A year of COVID-19 controversies

Despite the hopes of public health, government officials at every level and just about everyone else, the COVID-19 pandemic continues, and, for the second year in a row, was the biggest story in the region and around the globe.

The virus, despite efforts on the part of public health to vaccinate as many people as possible, killed almost as many people this year as last year in Hill County, and hospitalized dozens locally, but beyond the direct impact of the virus, it and the response to it was the cause of a number of local controversies, almost all having to do with masks.

Surge returns to the area by fall

As vaccinations started in the state and numbers of cases started dropping, the attitude of many toward the pandemic relaxed.

But by August, the numbers in the state and locally started rising again, mainly driven by the highly contagious delta variant of the virus.

Hill County had dropped to no active cases by June 21, and stayed at six or fewer active cases through July 1. The numbers grew a bit early in that month, ranging from three to 10 active cases through July 25, then the numbers started growing again. July 27 saw nine new cases confirmed.

Blaine County's newly confirmed cases dropped to a trickle through much of July, but the number of active cases started creeping up again in late July.

But by Aug. 3, Hill County Health Department reported the county had 21 active cases, and Blaine County Health Department reported six active cases there. The state tracking map Aug. 4 listed no active cases in Chouteau County, but showed two active cases in Liberty County.

By Aug. 6, when the surges started taking off in this part of north-central Montana, Hill County had 2,088 total cases and 46 deaths, while Blaine County had 879 total cases and 24 deaths, Chouteau had 519 total cases and seven deaths and Liberty County had 125 total cases and one death.

Cases, hospitalizations and deaths in the area continued to climb, and by mid-December the count of deaths rose to 71 in Hill County, 29 in Blaine, nine in Chouteau and two in Liberty.

No new deaths have been reported for a few weeks, and the number of new cases had slowed to a trickle by this Wednesday, but the number of total cases has grown to 3,547 in Hill County, 1,538 in Blaine, 799 in Chouteau and 268 in Liberty.

And that is as the latest surge in the country, driven by the newest major mutation, the highly contagious omicron variant, is just starting to hit Montana.

Gianforte ends the mandates

But things looked different early in the year with numbers dropping and vaccinations rolling out.

At a press conference in mid-January Gov. Greg Gianforte announced a revision to the COVID-19 mandates of his predecessor, Gov. Steve Bullock, that effectively eliminated any restrictions on gathering size, the operating hours of restaurants, bars, breweries and casinos or their in-dining-room capacity.

Gianforte said his administration consulted with public health experts, health care providers, and business leaders before making this decision, which he said was an effort to refocus the state toward personal responsibility.

Despite his expressed distaste for government mandates, Gianforte did urge Montanans to wear masks when appropriate and to continue social distancing.

"I look forward to a day where we can all remove our masks throw them in the trash and move on with our lives," he said.

Gianforte's next policy change allowed many Montanans to do just that, despite the advice of public health.

Feb. 12, the statewide mask mandate in Montana was rescinded by Gianforte, along with two election-related orders made by Bullock.

The state's mask mandate was put in place the previous year by Bullock in response to increasing spread of COVID-19.

Gianforte said the rescinding of the mandate was in line with his belief that the COVID-19 pandemic is better fought through personal responsibility and providing incentives for good behavior.

Gianforte said the ongoing and successful vaccination campaign run by the state made this possible.

While, early in the year Montana was ahead of most of the country in terms of vaccine distribution, immunization plateaued, and now sits at 53 percent, which the Centers for Disease Control and Prevention says is 35th in the U.S.

Herd immunity for COVID-19 was estimated by public health officials as somewhere between 70 and 90 percent.

Gianforte's mask decision drew the ire of many, including the Montana Nurses Association.

Local mask mandate

Days after the announcement of the mask mandate being rescinded the Hill County Board of Health voted 3-1 to implement a countywide mask order at a special meeting after a long and occasionally heated discussion.

The order would remain in effect for 90 days, or until the county saw a per-capita spread of COVID-19 of 10 per 100,000 people or lower for two consecutive weeks, after which the board would review all other factors and determine whether the order is still needed.

Hill County Commissioner Diane McLean voted against the mandate and Hill County Commissioner Jake Strissel abstained while board members Erica McKeon-Hanson and Kristi Kline and Hill County Commissioner mark Peterson voted for it.

In early March The Hill County Board of Health announced that it would hold a special meeting to reconsider the county's direction when it comes to actions addressing COVID-19 in the area.

Peterson, who called for the meeting, said that a couple members of the board, including himself, requested the meeting.

He would not say what issues he wanted to discuss, just that the county needed to look at the "direction" it has gone in dealing with the disease.

When asked if the meeting would specifically deal with the health board's decision to implement a mask order, or why the order would be reconsidered before the agreed upon time, Peterson would not directly answer.

The meeting was indeed about masks, and was very heated, but no official action was taken as no agenda for the meeting had been published.

Hill County's order required universal mask wearing except for children under the age of 5 as well as other specific exemptions and was scheduled to last for 90 days or until the county sees a per-capita spread of COVID-19 of 10 per 100,000 people or fewer for two consecutive weeks, after which the board will review all other factors and determine whether the order is still needed.

Neither of these conditions had been reached, though the rate of new cases in the county had decreased significantly in the months leading up to the meeting.

At that time it came to light that the order was drafted shortly after it was voted for in February, but was never signed by board chair Peterson, and it was unclear whether it was in effect as a result.

Peterson said after the meeting that he didn't sign the order due to his concerns regarding enforcement, which he said was the primary reason he called the meeting.

Days later Peterson sent an email to the Havre Daily News announcing that the county had reached the threshold required to lift the area's mask mandate.

In the meeting Feb. 18 where the mandate was voted for 3-1 it was determined that once the metric of 10 or fewer new COVID-19 cases per day per 100,000 residents was met the duration of the order, 90 days, could be changed.

But, the language of the order that was eventually signed by Peterson almost a month after the vote simply said it is in effect until the metric is reached.

Peterson said he had spoken to all but one member of the health board on the issue, but McKeon-Hanson said she had no idea why the order Peterson signed is different from what was voted on.

"The intent of the Board of Health motion and subsequent vote on February 18th was to revisit the directive once the metric of 10 new cases/day/100,000 was reached for two consecutive weeks or 90 days, whichever occurred first," she said. "However, the order that was written up and signed by the board chair did not reflect that language for reasons unknown to me at this time."

When asked about the apparent contradiction between the vote made in February and the wording of the order, Peterson said they have not received minutes of that meeting as yet.

A few days later Peterson released an official announcement that the local mask mandate had been rescinded upon reaching the agreed-upon threshold of an average of 10 or fewer new cases of COVID-19 per day per 100,000 residents for two consecutive weeks.

School mask mandate

The second big mask related controversy was at Havre Public Schools.

In the first week of June the Havre Public Schools Board of Trustees voted 6-2 to maintain their mask-wearing policies through the month at the recommendation of HPS Superintendent Craig Mueller.

But a sizable crowd of attendees, online and otherwise, objected to the continuation of the policy.

Mueller said the extension of the policy was just to cover summer school programs and Centers for Disease Control and Prevention had stated that it will update guidance for schools in the coming weeks. But, he said, until that update is released, and, given the recent uptick of COVID-19 cases in Hill County at the time, as well as the fact that only a few weeks of the program remained, it seems reasonable to hold course until the end of the month.

The policy required students and staff to wear masks if they cannot maintain a distance of three feet from each other while in the school buildings.

In the week leading up to the meeting, Havre Public Schools had three new cases associated with the school district, and the state reported, for the first time in months, that Blaine, Chouteau, Hill and Liberty counties all had new cases on the same days.

Mueller said he wanted things in the school to go back to normal as soon as possible, just like everyone else, but the situation calls for caution.

Before voting to implement Mueller's suggested continuation of current policy Trustee Jacob Ingram made a motion that the policy be amended to make masks optional.

He said many studies have shown that masks have little to no effect on the spread of COVID-19, but provided no such studies.

Virtually every major health or public health organization in the U.S. and worldwide says mask-wearing limits the spread of the virus considerably, particularly among those still unvaccinated. Cloth masks reduce the amount of moisture expelled, which is what carries the virus.

Ingram also said studies exist that show the adverse effects of wearing a mask are greater than the benefits, which is contradicted by virtually every major health institute and organization.

He also pointed to a recent statement from the Office of Public Instruction that recommendsedthat mask requirements be rescinded or allowed to expire.

Mueller said that recommendation was in conflict with that of the CDC, which recommended students be required to wear masks through the end of the 2020-21 school year, which the summer learning program is part of, but Ingram said the board needn't pay heed to the CDC and they have the authority to set their own policy.

All but one audience member present supported Ingram's motion, and of the statements submitted online all but two agreed.

Comments from the audience ranged from desperate and emotional pleas to the promotion of unfounded conspiracy theories. Multiple statements contained misinformation regarding masks.

While some testimony merely made arguments about the legality and practicality of masking in schools, much of it was conspiratorial in tone and sometimes in content, with some implying, and others outright espousing, belief in unfounded conspiracy theories about the pandemic being some kind of government plot.

Rep. Ed Hill, R-Havre, a former member of the board was among those who spoke, saying he had been asked to come by constituents. He said the school should follow the advice of OPI and make mask-wearing optional and touted the importance of local control.

Eleven statements submitted online also supported making masks optional, but the meeting was not devoid of advocates for continued caution.

Havre Public Schools Education Foundation Board Chair Kyle Leeds said continuing the policy was sensible given the recent uptick in cases in the area and the fact that the world is still in the midst of a crisis and herd immunity is still a long way off.

He said that the Biden administration had recently pointed out that the U.K. was seeing the spread of a highly-infectious variant of COVID-19 that was becoming more and more prominent in people age 12 to 20.

"We're still in a global pandemic," Leeds said.

McKeon-Hanson strongly encouraged the board to take Mueller's advice and continue the policy through June.

Her statement, submitted virtually, said the county is seeing an increase in cases, many in young people.

The motion to make masks optional was voted down 2-6 with Ingram and Trustee Brittnee' Loch voting yes, and all others voting no.

Later, a motion was made to adopt Mueller's recommendation which passed 6-2 with Loch and Ingram voting no and all others voting yes.

School mask controversy continues

During a special meeting a couple weeks later the board unanimously approved plans on how to handle the upcoming school year, including an extension on the district's declaration of emergency, making masks optional during the next school year and amending requirements on physical distancing.

Audience member Scott Adams, who briefly served on the board this year, spoke against the continuation of the declaration of emergency, saying he believed Havre and Hill County are not under a state of emergency.

The city and county were still under declarations of emergency, as was Montana and the United States.

Mueller told the board the continued declaration would allow the district to adapt as needed as conditions change.

Several audience members spoke in favor of adjusting policies including to allow masks to be optional, although several also said the actions of the district in the past year had made it difficult for students.

Mueller said the district is hopeful that will be the start to "a really normal approach to the year."

By August however, cases in the community and around the world were rising rapidly and HPS was considering what, if any, changes to make regarding HPS' masking policy.

The board voted unanimously to keep HPS' current policy of optional masks for students and staff for the upcoming school year but not before another chaotic meeting filled with confusion, anger and mask-related misinformation.

The vote to continue the policy came at the recommendation of Mueller, who thanked students, staff, parents, and community members for replying to a survey regarding mask-wearing policy, and the board for fielding questions from the public.

75 percent of respondents said they wanted masks to be optional while 23 percent voted in favor of following guidance from the Centers for Disease Control and making them a requirement for students, faculty staff and visitors.

Mueller said masks are a useful tool in the fight to mitigate the spread and damage of COVID-19, one of many used in the past year and a half, including increased hand washing, surface sanitizing and social distancing.

He said he thought the school system did a good job overall adapting to COVID-19, and he highly encouraged students and staff to keep wearing masks to protect themselves and each other.

Mueller said the COVID-19 situation in the U.S. was again becoming dangerous with a new surge in cases locally and countrywide, driven by the delta variant.

"We continue to trust in infectious disease experts, epidemiologists, and others in the medical profession to provide recommendations and guidance," he said.

He said he and his team, in conjunction with the Hill County Health Department, had kept track of the rate of transmission, localized positivity rates, the anticipated rise in positive case numbers, which would surely impact the educational environment, and how they would handle quarantined students if a face covering requirement is not in place.

Mueller stressed the importance of keeping school open five days a week and said the more transmission decreases the more likely that they will never have to go back to remote learning, which is difficult for staff and students.

He said to maintain this in-person learning the school has to continue relying on a science-based approach to its policies.

Mueller's recommended policy did not change the schools' approach to COVID-19, keeping masks optional but highly recommended, while allowing the administrative team the authority to shift back to remote learning in the event of a significant outbreak, decisions that can be reviewed by the board at an emergency boar meeting following the decision.

After Mueller provided this recommendation, Ingram proposed an amendment to strip all language from the recommendation outside of the first sentence which specifies that masks are optional and add language that would state that transfers back to remote learning would be solely contingent upon a majority vote from the board.

It was pointed out later in the meeting that because that authority had already been given to those teams in the policy approved last year that stripping that language from Mueller's recommendation wouldn't actually change anything, but conversation around the amendment proceeded around the assumption that the amendment would transfer that authority.

The motion was voted down 2-6, but not before 16 people from the largest audience at any school board meeting this year, expressed support for Ingram's amendment.

Only two spoke against the amendment: Leeds and McKeon-Hanson.

After the amendment failed community members expressed varying degrees of anger toward board members and occasionally Mueller.

Former School Board Chair Shad Huston said the performance of the board was a disgrace, and the board members should justify their votes to the attendees.

"I am absolutely disgusted," he said.

He was followed by more than 10 community members passionately condemning the board for their actions, accusations of negligence, ignoring the communities wishes, as well as running the meeting with inconsistent and confusing rules.

Former board member Adams said the trustees are sworn to represent the values, beliefs and priorities of the community and they are failing.

"You guys need to look at the code of ethics," he said.

While the tone of testimony at this meeting was not nearly as conspiratorial as the one in June, it contained no less misinformation about masks and the delta variant of COVID-19, which was the primary cause of the ongoing surge.

Among the board members defending their decision was Board Chair Curtis Smeby, who said he supported Mueller's recommendation, but believed it should go further and a mask mandate would be sensible given the situation.

"I'm concerned for the health and well-being of our students and I think it's the right thing to do," he said.

Smeby said he honestly didn't understand why wearing a mask is such a big deal.

"Lordy, are we serious that we can't put on a mask?" he asked rhetorically.

The crowd responded with shouts of "yes" and "no masks."

When asked after the meeting if the community response was what he expected, Mueller said yes.

An increasingly toxic public discourse

Beyond the rampant spread of misinformation related to the pandemic, masks, vaccines and the like, public discourse surrounding many of these things has become increasingly toxic, and has resulted in more stressful conditions for those in public health.

While many health care workers have been driven to exhaustion by repeated waves of COVID-19 which filled their facilities to breaking point with the unvaccinated, public health has had to deal with seemingly nonstop abuse from some members of the public.

A local example of the effect this has had is the resignation of Blaine County Public Health Nurse and Health Officer Jana McPherson-Hauer in October.

In an emotional meeting of the Blaine County Board of Health McPherson-Hauer said her resignation was due to the politicization of the COVID-19 pandemic and the damage it has done to her profession through the curtailing of their authority by the Montana Legislature as well as the daily stress of having the department's expertise, motivation and evidence-based policies questioned, ignored or rejected.

"I do not fit in a system where I must constantly defend evidence-based best practices to those they are designed to protect," she said in a letter announcing her resignation.

She said pushback toward her profession has included the insinuation that she and her department don't know anything about the subjects they are trained in, the misrepresentation of her department's goals and motives and a hesitation to allocate resources to her department when needed.

McPherson-Hauer said the pandemic has brought her profession's work to the forefront, and while many have responded with curiosity and support, many more have responded with negativity and disregard.

She said she is not happy leaving the relationships she'd developed in the county over the last seven years, but the situation has made it necessary that she move on.

Those at the meeting almost universally expressed their regret that the situation for public health has gotten as bad as it has.

Blaine County Commissioner Dolores Plumage provided a full-throated defense of McPherson-Hauer, her health department and the medical community as a whole.

Plumage said health care was one of the most highly respected professions there was, and now professionals are challenged and disrespected every day by the people they're trying protect, spurred on by a toxic political environment.

She said this environment and the endless negativity born from it have made it difficult to get anything done because, now, everything is up for debate in the eyes of people who are not trained in the subjects they profess experts know nothing about.

She said the fact that the situation has gotten so bad that it cost the county someone like McPherson-Hauer is devastating and she will be sorely missed.

County Sanitarian Ron Andersen expressed similar sentiments and lamented the nature of the environment public health must now operate in.

"I've worked on the environmental side of public health for over 50 years, I've worked with a lot of public health nurses in 12 counties, large counties, and Jana is at the top of the list, if not the best public health nurse I've ever worked with," Andersen said. "... It's going to be difficult to replace a public health nurse, and impossible to replace Jana."

McPherson-Hauer said she appreciated everyone's support and impressed upon them how serious she was in her letter when she said she would leave with good relationships, developed during her time at the county.

Legislative pressure mounts on public health

In an interview after the meeting McPherson-Hauer said there wasn't any one thing that led to her decision to leave, but the last legislative session and the policy changes that came out of it were a turning point for her.

She said in the past two months, her department had noticed a massive increase of people disregarding the department's recommendation and disrespecting its staff, seemingly emboldened by the Legislature's curtailing of its power.

She said staff were cursed out over the phone every single day, hung up on, and accused of malicious intent or incompetence.

McPherson-Hauer said her staff was well-trained and highly knowledgeable, that they know exactly what they are doing, and that their actions and recommendations have always aligned with science and data. She said she's not alone in her frustration that public health is now being required by "knee-jerk" legislation to follow the direction of people who know little about their jobs or their field of expertise.

Her resignation comes in the wake of multiple other public health officials in the state and the nation resigning during the pandemic.

McPherson-Hauer said the department's staff can't do the things they know need to be done to protect public health, especially supporting schools with making sure students are vaccinated for contagious diseases.

She said she's also frustrated with the hesitation to allocate necessary resources and provide guidance to health departments which she said can be seen on multiple levels of government, but particularly the at the state level.

She said the state of public health's reputation, a result of politicization and misinformation, makes her worry for the future.

"I'm a very proud public health nurse, and I think we did a really good job here, and I think that will continue. But the legitimate public health efforts have been undermined in enough ways that it has taken away our creditability, while it shouldn't, because there are very good reasons for us responding in the way that we are." she said. "When we give good sources, evidence-based sources and research and data, that doesn't seem to matter to a large group of the population. Until that matters again, not just public health but a lot of professions will lose credibility because, now, either everyone is an expert or nobody is."

HB 702 and its consequences

A subject of discussion at the Blaine County Board of Health meeting, as well as a Hill County Board of Health meeting around the same time, was what to do in the wake of Montana House Bill 702, which outlaws "discrimination" against the unvaccinated.

At the time, the Hill County Health Department, between a lack of funds and having its authority curtailed by Montana House Bill 702, was having trouble keeping up with the pandemic amid a nationwide surge driven by the delta variant.

During a special meeting in August the Hill County Board of Health had to change its isolation and quarantine policies in the wake of HB 702 as it prevented the Hill County Health Department from asking people about, or even considering their vaccination status, throwing a wrench into their operations.

The CDC recommended at the time that vaccinated people get tested three to five days after the date of being exposed to COVID-19 and wear a mask in public indoor settings for 14 days after exposure or until a negative test result comes back, but they don't need to quarantine. It recommends vaccinated people who test positive or are experiencing COVID-19 symptoms isolate.

CDC recommended unvaccinated people who are exposed to the virus quarantine and that they isolate if they were infected with the virus.

Then-Hill County Attorney Alley said even if someone volunteers that information to the department, it can no longer provide recommendations based on it due to the law.

Berg said the law's primary effect was on COVID-19 for now, but ultimately it affects all communicable diseases for which there is a vaccine, which will affect the work of public health long after the pandemic is over.

Given these circumstances, she said, her department worked with Alley to create two plans for how to handle quarantine orders.

The first option was to quarantine everyone and their close contacts regardless of vaccination status.

Berg said, from a public health standpoint, this option would provide the most protection to the people of Hill County, but, on a practical level, will be very difficult for the department due to the workload it would create for and an already strained workforce that no longer has access to extra funds to deal with the pandemic.

She said it would also disrupt schools and workplaces, many of which don't have policies in place for extended sick leave that would be needed by so many people.

Option two would be to cease issuing quarantine orders altogether and ask that people follow CDC guidelines when making the personal decision whether to quarantine, trusting them to make the right decision.

Berg said this option does pose a risk from people who choose not to follow CDC recommendations and it may lead to greater community spread, but, under the circumstances, it may be the best the department can do, at least for now.

She said the decision between the two options can be evaluated and changed later, but these are the best options they have at this point.

McKeon-Hanson expressed a general frustration that this is a choice that even has to be made when public health experts know what needs to be done and vaccine status is a relevant factor to take into account when making recommendations.

Board members argued about the options, but many expressed similar sentiments as McKeon-Hanson.

Havre Public Schools Board of Trustees Chair Curtis Smeby, who attended as a member of the public, said public health experts know how to keep people safe and the Legislature's efforts to interfere with them is unacceptable.

While Smeby said he'd prefer option one, what he'd most like to see is Hill County take a third option, follow CDC guidelines in defiance of the state, and, if need be, see the state in court.

"We have laws in this country, let's use them, but let's challenge them when they are inappropriate, and this is clearly in appropriate," he said.

The board voted 3-2 to recommend option two with all three commissioners voting yes and McKeon-Hanson and board member Kristi Kline voting no.

The commission voted to accept that vote at their next weekly business meeting.

McKeon-Hanson thanked the department and all of its employees for all of their hard work over the course of an extremely difficult 18 months likely with more hardship to come.

Later Berg said the department did indeed shift to asking people to follow CDC recommendations, but they found they were able to give their recommendation some teeth by informing people that if they choose to ignore the recommendations they are open to liability if they spread COVID-19, something that has happened with other disease in the past.

A lack of county funds

At the time of this controversy Berg said the department, for the first time since the beginning of the pandemic, didn't have the resources to get in touch with every close contact of a COVID-19 case, even as some staff were dropping all other duties to work exclusively on the pandemic.

She said the department already had to let two staff members go because they didn't have the money to pay them and they might lose more in the coming months.

In the meeting, Berg said last year the department had access to CARES Act funds that allowed it to deal with pandemic and the massively increased workload that came with it, but that money is gone and no additional funds were obtained to keep the department sustainable during this time of massively increase work.

She said the department received no funds from the county via the American Rescue Plan Act, which she said could have been used to bolster her department and keep it sustainable had the Hill County Commission asked for it.

McLean said Berg should have told the commission what the department needed, and Berg said while she didn't make specific asks she reached out multiple times by email ask for funds to keep the department sustainable.

After the meeting Berg said she sent the commissioners an email months earlier asking about their plans for how to use ARPA funds along with suggestions about holding public meetings on the subject, but received no reply.

When she saw in the Havre Daily News that the commission was talking about how to use the money, she said, she reached out again to ask why no funds were being allocated to public health given the fact that the pandemic was still ongoing but received no answer beyond that the commission's primary use for the funds was the Milk River Levee project.

Commissioner Peterson said at the time he hadn't had a chance to go back through his emails and look for what Berg sent him, and the commission was unaware that ARPA funds could be used for that purpose.

He said the commission had since looked into the issue and possible solutions to it and he hoped to set up a meeting with Berg to alleviate the problem.

The next month the commission allocated up to $100,000 in ARPA funds to the health department.

McLean said the commission received a letter from Berg requesting the $100,000 to help them bring on more contact tracers and case investigators like they did last year.

Berg said that the $100,000 she's requesting will allow the department to hire temporary contact tracers and case investigators much like last year, helping them keep up with the huge amount of new cases and avoid burnout as more and more come in.

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Havre Daily News editor Tim Leeds contributed to this story.