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UPDATE, 12:25 p.m. May 2: State Health Officer Dr. Alexia Harrist has signed the latest iteration of Teton County's more restrictive variance to state health orders.

In his justifications for the order, Teton County District Health Officer Dr. Travis Riddell cited familiar and new statistics:

• The lab-confirmed positive number of 65 cases minus 60 recovered and one death means 4 cases remain active. Teton County also has 31 probable cases.

• The county's "attack rate" of 277 per 100,000 residents is the highest of any county in Wyoming, more than four times the statewide rate.

• Of the 733 COVID-19 tests conducted in Teton County, 9.4% have returned as positive. That rate of positivity is more than double the statewide rate of 4.5%, which may indicate inadequate testing and a higher level of unidentified cases.

• With 10 Teton County residents admitted to St. John's Health and 4 residents admitted "to higher level units in other facilities" who tested positive for SARS CoV-2 infection, that's a hospitalization rate of more than 21% of confirmed cases.

UPDATE, 5:25 p.m. May 1: The county's health officer will be resubmitting a request for a variance to state health orders that would keep gyms, nail and hair salons, barbershops and a number of other personal service businesses closed through May 11.

Reached by phone Friday morning, Teton County District Health Officer Dr. Travis Riddell said he would discuss details of the variance at the community update at 3 p.m. today, live streamed from Town Hall.

In that meeting, Riddell took responsibility for what he called a factual error due to his miscalculation of data. However, he does not anticipate that meaning any change in the variance.

"This is one statistic on what are four pages of justification for the variance order," Riddell said.

Another important justification for why Teton County needs stricter orders than the rest of the state is the overall case prevalence, with a per capita case count higher than anywhere else in the state.

According to emails provided to the News&Guide, Riddell plans to resubmit the request to clear up the number — a statistic that Teton County was seeing a "hospitalization rate of more than 80% of confirmed [COVID-19] cases."

Until Thursday, the Teton County Emergency Management COVID-19 dashboard was reporting 55 "COVID-19-related hospital admissions" at St. John's Health. But of those people who were hospitalized, only 11 tested positive for the virus.

With 65 lab-confirmed cases of COVID-19 in Teton County, that pencils to roughly 17% of people diagnosed with the disease in Teton County were hospitalized. At Friday's meeting, Riddell did not use the 17% number, saying he was still working with hospital officials to get an accurate number.

Emergency Management had been reporting COVID hospital admissions in that way because the hospital was doing so. The dashboard takes data about hospitalizations from St. John's Health webpage.

The hospital was, in turn, reporting those numbers because of conditions during the early stages of the virus' spread in Teton County.

Then, testing was limited and turnaround time varied widely for tests that were processed. That meant St. John's Health's workers had to don personal protective equipment and treat suspected patients as if they were confirmed until a test could rule out the disease. In some cases, results didn't come back until after the patient left the hospital.

"The turnaround time on our testing was not great," said Karen Connelly, the hospital's chief communications officer. 

The hospital chose to report how many people had been admitted with COVID-19-like symptoms to better illustrate the reality of how it was being impacted by the disease.

"If we had only been talking about COVID positives, it wouldn’t have looked like we were being impacted, but in fact we had a lot going on," Connelly said. "The relevant metric at that point was how many COVID-related patients we were taking care of."

St. John's daily coronavirus update webpage now reflects both the number of "laboratory-confirmed COVID-19 tested hospital admissions" and "COVID-19 tested hospital admissions." The latter metric was previously labeled as "COVID-19-related hospital admissions."

Emergency Management's dashboard is now only reporting lab-confirmed hospital admissions.

Both Connelly and Emergency Management Coordinator Rich Ochs said the data could have been better explained.

"It makes a lot of sense to me that there could have been confusion," Connelly said.

However, St. John's officials support Dr. Riddell's variance to the state orders.

"Looking at the bigger picture of what’s happening it seems that it’s a really reasonable approach," Connelly said. "So we’re fully supportive of it."

— Rebecca Huntington contributed to this report.

This article was updated Friday afternoon after the 3 p.m. Community Update, partly to include quotes from that meeting. — Eds.

This article was updated Saturday just after noon to include new statistics Dr. Riddell included in the revised health order signed by Dr. Harrist. — Eds.

Contact Billy Arnold at 732-7063 or barnold@jhnewsandguide.com. Contact Managing Editor Rebecca Huntington at 732-7078 or rebecca@jhnewsandguide.com.

Teton County Reporter

Previously the Scene editor, Billy Arnold made the switch to the county beat where he's interested in exploring Teton County as a model for the rest of the West. When he can, he still writes about art, music and whatever else suits his fancy.

(11) comments

Susan Crosser

I totally get the better safe than sorry, buy why is no one working out why the tests came back negative if the doctor was sure it was going to be positive ? Was the lab wrong - it is important to figure this out. And why it was better safe than sorry, except they didn't think that should apply to Bill Sweney. Unless we want this all to happen again, the hospital needs to figure out what went wrong. Do we have a higher incidence of COVID, or is the number skewed because of lack of testing?

JOhn Smothers

open the bars already!!!!

Susan Crosser

I'm still confused on the numbers:

65 cases in Teton County were confirmed as positive

11 those 65 were hospitalized

26 with NEGATIVE results were also hospitalized, and although the hospital continues to insist they were COVID-19 related, they have been unable to explain how 26 can be tested as negative for COVID-19 but admitted to the hospital as

Probable" COVID. It seems like it has to be one or the other. The hospital can't say 31 probable COVID when they know 26 tested negative.

7 of the positive COVID patients were sent to another state. There are still 4 in other states on ventilators so 1 has died, and 2 have recovered ?

So 54 hospital admissions that had nothing to do with COVID ? But Bill Sweney who tested positive for COVID received no care for a week, and was assumed to just have he flu. Which is I guess what the other 54 had as well, but they were admitted.

So we start with 65, send 7 out of state and hospitalize 11 for a total of 18. Is that the percentage that Dr. Riddell is looking for ?

Otherwise, the people who tested positive were not so sick as to need hospitalization.

And that means 47 hospitalizations were not COVID related ? They were "better safe than sorry" admissions, but didn't include Bill Sweney until a week had passed? What changed?

I can see that in the middle of a pandemic, you might want to hospitalize just to be safe as you waited for results, but what was different about Bill. Sure sounds like he was clearly exhibiting COVID symptoms, even as they first waited to test him and then waited for the results. Who decided who should be admitted and who should not? Had the hospital figured out they were admitting seasonal flu patients because of an abundance of caution, so they decided to wait for a week before admitting Bill?

Basically 5 times the number of actual infections were admitted, because they had a bad case of the flu? (Which can be deadly, but it seems like they have all recovered)

It bothers me that the hospital wants to put these seasonal flu people into "COVID" related, or "probable COVID" when we know they did not test positive for the virus. If probable, shouldn't we be investigating how they ended up testing negative ? 18 actual lab verified and hospitalized is a lot different from the 50-60 the hospital is claiming. If there is a problem from a particular source, then it's worthless to proceed with testing and looking for asymptomatic. Did they not bother to test everyone hospitalized? WHY?

Janet Olson

Thanks Dr. Riddell for your Public Health expertise and guidance. As a retired Infection Prevention RN the healthcare journals I read were predicting how overdue we were for a global respiratory viral pandemic. And the other most mentioned topic was antibiotic resistance.

Susan Crosser

Are the 26 lab confirmed negative still counted in the "probable cases" ? If so, what is being done to figure out how they can be "probable cases" of COVID while at the same time have a negative result from the lab ? If we don't understand how this contradiction occurred, how can we judge the accuracy of the test. Did they all come from the State lab, from a private lab? Were the tests done improperly, so the results are false ? Has that problem been corrected ? We need to get everybody tested so the asymptomatic can be identified, but if the results are suspect, what is the point? I could never file a taxpayer's return knowing the 70% of it might be wrong. How can the specifics of the contradiction just be brushed aside ? Someone needs to own the problem or there is not point in sending tests to the lab that sent back false negatives, or the "Probables" need to be reclassified to agree with their test results.

TERRENCE MILAN

We live in uncertain times. There isn't a rule book for doctors to follow, as with all the diseases that are known and been around for a while. Due to malpractice, doctors, might be reluctant to prescribe new and unproven treatments. You should be prepared to make decisions about how you are treated. Assuming that if it comes time to make these decisions, you would be in a debilitated condition, you might want to consult with your own physician before you become sick. You want to talk about how would Covid affect your current conditions, and what would be your likely path through the virus to recovery and what are your treatment options. You should have an action plan ahead of time. I've learned that the probable cases are cases where the doctor suspects that the lab got it wrong. This happens a lot and when all the symptoms of Covid are there, but the lab results are slow or returns negative, the doctor will treat the symptoms as if the lab result is positive. In some people this virus is fast moving and the doctors just can't wait.

Susan Crosser

So it sounds like now they are saying that the COVID probable of 26 that had negative tests never did have COVID-19 ? The test results were accurate so they hospitalized 11 COVID patients, and 26 people with a bad case of the flu? I'm still confused. They hospitalized 26 people based on symptoms, but they didn't bother to hospitalize Bill Sweney. They hospitalized 26 negative for COVID patients in an effort to be "better safe than sorry", but did not hospitalize Bill Sweney and he tested positive for COVID. Who was in charge of making that decision ?

TERRENCE MILAN

With Airbnb business here a live and well, how do does the County have an accurate count of the current population? Yes, the numbers run higher here, but from looking at the license plates lately how many of the cases were imported versus just local transmission? I read an article from another second home market in Maine, that estimates that 75% of their cases came from the hotspot areas.

Martin Rogers

Teton County has a total of 11 individuals testing positive for Covid and the County wants to keep a shut down in place. They know nothing about how to run a business nor do they trust the citizenry to do the right thing, stay safe, sanitize their businesses and make a living. The people in charge of Teton County are idiots plane and simple. But we have known that for a long time. BTW, how is the county going to pay for all the capital improvements involved in the additional hotel/motel tax, if there is not Hotel /Motel revenue? How is the county going to meet its budget? I know you can't see past your nose but give it a try.

Jenny Gersack

You are 100% RIGHT!!

Michael MacDonald

Oh the irony. Calling someone an 'idiot' followed by an immediate misuse of the word 'plane'! Comment sections really are the best source of entertainment you can find during the pandemic. Remember Martin, if you pley with fyre you're going to get berned.

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