Letter from Dr. Scott Coleman to remain safe in public

In Park County, we have tested 18-25 patients per day for a full week, all with acute respiratory symptoms.  The state of Montana has performed just over a thousand tests, 125 of those tests have been here in Park County. 
All have been negative to date. A week ago, we were a relatively sick community with 6 other common viral infections prevalent including influenza.   
 
Our week of social isolation stands to help us shed these other infections and become a healthier community than at any other average time in late March.  There is ample evidence that social isolation, readily 
available testing early in the development of symptoms, tracking contacts, and enforcing quarantines can prevent a catastrophic surge of infections. Preventing a surge of infections allows healthcare systems to care properly for the patients that truly need care and can dramatically increase survival.   
 
We are very fortunate in Park County that we have been given the gift of time;  our extensive testing cautiously suggests that we do not have community spread at this moment.  Therefore, we have an opportunity that others around the world and country have not had.   
 
My biggest fear is that Montana's larger communities are not testing extensively.  They are testing in a way too limited manner and will discover the tip, not the base of the iceberg when it comes to community 
spread of infection.  Therefore, we will not know community spread until it is too late.  Gallatin County in my estimation is very vulnerable to community spread right now.  So is Wyoming.  
 
I do see a way forward.  We anticipate commercial onsite rapid diagnostic tests for Covid-19 in 2-3 weeks.  This would be a game changer.  Currently tests have to go to the state and take 36-48 hours to return results.  
 
I am most concerned with those hosting family and friends from elsewhere and those returning from elsewhere to ride this out in Park County.  For those returning to Park County from elsewhere, recognize that your very return makes vulnerable the safety you seek.  These folks must commit to a strict 14 days of quarantine,  early testing (by simply calling the hospital main number) of symptoms of fever, headache, and cough, and strict adherence to health department instructions of isolation should they test positive. If anyone has any questions as to what quarantine should look like, call the Park County Health Department.   
 
I also fear that Bozeman will develop community spread and Park County residents will continue to travel and become exposed in Bozeman.  I am certain Wyoming now has community spread. There is minimal testing. They will not know the extent of the disease and will have critical care cases arriving soon. 
 
If we can control the next three weeks, we have a remarkable opportunity to avert much of the suffering that is so baked in the cake for many other locations. It is our singular moment to mimic the experience of 1918 Gunnison, Colorado.  
 
Our businesses must understand that should we be successful in avoiding a surge of infections, we will also be poised for an earlier and faster recovery.  This message must reach all Park County residents.  
Each of us controls our collective destiny. We must not just enforce our own behavior in this crisis, but be outspoken and enforce and educate others around us.  There is too much at stake.  
 
Please make sure all who will listen know what an opportunity we have and what is at stake.  
 
Travel outside of Park County should be severely restricted or better yet cease now.  Necessary trips to local supermarket, pharmacy, or hardware  must occur.  Consider calling ahead with order and curbside pick up.  If enter stores, keep 6 foot distance between all, and treat all public surfaces as contaminated.  Thorough hand wash every time one enters their house from community.  Hand bleach wipes or sanitizer when returning to car from community.  Do not touch face after being in the community and do not take or touch phone while in community (or wipe down thoroughly after leaving community setting) until you are able to wash hands thoroughly. Shop at off times when you will run into fewer people.  
 
Reach and educate all of our neighbors returning to Park County from other places.  Encourage our neighbors to not host people from elsewhere.  Temporarily close hotels and motels to discourage folks from high infection areas coming to Park County.   
 
We can control our Covid-19 experience, and we can lead the state of Montana on the backside showing just what a vigorous recovery looks like! 
 
Thank you again for your efforts! 
 
Scott Coleman 
 
This message is from me personally, not from Livingston Healthcare.