Berg: Surge straining county health department

Another COVID-19-related death has been reported in the area as the Hill County Health Department becomes increasingly strained by a pandemic that shows no signs of letting up.

The department reported this morning that, along with 18 new COVID-19 cases, another Hill County resident has died from COVID-19 related causes.

"We send our thoughts and condolences to the family and friends of this individual," Hill County Public Health Director Kim Berg, also the county's health officer, said in the report.

Berg told the Hill County Commission Thursday the rate new cases in Hill County is five times what it was at this point last year and is only getting worse as fall approaches and the school year continues.

"We're struggling already at the health department, and it's only going to get worse. We've only been in school one week," she said.

During the meeting, the commision also accepted the resignation, effective Oct. 24, of Hill County Attorney Karen Alley who they said took a position with Montana Association of Counties in Helena.

When asked if she had a statement regarding her departure Alley declined to comment.

Berg said the COVID situation could get worse.

Even with 48 percent of the eligible population in Hill County fully vaccinated and another 7 percent on the way, Berg said, she isn't prepared to speculate on how many deaths there will be this year compared to last year.

She said the good news is that the vaccination rate for those 65 and older, who are in more danger of dying from COVID-19, is more than 70 percent immunized.

However, she said, the delta variant, which is twice as contagious as the original strain and is now the dominant strain in the U.S., is attacking younger and younger people.

These increasingly dire circumstances are being compounded by the fact that the health department has been hamstrung by the Montana Legislature and a lack of emergency funding, she said.

House Bill 702, passed by the Legislature in the last session and signed into law by Gov Greg Gianforte, outlaws "discrimination" against the unvaccinated and, as a result, health departments around the state are no longer allowed to make recommendations or issue quarantine orders based on someone's vaccination status, even if that information is volunteered.

The Centers for Disease Control and Prevention recommends that the vaccinated don't have to quarantine if they are exposed to the virus and show no symptoms, but the unvaccinated do because they are far more likely to have caught the virus and more likely to spread it.

But HB 702 prevents the Hill County Health Department from following this recommendation and issuing orders based on it.

"We can't, what they call, 'discriminate' against anyone based on their vaccine status," Berg said.

This has put the health department in the uncomfortable position of having to decide whether to quarantine everyone found to be a close contact of a COVID-19 case, or quarantine none of them on the hope they follow the departments advice to follow the CDC's guidelines.

At the Hill County Commission's weekly business meeting Thursday they voted unanimously to implement the second approach, which was recommended to them by the Hill County Board of Health, on which all three commissioners sit, last week.

Berg said neither approach is what they department wants to do, but if they want to follow the law those are the only two options.

She said the option to quarantine everyone is safer and will do a better job of reducing the spread of COVID-19 through the community, but it will be unfair to those who got vaccinated so they wouldn't need to quarantine, and would result in so many people ordered to stay home that it will cause major disruptions to local employers and schools who do not have measures in place to deal with so many people being kept home.

She also said her department simply does not have the resources to do this effectively, now that emergency funding for COVID-19 has run out and hasn't been replaced.

At last week's health board meeting Berg said she had sent multiple emails to the Hill County Commission telling them they could apply for American Rescue Plan Act COVID-19 relief funds to bolster public health, but she got no response.

Hill County Commissioner Mark Peterson said then that the commission was not aware that the funds could be spent on public health and he's trying to find a way to fix the situation with Berg.

Unfortunately, Berg said Thursday, even now her department is falling behind due to the sheer number of cases and contacts.

"We're already backlogged," she said. "We have cases we haven't been able to get a hold of because we don't have enough time in the day."

She said this week alone, they have more than 100 contacts from Monday, and it's only going to get worse now that the department doesn't have the authority or funding it did last year.

"It's going to be a bad year, it's going to be a bad fall, because a lot of the mitigation efforts that we had in place and we had the power to put in place are no longer there," she said.

She said the department will be contacting people as quickly as possible but there often just isn't enough time to get them all, and they will need to rely on schools and large employers to start contacting people who've been exposed.

She said the CDC does provide guidance on how to prioritize who gets contacted first based on how much danger they are in, and they will be following that.

She said the department can no longer require crowded events and community functions submit COVID-19 mitigation plans for approval due to Gov. Gianforte's actions, and no longer have many of the tools they used to.

"We're trying to protect the community as best we can," she said.

Berg said option two, where no one is ordered to quarantine and are recommended to follow CDC guidelines, runs the risk of more COVID-19 spread, but it is far more feasible for the department to do with the resources they have and will prevent major disruption to the community.

She said her department also recently received guidance from the state regarding what the department is allowed to do under the law and it did make clear that they can remind people that if they choose to knowingly ignore CDC guidelines they are open to personal liability if they spread COVID-19 throughout the community.

She said she doesn't like this option either, but at this point it makes the most sense.

Hill County Commissioner Jake Strissel said, as someone who worked in public health before his election, he's not happy having to make this choice, but option two appears to be the lesser of two evils based on the public comments he's received.

The commission voted unanimously to adopt option two, which they all voted for last week in the Board of Health Meeting as well.

During the meeting Berg also provided details on how the department is working with Montana State University-Northern and Havre Public Schools who are providing testing to students and staff, but those entities also are already at capacity for testing.

When Hill County Commissioner Diane McLean asked if they need more tests Berg said they're not running out of tests, they're running out of time to do those tests.

She said Montana Department of Public Health and Human Services may be providing funding for schools for testing, maybe, but she doesn't have all the details yet.

She said the department is also working with people in rural schools like North Star and Box Elder to get them tests and they've been considering trying to work with the County Superintendent of Schools to hire someone to cover testing for the rural schools.

Berg said it would be a lot of work and driving but it's better than nothing.

She said Bullhook Community Health Center and Northern Montana Health Care's flu clinic are both helping with testing as well, but they're seeing more and more sick people so contacts are often having to wait for tests.

As for the community at large, she said, people really need to realize how serious the situation is, and now that her department can't do what it used to they need to step up to keep each other safe, despite the natural desire to return to normal.

"The cases are increasing at very rapid rate right now. I think a lot of people just wanted it to be gone and are in denial," she said.

She said people need to engage in sensible mitigation measures like wearing a mask in doors in public spaces, washing their hands, staying home when sick and avoiding large gatherings.

She said these, along with getting vaccinated will reduce the spread and make the virus less likely to mutate, producing more variants.

She said people should call the department with any questions they have, about the virus or the vaccine.

She said the Pfizer vaccine they have access to has now been fully approved by the Federal Food and Drug Administration, but she doesn't expect people to get it just because they said so, and she can answer all of their questions.