patients; and
  • Encouraging all patients to wear cloth face coverings as they come into the clinic.

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Cheyenne Hospital Likely to Lose $10M for April Due to Coronavirus

in Business/Coronavirus/Health care/News

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The Cheyenne Regional Medical Center will likely see a loss of close to $10 million for the month of April, its CEO said in a statement Friday.

Hospitals across Wyoming have taken major financial hits during the coronavirus pandemic, due to the increased social distancing practices calling for fewer people to be in the building at one time and the cancellation or postponement of elective surgeries and other procedures.

CMMC CEO Tim Thornell said the hospital lost $1 million in March and is projecting an operating loss of close to $10 million for April.

“Cheyenne Regional Medical Center, like every other hospital in Wyoming, is certainly feeling the negative financial impact that COVID-19 is having,” Thornell said in a statement. “We are seeing about a 30% reduction in inpatient care and an upwards of 50% reduction in outpatient care.”

The hospital system is managing the situation, but Thornell noted that these losses aren’t sustainable in the long term. To address funding shortfalls, CRMC is using financial reserves to supplement current operations, which means major capital projects have been placed on hold to divert funds to daily operations.

There is also a hiring freeze in place at the hospital and overtime is being limited. Reduced hours have been implemented for select non-urgent service lines.

“Our volumes are down in all areas,” Thornell said. “We have a strong and dedicated staff that continues to provide the best possible care to our community during these challenging times.”

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Wyoming Hospitals Take Extra Precautions to Prevent Coronavirus Spread

in Coronavirus/Health care/News

By Ellen Fike, Cowboy State Daily

Hospitals across Wyoming have taken numerous precautions to limit the possible spread of the coronavirus in their establishments and in their communities. 

Since the patients and staff are at such high risk for transmission, hospital managers are putting new rules in place for the interim to keep everyone safe, patients, staff and visitors alike. 

Here is a look at what rules hospitals in Wyoming have implemented regarding the virus: 

Albany County

Ivinson Hospital: If anyone in the county is experiencing flu-like symptoms, including a fever of at least 100.4 degrees, a cough or shortness of breath, they should call the nurse triage line at 307-755-4750 between 8 a.m. and 5 p.m. Monday through Friday. 

Certain entrances are limited to patients and the public, which can be found here. 

Visitor restrictions have been implemented, now limited to 8 a.m.-8 p.m. daily. Patients can’t have more than one visitor in a 24-hour span. No one under the age of 16 can visit the hospital except for treatment. Visitors with cold or flu symptoms are asked to refrain from visiting a patient. 

Certain services have been reduced or postponed at the hospital These include elective surgeries, which are suspended until further notice. The hospital is reducing non-emergency outpatient services, as is the Meredith and Jeannie Ray Cancer Center. The gift shop operation hours will be from 8 a.m. to 3 p.m. Monday through Friday. 

Big Horn County

North Big Horn Hospital District: Sick visitors are restricted from visiting, as are children under 18 in most areas of the hospital. 

All staff, patients and visitors are screened for the virus prior to entering the facility. If someone believes they’re experiencing symptoms of the virus, they’re asked to call the hospital ahead of time so staff can prepare for the patient’s arrival. 

Certain entrances are limited to patients and the public. 

New Horizons Care Center isn’t allowing visitors at this time. 

Campbell County

Campbell County Memorial Hospital: The hospital is currently closed to all visitors except one parent of pediatric patients and one support person for anyone giving birth. All patients are required to undergo a respiratory health screening with a temperature check. No visitors under 18 are allowed in the hospital. 

The hospital has also closed certain departments, including cardiac and pulmonary rehabilitation, outpatient respiratory therapy and surgery. The only surgeries that will be done are emergency cases and those deemed medically necessary. One support person will be allowed in the hospital for those having surgery, following a health screening.

Access to certain entrances is limited to patients and the public. The Heptner Cancer Center is open for regular business hours for dialysis and oncology patients only. The pediatric clinic is canceling all non-essential appointments. 

The Close to Home Hospice and Hospitality House will require all visitors to be screened for respiratory symptoms. The Powder River Surgery Center is closed. No visitors are allowed at the Legacy Living and Rehabilitation Center. All employees and select volunteers will be screened for respiratory symptoms. Powder River Orthopedics and Spine is open and seeing limited patients. 

The wellness daily community blood draws, lab tests and health and wellness screenings have been discontinued until further notice. 

Carbon County

Memorial Hospital of Carbon County: The hospital is screening all patients, staff and visitors when they enter the facility, including asking a series of questions and conducting a temperature check. 

Only patients in critical condition and women in active labor will be allowed a visitor. No children under the age of 18 will be allowed in the hospital except for medical care. No visitors are allowed in the common areas, such as the waiting rooms and lounges. 

The hospital can only be entered through the main lobby or the emergency room. All non-urgent or elective surgeries are postponed. 

Converse County

Memorial Hospital of Converse County: Elective surgeries are postponed until further notice. Primary care providers are canceling or rescheduling all non-urgent appointments, however all of the clinics are still open. Patients will be asked a series of questions before being allowed into the buildings. 

The main entrance of the hospital will be monitored from 7 a.m. to 5 p.m. Monday through Friday. Exterior hospital doors will be locked after hours. The Arbor Cafe and Mocha Molly’s are closed to the public. 

No visitors or guests will be allowed in the hospital. 

Fremont County

SageWest Health Care: Patients in the emergency department, inpatient units and outpatient clinics are screened for the virus. Staff treating a potential case of the virus are provided with appropriate protective equipment to help prevent exposure. Patients with symptoms of the virus are immediately provided masks to prevent exposure. 

Only pediatric, OB, outpatient surgical patients and those receiving end-of-life care will be allowed visitors. These groups may only have one healthy adult (a person over 16) as a visitor and everyone must be screened upon entering the facility. 

Goshen County

Banner Health Community Hospital: Pediatric patients can have one adult visitor with them and laboring mothers may have one support person, but all other guests are barred from teh hospital. Deliveries of gifts, care packages, flowers or anything else will not be accepted at this time. 

Banner Health has canceled elective surgeries in two other states, but not Wyoming as of press time. The hospital won’t give “fit-for-work” clearances or test for the virus for an employer. 

The main entrance and emergency room entrance remain open to the public. 

Laramie County

Cheyenne Regional Medical Center: The hospital’s visiting hours are limited from 7 a.m. to 7 p.m. daily and patients may only have one visitor during the entirety of their stay. However, patients who are admitted and screened or test positive for the coronavirus won’t be allowed visitors.

Cancer Center patients are also only allowed one visitor. Visiting hours are the same as the hospital’s. 

The Davis Hospice Center is locked at all times, but visitors will be allowed in special circumstances, such as an end-of-life event or when the visitor is essential for the patient’s well-being. This will be assessed on a case-by-case basis. 

Natrona County

Wyoming Medical Center: Medically necessary surgeries will be conducted on a case-by-case basis. The schedule is checked daily for appropriateness in order to conserve resources. 

Medically necessary exams such as echocardiograms, pulmonary function tests and stress tests are still being scheduled. All procedures are being evaluated on a case-by-case basis. The Sleep Lab is closed. 

The NERD Health and Wellness Center’s health coaching, acupuncture and massage appointments are canceled. Pulmonary rehabilitation is canceled until further notice. The childbirth education and breastfeeding classes are canceled, as well as in-person lactation consultations. 

Visiting hours are now from 7 a.m. to 8 p.m. daily. A patient will be allowed one visitor per day, but exceptions will be made for comfort care or terminally ill patients. Pediatric parents and babies in the nursery can have both parents visit, but only one at a time. Visitors will go through a health screening before being allowed to enter.

Park County

Cody Regional Health: Pediatric patients admitted to the ER or inpatient services will be allowed one legal caregiver with them for the entirety of their stay. Maternity patients will have the same rules applied to them. Visitors aren’t allowed in the hospital otherwise. 

Health Fair lab draws have be canceled at all of CRH’s location. The orthopedics department is reduced to essential appointments only, including fractures, post-operation appointments and traumatic injuries. 

All elective procedures for radiology and cardiac catheterization procedures are canceled, except for critical diagnostic/testing procedures. Cedar Mountain Center rehab services are canceled. 

Pediatric clinic visits are reduced to only visits for newborns up to four months old. 

Certain medical practices, like internal medicine and cardiology, are reducing their hours for the time being. 

Platte County

Platte County Memorial Hospital: See entry for Banner Health Community Hospital in Goshen County. 

Sheridan County

Sheridan Memorial Hospital: Visitors aren’t allowed for most patients. Exceptions include OB patients, those coming in for surgery or an outpatient procedure, patients at the end of their life and pediatric patients, all of whom are allowed one support person. They will all be screened for illness symptoms before their visit. Patients and staff are also screened when they enter the building. 

Sweetwater County

Memorial Hospital of Sweetwater County: Anyone with a fever or cough is asked to wait to go to the emergency room before contacting the nurse triage line. 

Visitors are restricted except for OB and pediatric patients, as well as those at the end of their lives. They must be the same person for the OB and pediatric patients. No children are allowed as visitors. Everyone entering the hospital will be subjected to a temperature scan. 

Teton County

St. John’s Health: Patients can have only one designated visitor per day, but both parents can visit if the patient is a child. No one under 18 or displaying flu-like symptoms is allowed to visit. Everyone entering the hospital must wash their hands or use a sanitizer with a 60% alcohol base before entering. 

Emergency department patients can’t have visitors except one parent for a child or one caregiver for a patient who needs help communicating. 

The St. John’s Living Center is restricting all visitors except in the case of an end of life situation. It’s canceling all communal dining and group activities, both internally and externally. All staff are screened for fever and respiratory symptoms at the beginning of their shift. Residents are also being screened. 

The hospital can’t currently clear anyone to return to work after an illness. 

Uinta County

Evanston Regional Hospital: The ER is the only accessible door to patients at this time. Patients are allowed one to two visitors, but no one under 18 or displaying sickly symptoms. Everyone entering the facility will do a health screening. 

Weston County

Weston County Health Services: Visitors aren’t allowed at this time. People experiencing coronavirus symptoms are asked to call the center before arriving. 

Wyoming’s First Coronavirus Disease 2019 Case Reported

in Health care/News

Lab testing at the Wyoming Public Health Laboratory has identified the first known case of a state resident with coronavirus disease 2019 (COVID-19), according to the Wyoming Department of Health (WDH).

Dr. Alexia Harrist, state health officer and state epidemiologist with WDH, said the patient is an adult female from Sheridan County with some recent domestic travel history.

WDH is following up to learn more details about the person’s exposure risk and to identify and communicate with anyone who may have been in close contact with the patient. Known contacts will be monitored for symptoms and tested if needed. As is currently standard, the test result is considered to be a “presumptive positive” and the Centers for Disease Control and Prevention (CDC) will conduct further testing for confirmation.

Harrist noted the current risk of transmission in Wyoming remains low for most residents. “We expected to identify a case in Wyoming at some point because the reach of the disease is clearly growing. Travelers to certain affected locations and close contacts of ill people are still overall at the highest risk of becoming ill,” she said.

“Our state has been planning for this situation for weeks and we will continue our coordinated efforts to address this threat,” Governor Mark Gordon said. “I pledge to work closely with our state agencies, federal partners and local officials to ensure we are implementing all the necessary steps to protect public health.”

Harrist said symptoms reported with this disease are familiar: fever, cough and shortness of breath. There are many different coronaviruses, some of which cause the common cold in people and others that circulate among animals.

Experts believe COVID-19 spreads mostly between people who are in close contact and through respiratory droplets when an infected person coughs or sneezes. People are thought to be most contagious when they are most ill with obvious symptoms. A person may also get COVID-19 by touching a surface that has the virus on it and then touching their own mouth, nose or eyes.

Recommended steps that can help avoid the spread of COVID-19 or similar illness include:

· Avoid close contact with sick people.

· While sick, limit contact with others as much as possible.

· Stay home if sick.

· Cover nose and mouth when coughing or sneezing. Avoid touching eyes, nose and mouth. Germs spread this way.

· Clean and disinfect surfaces and objects that may be contaminated with germs.

· Wash hands often with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand rub with at least 60 percent alcohol.

“Travel recommendations and restrictions are also important,” Harrist said. The CDC currently recommends no nonessential travel to China, Iran, South Korea and Italy and no travel on cruise ships.

The CDC also says older adults and travelers with underlying health issues should consider avoiding situations with increased risk for transmission because they are at higher risk of severe COVID-19 illness. Examples include avoiding non-essential travel such as long plane trips and avoiding crowded places.

For more information about coronavirus disease 2019 and Wyoming, visit:

For more details about the disease from the CDC, visit:

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