Epidemiologists and County Health Department deliver COVID update

MISSOULA - Missoula City-County Health Department staff joined epidemiologists from the University of Montana's School of Public and Community Health Sciences for a virtual meeting to provide updates on COVID-19 Thursday, Oct. 22. This is the third epidemiological update that has been presented to the county since response efforts began earlier this year. 

The intention of the meeting was to provide updates on epidemiological information, showcase COVID-19 trends in Missoula County and make recommendations on what actions to take in various circumstances related to the pandemic. Mary Parrish, COVID-19 Public Information Officer, facilitated the meeting.

Dr. Erin Semmens, epidemiologist at the University of Montana, said at their last update on Aug. 19, the community's COVID-19 status was relatively stable, however because a vaccine or treatment was not available panelists knew that the disease "was not going anywhere."

"The stability we saw a couple of months ago was fragile and we can see that now very clearly," Semmens said.

Dr. Ethan Walker, postdoctoral researcher at the University of Montana, said early on in the outbreak, closing schools and businesses was fairly effective in stopping the rise in cases in March. When the second phase of reopening was implemented, county cases rose in June and then plateaued. After Labor Day, the county began seeing spikes in cases which were likely attributed to multiple factors such as schools reopening, University of Montana reopening their campus and Labor Day travel. 

Walker said similar trends are expected to continue moving forward with colder weather and multiple holidays quickly arriving.

"Not only are these popular times for gatherings and travel, but they also occur during this colder weather we're starting to experience so these are going to be indoor gatherings.  When gatherings occur indoors there's going to be a higher possibility of transmission because there's less ventilation and there's more close contact," Walker said. "So it'll be important going forward to have individual plans in place just to remain safe over those holiday periods and in those family gatherings."

He showed a bar graph indicating the total number of cases per age group since March. Individuals between the ages of 20 and 29 had the highest total, but Walker said it does not tell the full story. According to a line graph documenting cases every week by age group, individuals in the over 80 demographic have had the highest incidence rates in the last couple of weeks.

Kristie Scheel, Health Department COVID-19 Situation Unit Leader, said individuals between 20 and 29 made up 51% of the cases while those over 60 made up 5% in the Sept. 30 update. In the Oct. 22 update, individuals in their 20s made up 29% of the chart while individuals over 60 made up 20%. This has led to a 300% increase in three weeks indicative of infections being spread into other age groups.

Health Officer Ellen Leahy said cases in the 20s age group appeared to have dropped off because it follows an epidemiological curve indicative of suppression working. As information was gathered in regard to how transmission was occurring, University of Montana extracurricular activities were pulled back where regulations could not be enforced.

If people are breaking out into acne or rashes as a result from wearing masks, panelists recommend handwashing or laundering them frequently or even daily. Harsh chemicals like bleach should be avoided to prevent further skin irritation.

Scheel said the department has developed a new website called https://www.missoulainfo.com where the public can access COVID-19 resources, much of the information related to Missoula County specifically. Provided information includes frequently updated case data, testing clinics and short-term employment opportunities.

Cindy Farr, Health Department Incident Commander talked about healthcare capacity and the importance of taking preventative measures during cold and flu season so as not to put further strain on healthcare facilities. She encourages getting tested even when showing mild symptoms because COVID-19 can show itself in multiple forms. Montana currently has one of the highest rates of transmission in case rates per capita of any state.

Parrish encouraged the public to have a shift in their "framework" regarding how they view Halloween this year. Those who are going out should wear a face covering or incorporate a mask as part of their costume so long as breathing is still possible. She also recommends keeping activities outside and groups small.

Leahy said younger adults should really think of celebrating differently this year.

"We are giving this virus to each other," she said. "A gathering in an apartment or a house for Halloween will spread. Try to keep the households that are represented in that to actually three. We are at a precarious point of being able to slow the numbers and this next week we're going to know a lot more about whether we're going to be able to do that or not."

In her daily briefing Thursday afternoon, Farr said Missoula County Board of Health established a COVID sub-committee. They looked at several indicators in the epidemiological profile for the county including: the case numbers ascending "at an alarming rate;" the seven-day average of daily cases; the rate of transmission; the type of spread through close contacts or community spread; test positivity rate; turnaround time for test results, case identifications and contact tracing; hospital capacity; community compliance; and the average number of contacts for active cases.

Based on these indicators, the Board of Health will be recommending more restrictions for Missoula County to limit the spread. Restrictions they are considering includes further limiting capacity in some businesses and reducing the maximum number people that can gather without distancing. As of now, the Governor's directive is to cap group gatherings at 50.

"Currently the incident rate in Missoula is too high to allow that number, 50, to go forward," Farr said. "There is a benefit to allowing people to gather in structured settings versus unstructured settings. We are trying to avoid lowering that number to a point where structured social settings might be removed as options."

The full presentation is available at https://www.missoulainfo.com/covid-19-trends.