An Idaho county had one of the worst COVID-19 outbreaks anywhere. Here’s how it recovered
Nicole Blanchard, Idaho Statesman
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TWIN FALLS (Idaho Statesman) – Two months ago, Blaine County looked like it was in dire straits.
The rural Idaho community, popular with tourists and celebrities, was the second county in the state to diagnose a case of COVID-19, the disease caused by the coronavirus. Soon Blaine County surpassed the state’s most populous counties in confirmed cases. It reported Idaho’s first case of community spread. It was home to the first two coronavirus-related deaths in the state. It made national headlines for its incredibly high per-capita rate of infection.
And then, almost as quickly, the tide of COVID-19 cases in Blaine County began to ebb. By May, as new daily case numbers started to decline across the state, they slowed to a trickle in Blaine County. And despite an early rash of coronavirus-related deaths, Blaine County has not reported another since its fifth on April 8.
The county still has an astounding infection rate (216 infections per 10,000 people) thanks to its early surge of cases and a relatively small population of around 23,000. But by many accounts, Blaine County has beaten back the coronavirus. Through Friday, it boasted just six active cases out of 510 — lower than the active numbers in Gooding, Jerome, Minodoka and Twin Falls counties, all of which are also part of the South Central Public Health District.
Local leaders say the turnaround is thanks to quick action, stringent restrictions and a community that pulled together (while staying home, of course) to reverse course and rally resources. Now, as Blaine County joins the rest of Idaho in reopening, it faces the possibility of increasing infections — a challenge officials say they’re equipped to take on.
“While we’re seeing encouraging health data, there’s fear we could return to the days of March,” Ketchum Mayor Neil Bradshaw said in a phone interview. “We can’t stay paralyzed. We must move forward.”
HOW DID BLAINE COUNTY STOP ITS CORONAVIRUS OUTBREAK?
Blaine County started its attack on the coronavirus early.
“March 13 was the first positive case we had,” Jacob Greenberg, chair of the Blaine County Commission, said in a phone interview. “By the morning of the 18th … (health officials) put up a red flag and told me we had community spread, and I immediately went up the chain to the Department of Health and Welfare and the governor’s office. By noon, we had a meeting on (creating) an isolation order.”
Greenberg said he asked Gov. Brad Little to order county residents to shelter in place, and the governor issued the order on March 19. When Little later extended his stay-home order statewide, Blaine County cranked its restrictions down tighter, disallowing construction and landscaping — work deemed OK to continue in the rest of Idaho — and asking residents and outsiders to cross county lines only for essentials.
“Doing it straight away, I think, is what saved us,” Greenberg said. “And I think the diligence of the community to adhere to this policy, that’s brought us out of it.”
State and county quarantine orders also largely shut down tourism, which was a major driver of traffic to Blaine County and the likely source of the area’s initial outbreak.
“It sort of caught everyone by surprise because there had been no cases in Idaho, so people were just carrying on doing normal living,” said Brent Russell, an emergency room physician in Ketchum who has recovered from COVID-19. “So once it became apparent that we had a real problem here … it took a week or two for people to really, truly start social distancing and everything. But I think people have done a good job of that.”
Blaine County saw its peak confirmed number of new cases on April 2, when 95 new cases were announced. Since May 1, only 12 new cases have been reported in the county. Russell said there are fewer critically ill COVID-19 patients at St. Luke’s Wood River Medical Center, the county’s hospital.
“People are still taking precautions, which is what they should do,” Russell said. “… Even a month ago, I didn’t see nearly as many people wearing masks. It’s a small thing people can do that allows them to still go to work. And I think people are still really social distancing here.”
Russell also said the rural aspect that made the Wood River Valley high risk may well have been its saving grace.
“In New York, how do you get away from people without just staying in your apartment?” he said. “One advantage we have in this county more than most places is there’s very little high-density housing. Everybody lives in a house and has a car. … We were able to solve the problem a lot easier than New York will be able to or other metro areas will be able to.”
COMMUNITY CREATED ANTIBODY TESTING TO ASSESS COVID-19 SPREAD
Bill McLaughlin, the chief of the Ketchum Fire Department, said the pandemic had him worried about the paramedics he oversees, who were regularly at risk of being exposed to coronavirus. And he was tired of “sitting around” waiting for the situation to get worse, he said in a phone interview.
“You get into the fire department because you get a chance to do things,” he said. “When you get into something where you feel helpless, I had to find something where we could do more than taking people to the hospital.”
So he turned to his sister Colleen McLaughlin, an epidemiologist in New York at Albany College of Pharmacy and Health Sciences. Albany College partnered with Seattle’s Fred Hutchinson Cancer Research Center and the city of Ketchum to begin an antibody testing study. They took samples from 400 random Blaine County residents to see whether the residents had been infected with the coronavirus.
“We had all these questions we wanted to answer for the community,” Bill McLaughlin said. “How prevalent the disease was, how many people had been infected but were not showing symptoms.”
McLaughlin said the last samples were sent off to the laboratory at the University of Washington on May 19. He’s anxious to see the final results and get a better idea of what the true infection rate — in both symptomatic and asymptomatic people — is in Blaine County.
“We will have a really good picture of how prevalent the antibodies are in the community,” McLaughlin said. “Once we know that antibodies will last, as it were, and actually confer immunity, then we’ll know pretty well how close we are to a herd immunity kind of situation. We know we’re not there, that much I can tell you.”
At the same time, local health care providers spearheaded their own testing effort, called COVID-19 Response Group, to perform a different type of antibody testing. The rapid test involves pricking a patient’s finger and testing blood on a card that displays a negative or positive result similar to a pregnancy test. The team, including pharmacists Cathy Swink and Paula Shaffer, nurse Ryland Mauck-Duff and physicians Brock Bemis and Russell, tested around 400 people, Bemis said in a phone interview.
He said Swink ordered the tests after noticing demand in the community for more testing.
“There were so many unknowns that I think people were really just hungry to wrap their minds around what happened,” Bemis said.
Russell said rather than adding to research data about COVID-19, this testing effort was meant to identify asymptomatic spreaders to help control the spread in the community.
“We found in our population about a 1.5% asymptomatic carrier rate,” Russell said. “So our hope was to find all those people and quarantine them because that could make a huge difference in recovery.”
COVID-19 Response Group recently put its testing on hiatus after the FDA changed its requirements for processing the test, according to Russell and the group’s website. They’re working with potential partners to get the effort back up and running, Bemis said.
HOW WILL BLAINE COUNTY KEEP COVID-19 AT BAY AS IDAHO REOPENS?
In the last several weeks, Blaine County entered Idaho’s first two phases of reopening along with the rest of the state. But Greenberg said sentiment in the community has been mixed.
“A lot of people are excited about reopening businesses and getting businesses going again,” he said. “Obviously people are in a hurt financially. There’s also some apprehension by some people who are still afraid to come out. We have some people who are wearing masks and some aren’t. There’s a variety of feelings and opinions.”
Greenberg and Ketchum mayor Bradshaw said they feel confident in the COVID-19 numbers in the county, which have continued to taper over the last month. Still, Idaho has tested just over 2% of its population, and testing numbers on a county level aren’t available.
“It’s definitely time to move to the next stage,” Bradshaw said. “We are now at a point where we must consider opening up our economy and social life in a responsible way, a way that reassures those concerned about the virus while allowing others to put food on the table.”
Certainly things won’t just return to normal. Greenberg and Bradshaw said business owners have diligently drawn up plans to comply with state reopening protocols to keep employees and patrons safe. Several large annual gatherings in the Wood River Valley have been canceled, which could keep some tourists away.
Melody Bower, director of the South Central Public Health District, told the Statesman in an emailed statement that Blaine County residents must continue to “fight for (their) health” as restrictions continue to relax.
“If you are invited to an event that will encourage crowding, ask the organizer what they are doing to make social distancing a priority,” Bower said. “Patronize the restaurants and grocery stores that are protecting your health. Leave when an area gets too crowded, or if someone appears to be unwell. Applaud, don’t shame, the people who are taking obvious steps to protect their community’s health, like wearing a mask in public places. No one is a casual bystander in the ongoing fight against COVID-19. We all have a role to play and we can all do our part to limit community spread.”
The health district warned Tuesday that it was ramping up “cluster testing” at some organizations in the district and expected the number of positive test results could begin to increase again as a result. Greenberg said that kind of additional testing — as well as a comprehensive state plan for testing and contact tracing — will be key in keeping Blaine County on the right track.
Russell said he expects an increase in COVID-19 cases.
“It’s gonna happen,” he said. “The more we relax the stay-at-home orders, the more people are going to catch it. It’s a balancing act, and no one really knows where the right balance is. Staying on lockdown is bad and opening up is bad — it’s just a question of which is worse.”
Still, he said Blaine County’s progress to this point is “a success story, for sure.”
“It shows what happens when you have everyone chip in as part of a community to protect someone else,” Russell said. “If you go to the store and wear a mask, you’re being a better citizen than if you’re not (wearing one).”