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More than 100 million prescription painkillers ended up in Wyoming in six years

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More than 100 million prescription painkillers ended up in Wyoming in six years

By Laura Hancock, Cowboy State Daily

Drug makers distributed nearly 126.7 million painkillers in Wyoming between 2006 to 2012, according to a federal prescription database recently made public.

That includes hydrocodone, which goes under the name brands of Vicodin and Lortab, and oxycodone, which goes under the name brand of OxyContin

The U.S. Drug Enforcement Administration database is being used in litigation by more than 2,000 entities such as state governments, local governments, tribes, labor unions and hospital systems – including several in Wyoming – in a federal courtroom in Cleveland. The litigation alleges drug manufacturers and distributors aggressively marketed the medicines, downplayed their addictive tendencies and created an opioid scourge that’s become a national epidemic. 

The Washington Post and the Charleston Gazette-Mail in West Virginia successfully fought to make the information public, and the Post created a searchable database — from which the Wyoming data was pulled.

The following describes prescription opioids sent to each Wyoming county between 2006 and 2012:

Albany4.5 million pills18 pills per person each year.
Big Horn3.7 million pills45 pills per person each year.
Campbell10.6 million pills35 pills per person each year.
Carbon3.1 million pills28 pills per person each year.
Converse2.9 million pills31 pills per person each year. 
Crook250,100 pills5 pills per person each year. 
Fremont7.8 million pills28 pills per person each year. 
Goshen2.2 million pills25 pills per person each year. 
Hot Springs1.8 million pills53 pills per person each year. 
Johnson1.2 million pills21 pills per person each year. 
Laramie20 million pills32 pills per person each year. 
Lincoln3.9 million pills32 pills per person each year. 
Natrona20.4 million pills39 pills per person each year. 
Niobrara421,800 pills25 pills per person each year. 
Park10.3 million pills53 pills per person each year. 
Platte2.2 million pills35 pills per person each year. 
Sheridan7.1 million pills35 pills per person each year. 
Sublette1.5 million pills23 pills per person each year. 
Sweetwater9 million pills30 pills per person each year. 
Teton3.3 million pills22 pills per person each year. 
Uinta5.8 million pills40 pills per person each year. 
Washakie3.1 million pills54 pills per person each year. 
Weston1.6 million pills32 pills per person each year. 

Several Wyoming governments are involved in separate litigation over opioids, including the state, Carbon County, Rock Springs, Green River, Casper, Cheyenne, and the Eastern Shoshone and Northern Arapaho tribes. Lawsuits have been filed in state and federal court

The plaintiffs in all of the lawsuits argue that drug treatment has cost them millions of dollars through Medicaid and community treatment facilities. Many people, hooked on prescription opioids, have turned to street drugs – including fentanyl-laced heroin. Some have overdosed and some have died— including nearly 50,000 across the U.S. in just 2017 alone

State Rep. Charles Pelkey, D-Laramie, said he was pleased to see the state taking action in the face of large distribution numbers.

“Much of the responsibility lies with the pharmaceutical companies who marketed aggressively, unaware or intentionally ignorant of the consequences,” he said in an email. “We can some things legislatively, but I am pleased to see that the state is pursuing the matter in the courts as well. If legislation doesn’t achieve the desired goal, maybe hitting them in the pocket, where it counts, will.”

Wyoming’s case is pending in district court in Laramie County, where OxyContin maker Perdue Pharma wants it dismissed. The state is opposing the motion.

Michael Pearlman, spokesman for Gov. Mark Gordon, said this week that the Wyoming Attorney General’s Office is waiting for the district court to rule on dismissal. 

“In the meantime, the court entered a scheduling order, including among other things, discovery deadlines which the AGs office is following,” he said in an email.

According to filings, the case is expected to continue at least through 2020.
The lawsuits filed by Wyoming cities and tribes are in federal court, all consolidated in U.S. District Judge Dan Polster’s Ohio courtroom. Bloomberg reported Tuesday that McKesson Corp., Cardinal Health and other drug distribution companies have offered a $10 billion settlement in lawsuits filed by the various states. A group representing some plaintiffs countered with $45 billion. 

Drug makers haven’t yet begun settlements with the plaintiffs in federal court in Ohio, but the judge is pushing for the parties to settle soon to end all the suits and help set aside money for drug treatment and prevention. Perdue Pharma separately settled with Oklahoma for $270 million.

Pearlman, Gordon’s spokesman, said opioids aren’t just an addict’s problem. Their families and communities are affected too. 

“It causes extra burdens on our law enforcement agencies and first responders,” he said. 

Public health officials continue to eye Wyoming’s immunization rates

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Graph of Wyoming vaccination rates

By Laura Hancock, Cowboy State Daily

At a time when all-but-eradicated diseases are making a comeback, immunization rates among young children in Wyoming tend to closely mimic national trends, according to an analysis of federal data. 

Some years, Wyoming’s rate is lower than the national average. Other years it’s higher. 

However, looking at data for four common vaccines tracked by the National Immunization Survey, Wyoming’s rates increase and decrease by more percentage points than the national average. 

That could be the result of the margin of error that comes from polling the country’s smallest population state, said Alexia Harrist, the Wyoming state health officer and epidemiologist. 

Although signs are good that Wyoming hasn’t significantly deviated from the national norm, that doesn’t necessarily mean Wyoming has escaped the “anti-vax” movement, which inaccurately pushes the belief that vaccines are harmful. Research shows that vaccine reactions are rare and the one study linking vaccinations to autism contained falsified information

“We are seeing some increases in the amount of waivers (for vaccination) that we’re getting,” Harrist said. “That is concerning that we may be seeing fewer children getting vaccinations.”

Wyoming is one of 45 states and Washington, D.C. where parents can seek waivers from required vaccinations for their children due to religious beliefs. 

Dr. Mark Dowell, the Natrona County health officer, remembers the days when he could override a family’s desire to waive their children’s vaccines. 

“I made sure that they had good reasons to prove to me there was a medical contraindication to the vaccine,” he said. “(Otherwise) I’d deny it. That’s how I’ve always felt, and I’ll continue to preach that.”

In 2001, the Wyoming Supreme Court ruled that public health officers exceeded their authority by denying immunization exemptions. Since then, Dowell and others stopped intervening. 

Public health officers stress the concept of “herd” immunity or “community” immunity, in which most people get vaccinated so that the few who cannot – those with cancer or immune deficiencies that prevent them from developing immunity with vaccines – are safe from smallpox, polio and other diseases once thought to be in the Western world’s past, Harrist said. 

That Wyoming hasn’t seen a measles outbreak could be luck. Or it could be the result of the Cowboy State’s vast spaces and few people. 

“The majority of the time I’m not running into major problems in this county,” Dowell said about Natrona County. “But almost all of the counties in Wyoming are very rural. They don’t have a lot of infectious disease.”

News of outbreaks outside of Wyoming may actually boost immunization rates. 

The phone starts ringing at Sheridan County Public Health whenever there is an outbreak. People want the health department to check their records to ensure they’re up-to-date on all their shots, said Debra Harr, the county nurse manager. 

“We’ve seen quite a bit more people calling to see if they are current on their measles,” she said. 

Doctor Shortage in Wyoming; “Almost Impossible to Recruit”

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Doctor Shortage in Wyoming; “Almost Impossible to Recruit”
Wyo Hospital Assoc. President: Federal changes makes it almost impossible for us to be competitive and for us to recruit especially family practice physicians in these rural areas where they’re needed the most.

By James Chilton, Cowboy State Daily

CHEYENNE – When it comes to sheer numbers, Wyoming’s doctor shortage isn’t all that bad, on paper at least.  Just two dozen additional full-time outpatient physicians would be enough to meet the primary care needs of the nearly 188,000 Wyomingites living in federally-designated Health Professional Shortage Areas, or HPSAs.

“The population of designated HPSAs in Wyoming for primary care is 187,903, and only 53.81 percent of that population’s need is met,” said Keri Wagner, of the Wyoming Health Department’s Office of Rural Health. “The practitioners needed to remove that designation is 24 for the entire state.”

While it might not sound like much, getting those 24 full-time doctors into the state, getting them to the communities where they’re needed most, and offering them the compensation and quality of life needed to keep them here have proven uniquely difficult in the Cowboy State. Federal and state programs have made some headway in the effort to bring more doctors, dentists and psychiatrists to all corners of Wyoming. But while the state’s reputation for wide-open natural splendor brings in the tourists and outdoorsmen, it’s not necessarily what most doctors are seeking when looking to relocate.

“It really takes a specific type of person, someone who grew up in these frontier communities that really wants to get back to practicing someplace where they’re relatively isolated. If they’re outdoorsmen or like cross-country skiing or hunting, sure; but there are long distances to get to any other type of entertainment,” Wagner said. “We’re surrounded by states with larger population centers, more enrichment opportunities and educational opportunities, so it can be a really tough sell for some communities that don’t even have a supermarket.”

The HPSA designation seeks to help with this by grading facilities, geographic regions and specific populations on criteria like patient-to-provider ratio, percentage of the population living below the federal poverty level and travel time to the nearest source of care. From this, hospitals, clinics and geographic areas are scored, with higher scores getting the most attention from the U.S. Health Resources and Services Administration.

“If they have the HPSA designation for any of the three disciplines (primary care, dental or mental health services) it opens up the opportunity to participate in the National Health Service Corps,” Wagner said. “We have roughly 30 corps participants every year.”

The National Health Service Corps tries to get practitioners to where the need is by offering scholarships and loan repayment programs to fledgling doctors in exchange for an agreement to work in a designated HPSA for at least two years. Physicians working in geographic HPSAs can also obtain additional bonus quarterly payments from the Centers for Medicare and Medicaid Services.

For HPSA designation and related support, practitioners must submit reports updating the state on statistics such as doctor-to-patient ratios.

“It’s important enough they’ll return their surveys if they’re afraid they’ll lose their designation,” Wagner said. “I’ve seen people where they receive the bonus payment, but there was some cutoff or something wrong with the timing, where the HPSA designation goes away and they have to return it. I think one of the big things that’s happened is the population is so small that just the loss of a quarter of an FTE (full-time equivalent, i.e. 40 hours of work per week) can make or break a designation.”

That’s been a continuing cause for concern for Eric Boley, president of the Wyoming Hospital Association. Boley agreed with Wagner’s assessment that, for whatever reason, the HPSA system seems weighted to apply to more densely-populated areas, where small changes in population don’t move the needle as much.

“The feds have changed the way the HPSA scoring is calculated based on service areas, so areas I and my members would designate as shortage areas no longer meet their criteria,” Boley said. “For example, south Lincoln County used to easily qualify for HPSA funding, where northern Lincoln County, the Star Valley area, didn’t have some of the challenges. But now because of criteria changes, the whole area is lumped into one.”

As a result, Boley said some of the state’s most vulnerable rural communities are left with few resources to attract medical talent from larger hospital systems, and even those that do have the resources have to make steep offers to even stand a chance.

“My facilities are having to pay, in some cases, the 95th percentile for salaries, with sign-on bonuses and really lucrative living expense packages,” Boley said. “It makes it almost impossible for us to be competitive and for us to recruit especially family practice physicians in these rural areas where they’re needed the most.”

Wagner noted the state has led its own effort to try to provide a little more financial leverage to small communities through the Wyoming Provider Recruitment Grant Program, which provides up to $50,000 to a hospital, clinic or community organization attempting to recruit a healthcare provider. Initially funded for the 2009-10 biennium, the program doesn’t level the playing field, Wagner said, but it has helped to recruit more than a dozen physicians, psychiatrists and, following a 2015 legislative change, other health professionals like registered nurses or occupational therapists.

Like most programs, Wyoming’s provider recruitment program has some strings attached that have kept it from being fully utilized. One big problem is that the grants are meant for reimbursement, meaning whoever’s doing the hiring needs to have the money up front and has to have someone recruited within one year for the payments to come through. 

“If they don’t recruit within that one year, they don’t get any money. If they do recruit, the provider has to start within six months of the date they sign them,” Wagner said. “So, is this entity able to fund all of this up front and wait for the reimbursement? Our neediest have applied, but they couldn’t go anywhere without money to front it.”

As such, Wagner said applications made through the program dropped from 45 in the 2009-10 biennium to just nine in the following biennium, and they have remained low ever since. But for those hospitals able to navigate the process and pay for the initial recruitment process, the program has proven a useful tool.

“I think it’s successful in that it provides funding to help recruitment at safety-net facilities. These are organizations that don’t have a ton of funding; they have a hard time competing with larger hospital systems in surrounding states,” she said. “So when a provider is contacted and they’re mulling over whether they should go to a rural health clinic in Colorado that’s offering an $80,000 loan repayment on top of a $40,000 sign-on bonus, versus this hospital in Wyoming … this program improves Wyoming’s negotiating position. It provides them with a little bit more clout.”

VA to implement Mission Act, cutting wait times, enhancing healthcare programs

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Veterans Affairs Health Care

By Ike Fredregill, Cowboy State Daily

A congressional act going into effect June 6 could make it easier for Wyoming veterans to access the health care providers of their choice. The Mission Act will replace the Choice Act of 2014, which was adopted as the congressional response to extreme wait times experienced by veterans seeking medical care through the Department of Veterans Affairs.

“The Choice Act was a three-year law, which was intended solely for the purposes of pulling the VA into a newer era of community care,” said Sam House, a Cheyenne VA Medical Center spokesperson. “Then, President (Donald) Trump extended it for a year. The Mission Act, however, does not have a sunset, so it will be in place until Congress decides to remove it.”

With the Choice Act, veterans could seek primary and mental health care services from a local health care provider rather than from a VA facility if they lived outside a 40-mile radius of a VA medical center or could not schedule an appointment with their primary care provider at the VA within 30 days.

The Mission Act reduces those standards to a wait time of 20 or more days or a drive time of more than 30 minutes.

“They are not using specific matrix to look at drive times, but rather looking at the average drive time and taking into account heavy traffic periods,” House explained. “A guy living in Denver could live 5 miles from the VA, but it might take him 45 minutes to get there.”

For specialized care, the new act reduces the veterans’ wait time to be eligible for services at non-VA facilities from 30 days to 28 and changes the 60-mile radius requirement to a 60-minute radius.

“Congress is focusing on ensuring our vets are getting the best possible care as quickly as they need it,” House said.

Enhancing programs

In addition to easing access requirements, the Mission Act seeks to improve services already in place such as tele-health options, caregiver programs and VA infrastructure.

“The Mission Act streamlines and improves community care,” House said. “It establishes a new urgent care benefit for our veterans, and it expands caregiver eligibility.”

When the Choice Act was implemented, veterans were given the opportunity to seek healthcare providers outside VA facilities, which is referred to as community care, he said.

The VA’s internal software, however, did not communicate with the myriad programs used by health care providers outside its facilities. Simple tasks such as transferring medical records and authorizing payments required mountains of paperwork as well as numerous case-worker hours, House explained. The Mission Act seeks to streamline the process through installing new software, HealthShare Referral Manager (HSRM).

“HSRM is an end-to-end healthcare referral system,” said Josh Benavente, Cheyenne VA Community Care supervisor. “That’s where the VA will build our authorizations for payments and providers can submit medical records.”

The new system goes live in June.

“The biggest problem it’s fixing is previously we were relying on too many outdated programs to get information to and from community providers,” Benavente said. “It allows the VA to communicate with community providers faster and easier.”

Eligibility for the VA’s caregiver program is also slated to expand to include veterans from all eras of service. The expansion is scheduled to roll out during the next two years, starting with veterans who were injured on or before May 7, 1975.

On the tele-health front, the act could facilitate community partnerships in rural areas to increase long-range, video and phone healthcare-conferencing accessibility, House said.  

“What the Mission Act will do is strengthen our ability and reason for going into communities to establish a centralized tele-health port,” he explained. “We have a number of veterans that don’t have internet capability, but they want to stay with the VA and can’t make the trip to the Cheyenne VA every time.”

One such program could soon provide veterans living near Saratoga an opportunity to use equipment at the Saratoga Care Center to access Cheyenne VA tele-health programs, House added.

Bureaucracy

As June 6 rounds the corner, House said the VA is racing to ensure the transition is smooth. 

“It’s been a mad rush for all of the VA to be trained by June 6,” he said. “There are so many pieces and parts to the act.”

Despite more programs and enhanced services, House said the act will not likely lead to an increase of staffing at the Cheyenne VA.

Cowboy State Daily talked to several veterans who were unaware of the changes coming to the VA, but most said they would like the Mission Act to make it easier for veterans living in rural Wyoming to enter the community care program.

“The Choice Program didn’t work too well because of all the bureaucracy,” said John Hursh, a Laramie resident and former captain in the U.S. Marine Corps Reserve. “So, I’m hoping the Mission Act can fix some of that.”

Cheyenne VA services remain intact a year after administrative downgrade

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Cheyenne VA services remain intact a year after administrative downgrade

By Ike Fredregill, Cowboy State Daily

Services at the Cheyenne Veterans Affairs Medical Center remain largely intact a year after the Department of Veteran Affairs downgraded an administrative ranking for the facility, a VA spokesperson said.

“Our lower complexity level has not affected the quality or services we provide,” said Sam House, the Cheyenne VA public affairs officer. “It didn’t affect our funding. The only thing it did was should we get a new director, they would be hired at a lower pay rate.”

According to the department, VA facilities are categorized by “complexity levels,” which are determined by characteristics of the patient population, clinical services offered, educational and research initiatives and administrative complexity. 

“It’s a system of looking at hospitals, and what they are capable of doing,” House explained. “They assign numbers to them, and they base the hospital director’s pay off that number. That’s all the complexity level means.”

The complexity system consists of three levels with level one and its subcategories being the highest and level three being the lowest. The Cheyenne VA, with a budget of $185 million in 2018, was downgraded from level two to level three early in 2018, which House said signifies no research is being conducted at the facility.

“We don’t have a focus on research,” he added. “Our focus is on mental health, primary care and geriatric care.”

House said one service was changed by the downgrade — orthopedic repairs. While the facility still provides othorpedic surgery, its staff no longer repairs orthopedic implants.

Wyoming Veterans Commission Director Steve Kravitsky said he was initially alarmed when he heard about the downgrade, but his fears were allayed after talking to Cheyenne VA Director Paul Roberts.

“(Roberts) assured me not only were they not going to decrease any services, but they were still bringing more services online,” Kravitsky said. “As director of the veterans commission and a veteran myself, I receive care at the VA, and I haven’t seen anything to the contrary.”

Built in 1934, the Cheyenne VA originally employed 100 staff members and provided 100 beds for primary care.

Nowadays, the facility’s area of service, also known as a “catchment” area, stretches from Rawlins to Sydney, Nebraska, and from Douglas down to north of Denver.

About 79,000 eligible veterans live in the catchment area, House said, but only 29,000 used the facility’s services in 2018, a 3 percent reduction from 2017.

House explained that the VA is made up of three entitles to administer three areas: Healthcare, benefits and the national cemetery.

Most of the services offered at the Cheyenne VA are centered around primary healthcare, but all three divisions of the department have offices on the grounds. 

“Recently, we’ve expanded our nursing home and hospice care facility,” House said. “The average age of Cheyenne VA users is 61. Our youngest user is 19, and our oldest is 102.”

A large portion of the facility is dedicated to offering primary care, including physical therapy, orthopedic surgery, cardiopulmonary lab work, audiology and otorhinolaryngology, or ear, nose and throat care.

The Cheyenne VA also provides some emergency services through its emergency room.

“Our ER is open and staffed 24/7, 365,” House said. “But we’re not a trauma center.”

Because of this, ambulances do not deliver patients to the Cheyenne VA, but rather, veterans are transported to Cheyenne Regional Medical Center, and the VA reimburses the medical center for the care provided.

“Because we have CRMC, we don’t have a trauma care unit in our ER,” he added. “We are in partnership with our community, not competition.”

Additionally, the facility offers limited dental care and was the first in the region to install a women’s clinic.

“The need for women-specific care is something I think the VA has really realized in the last nine to 10 years,” House said.

Laramie County is home to the largest concentration of veterans in Wyoming, and as such, the Cheyenne VA is well-placed to provide them with vital services, Kravitsky said.

“There are 12,085 vets living in Laramie County, according to the VA,” he said, “which is about 25 percent of the 47,472 living throughout Wyoming.”

Without the Cheyenne VA, veterans would need to travel to Denver or Sheridan for veterans services, Kravitsky added.

“With 20 veterans committing suicide every day, quality care close to home is essential to potentially reducing that number,” he said.

The veterans commission files veteran claims with the VA benefits division and is occasionally charged with reviewing inquiries into the VA’s quality or frequency of care. 

“Those inquiries are infrequent,” Kravitsky said. “We don’t get a lot of negative feedback about the Cheyenne VA.”

Wyoming measles-free, but officials urge preventive action

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Wyoming measles-free, but officials urge preventive action

By James Chilton, Cowboy State Daily

CHEYENNE – Wyoming has not yet been affected by what has become the largest United States measles outbreak in 25 years. 

But local healthcare officials are echoing federal calls for parents to keep their children current on vaccinations and to trust the experts when they warn how serious – and how contagious – the disease can be.

While still common in the developing world, measles was declared effectively eliminated in the U.S. in 2000. The measles vaccine, licensed just 36 years earlier, was credited with bringing annual U.S. measles diagnoses down from more than 440,000 cases in the early 1960s to just 43 cases in 2007. 

But measles diagnoses have been jumping sharply in recent years, and so far in 2019 more than 700 cases of the disease have been reported in 22 states, with 500 of those cases contracted by unvaccinated patients, according to the Centers for Disease Control and Prevention.

It’s an alarming trend that healthcare specialists say is based in part on a long-discredited 1998 British research study that suggested the measles, mumps and rubella vaccine was associated with higher rates of autism in patients who received the vaccine in childhood. 

The author was later banned from practicing medicine and the study was ultimately retracted from the prestigious medical journal that originally published it, but decades later, the seeds planted by that erroneous study are still bearing fruit, as this latest outbreak shows.

“I think social media has really aggravated it, and I just don’t think people know how to judge their sources.” said Dr. Robert Prentice, a pediatrician with Cheyenne Children’s Clinic. “There’s misinformation, there’s distrust, and for some people it’s almost like a religion. I think it’s an attempt to gain control over things that can’t be controlled.”

The reality, Prentice said, is that measles should not be dismissed as a harmless childhood disease one can bounce back from easily. The virus can remain contagious in airborne droplets for up to two hours after an infected person sneezes or coughs, and more than 90 percent of unvaccinated people who come into contact with the virus will contract it.

 “If you can prevent something, especially something like measles, which I had as a kid— my wife’s mother had it and thought she was going to die. It was a terrible disease,” Prentice said. “Yeah, most people survived it. But on the other hand lots of people died due to complications or the result of complications.”

He added that, in the past, isolated families were able to get by without vaccinating their children due to “herd immunity” – so many people were already immune to measles that it couldn’t spread to those who are not. But as more parents opt to skip the vaccine, herd immunity starts to break down, which poses problems not just for the unvaccinated children, but also for infants who are too young to safely receive the measles vaccine and adults whose immune systems may be compromised by other conditions.

“We can’t vaccinate children under a year of age; in an epidemic situation we can immunize after six months old, but at that point babies still have maternal blocking antibodies, so they don’t take viral vaccines very efficiently,” Prentice said. “Sometimes if kids are sick enough they have to be admitted to the hospital, and then I have to think about the other children there, the nurses there.”

Laramie County School District No. 1 Head Nurse Janet Farmer said all the district’s students must have documentation showing they’ve received two doses of the measles-mumps-rubella vaccine as recommended by the CDC and the Wyoming Department of Health. But there are ways some parents can get around that requirement by obtaining a medical or religious exemption.

She said it’s rare to see parents seeking a medical exemption from the measles vaccine, and even then they’re required to provide documentation explaining their why the exemption is medically necessary. 

“With the religious exemption, they just have to say they have a religious reason they don’t want the vaccine, and they don’t need to elaborate; and we’ve been told we cannot ask what their religion is or why they want it,” Farmer said. “(The exemption) still has to be approved by the Wyoming Department of Health, but they don’t have any recourse to say no.”

While such exemptions are still uncommon, Farmer agreed with Prentice’s impression that anti-vaccine sentiment is growing stronger lately, and the misinformation can be hard to correct.

“I don’t begrudge parents wanting to do what’s best for their child. But a lot of times people will believe what they read and see, and if they feel like the source is credible, they’ll believe it without doing research to see what’s behind that information,” she said. “So it’s hard to backtrack to convince people who’ve made up their minds.”

That said, Farmer noted that if a measles outbreak were to be confirmed within a district school, unvaccinated students would have to be sent home for safety’s sake.

Department of Health spokeswoman Kim Deti said that while Wyoming remains measles-free for now –the last confirmed case was reported in 2010 – the best way to keep that streak going will be for parents to trust that their pediatrician has their child’s best interest at heart.

“What we want people to do is follow the vaccine schedules as recommended,” Deti said. “That was the reason measles was eliminated before.”

‘Rugged individualism’ may contribute to high Mountain West suicide rates, says expert

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A sense of “rugged individualism” may contribute to the fact that the Mountain West states have some of the highest suicide rates in the nation, according to an expert in Cheyenne.

By Cowboy State Daily

A sense of “rugged individualism” may contribute to the fact that the Mountain West states have some of the highest suicide rates in the nation, according to an expert in Cheyenne.

Linda Goodman, the chief clinical officer at Peak Wellness Center in Cheyenne, said people suffering from depression or other issues in Wyoming and other rural states resist seeking assistance from counselors.

“The rugged individuality is a big piece of it,” she said. “The mentality that ‘I just need to cowboy up and be tough.’ That rugged individualism says ‘I need to be able to handle my problems by myself.”

In 2017, the Centers for Disease Control set Wyoming’s suicide rate at 26.9 per 100,000 people, the third highest ranking in the country. Wyoming joined Montana, Utah, Idaho and Colorado among the states with the 10 highest suicide rates in the nation.

Nationally, suicides have contributed to what was reported in a Detroit newspaper as a reduction in the life expectancy of Americans.

Author Mitch Albom wrote that death rates are rising among working class people who are middle aged and older, largely from what he described as “deaths of despair,” suicides and complications that arise from alcohol and drug abuse among people who believe they cannot achieve the “American dream.”

Goodman said she believes such feelings are often seen among the children of families who survived the Great Depression and World War II and vowed to give their children everything they needed to live the American dream.

“And for some of us, that is looking less and less like the American dream we had envisioned,” she said. “For some Americans today, it means having to let that dream go and if you don’t have the resilience to have another dream that emerges, then you are left with despair.”

Many people found themselves homeless or broke with the turbulent economies of recent years,” Goodman said.

“For people that had the ability to say ‘I’m going to drop back … I’m going to get back on my feet,’ that was fine,” she said. “But for people who did not have that, they turned to ways to avoid having to deal with those problems. That can be through the use of alcohol, it can be through the use of drugs, it can be through depression …”

Goodman said one thing that can help someone suffering from despair is for those people to help others who are less fortunate.

“There’s nothing that will help you more to feel like you have meaning in your life than to help someone else,” she said.

This story has been updated. A previous version of this story misstated the suicide rate.

Dangerous flu strain reported in Colorado could spread north

in Health care/News
Health Department warns flu

By Ike Fredregill, Cowboy State Daily

A virulent strain of influenza sweeping through Colorado could jump into Wyoming before flu season is finished, a Wyoming Department of Health spokesperson.

While she did not refer specifically to the variation of flu diagnosed in Colorado, Kim Deti, the public information officer for the Wyoming Department of Health, said it is not unusual for different strains of flu to spread.

“Strains move around,” she said. “In flu season, sometimes you will see more than one strain be dominant. That’s not unusual.”

While Influenza A (H1N1) is currently the predominant strain in Wyoming, Influenza A (H3N2), is spreading quickly through Colorado’s population.

“Over the last three weeks, we’ve started to see H3N2 circulating in Colorado,” said Nisha Alden, Colorado Department of Health respiratory disease program manager. “It’s somewhat of a second peak in our flu season. First, we were seeing a lot of H1N1, but in the last two weeks, we’ve seen more H3N2 than H1N1.”

Alden said H3N2 can be resistant to the flu vaccine and tends to affect people older than 65 more severely than H1N1.

“We see more (H3N2) outbreaks in long-term care facilities,” she said. “We see a higher number of hospitalizations. And sometimes, we see a higher number of deaths as well.”

Flu season typically runs from October-May, and during the 2018-2019 season, Alden said several flu-related deaths were recorded, including two fatalities among children.

Deti said Wyoming has also experienced several flu-related deaths in the current season, but none in children.

“Flu season is definitely continuing,” she said. “That’s not necessarily surprising, considering the season can run until late spring. But, we are one of the 30 states that are seeing a higher number of cases in the nation.”

The H3N2 flu strain has not cropped in many places around Wyoming this season, Deti said. But both strains can be combatted with a few simple steps.

“We always recommend the people get the vaccine,” Deti said. “People need to know the vaccine takes two weeks to do any good, so if you wait until everyone around you is sick it might not prevent you from getting the flu for that go around.”

Flu vaccines aren’t perfect, and though H3N2 can be resistant, the vaccine is still the most effective preventative measure, she said.

“Also, frequently wash your hands,” Deti added. “It sounds so simple, but it’s very effective.”

Anyone can contract the flu, but infants, pregnant women, people older than 65 and people with chronic health conditions such as asthma could be at a higher risk for severe complications including death, she said.

“We know flu season is coming every year, but we can’t predict when it will peak, and we don’t always know which strains are going to be circulating,” Deti said. “One our biggest concerns is that because flu is so common, it’s not always taken as seriously as it should be.”

In 2018, 27 people died in Wyoming of flu-related illnesses. Go to www.health.wyo.gov/news for up-to-date information about influenza strains and other illnesses prevalent in Wyoming.

Health Department urges care in handling baby poultry

in Agriculture/Health care/News
springtime Easter baby chicks

By Cowboy State Daily

With springtime and Easter just around the corner, Wyoming’s Department of Health is warning people who buy baby poultry to use care in handling the birds to avoid the illness Salmonella.

Tiffany Greenlee, surveillance epidemiologist with the department, said in a news release that Wyoming regularly sees cases of Salmonella as a result of the improper handling of poultry.

“Because poultry chicks are soft and cute, many people want to touch, hold or even snuggle them, but this behavior can be risky because the birds can have germs on their body and in their droppings,” Greenlee said.

Salmonella can cause diarrhea, fever, stomach cramps and other symptoms, which can be especially severe in young children, the elderly, pregnant women and those with weakened immune systems.Infections generally occur after someone puts their hands in or near their mouth after handling birds or touching areas where they live, Greenlee said.

Tips for the safe handling live birds include:

  • Children younger than 5 years of age, elderly persons or people with weak immune systems shouldn’t handle or touch chicks or other live poultry.
  • After touching live poultry or anything in the area where they are found, wash hands thoroughly with soap and water. If soap and water aren’t available, use hand sanitizer.
  • Don’t eat or drink around live poultry, touch with the mouth or hold closely to the face.
  • Don’t let live poultry inside the house, in bathrooms or in areas where food or drink is prepared, served or stored.
  • Clean equipment or materials used in caring for live poultry outside the house, such as cages or feed or water containers.

Wyoming’s 65th Legislature: General Session Review

in Agriculture/Criminal justice/Education/Health care/News/Taxes

It’s all over for this year. Check out our bitesized rundown of what passed and what failed in the 65th Wyoming Legislature’s General Session. Stay tuned this weekend for more analysis on the session highs and lows with our Robert Geha.

Thanks for watching and be sure to follow Cowboy State Daily for our expanded statewide coverage of Wyoming news coming to your feed in the days ahead.

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