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Casper College's women's basketball coach Dwight Gunnare talks with his team during a timeout in its game against Gillette College on Feb. 6, 2019 at Swede Erickson Thunderbird Gym.


State-and-regional
breaking top story
State takes more steps to slow virus including closure of hair salons, tattoo shops, massage parlors

Businesses such as hair salons, tattoo shops and massage parlors must close temporarily to limit the spread of coronavirus, Gov. Mark Gordon and state Health Officer Dr. Alexia Harrist ordered Tuesday.

The order begins Wednesday and extends through April 3. It focuses on businesses where “appropriate social distancing measures are not practical,” according to the governor’s office. The list includes nail salons, hair salons and barber shops; cosmetology, electrology and aesthetic services; massage parlors; and tattoo, body art and piercing shops.

“While I understand the impact and sympathize with those most affected by these measures, especially small business owners, I support Dr. Harrist’s recommendation because this is about saving lives,” Gordon said in an written statement. “We have tried to navigate a thoughtful course, but as COVID-19 spreads through our communities, we must take this action now.”

The order comes less than a week after Gordon and Harrist ordered the closure of a host of businesses where people are in close contact with one another including bars, gyms and museums. That order also barred restaurants from serving customers in their dining rooms, allowing only to-go orders. The state has also prohibited gatherings of 10 or more people in a single room or confined space.

“People who are ill with COVID-19 can easily spread this disease to others to anyone nearby if they cough or sneeze,” Harrist said. “Staying away from others as much as possible helps protect all of us, including those who are most vulnerable to illness complications.”

Gordon and Harrist issued the order on the day that Wyoming’s 30th, 31st and 32nd coronavirus cases were identified. However, health experts say the actual number is almost certainly higher due to the dearth of tests. Nationally, tests have identified 52,000 cases nationally, according to a New York Times count. At least 675 patients have died.

Data details

Statewide, the Wyoming lab has processed 567 tests, with the vast majority returning negative. Commercial labs have tested scores more. New data from the state Department of Health shows roughly 45 percent of the state’s confirmed cases are from “contact with a known case.” More than 25 percent is from domestic travel, less than 5 percent is from international travel, and 25 percent are from unknown origins.

Roughly an equal amount of patients have pre-existing health conditions or are otherwise healthy. For a fifth of Wyoming’s cases, it’s unclear if they had previous medical conditions. Most had fever and cough.

Cases have been identified in Campbell, Carbon, Fremont, Laramie, Natrona, Park, Sheridan, Sweetwater and Teton counties.

Natrona County’s second novel coronavirus patient, confirmed Monday night, likely contracted the virus after traveling internationally, officials said Tuesday afternoon.

Hailey Rodgers-Bloom, spokeswoman for the Casper-Natrona County Healthy Department, told media Tuesday that the new patient in the Casper area has been self-quarantining since they returned from their trip and that health officials don’t believe there’s an immediate danger of spread to the broader community.

The test for the new Natrona County patient was taken by the health department and submitted to the state lab. The sample for the county’s previous patient was taken at a Wyoming Medical Center clinic.

Rodgers-Bloom said that 70 tests from Natrona County have returned negative. Two have been positive, and 30 more are still awaiting results.

On Tuesday, the state announced an eighth case in Cheyenne. The latest Cheyenne patient is in their 40s and has had contact with another confirmed patient, according to a city press release. Cheyenne’s eight known cases are the state’s second highest, surpassed by Fremont County’s 11 patients — the last of which was announced Tuesday evening. Details about the 11th patient were not immediately available.

Sweetwater County announced its first confirmed case Tuesday night. The patient, a Green River man in his 40s, is self-isolating.

If you’re sick

COVID-19, the disease caused by the novel coronavirus, is a respiratory illness. Its symptoms include cough, fever and shortness of breath. Symptoms appear within two weeks. If you have contact with a person who has COVID-19, you should self-isolate for 14 days.

Natrona County residents who fear they have COVID-19 or another respiratory illness are encouraged to call Wyoming Medical Center’s newest clinic, which was established specifically for this issue. The clinic will only test those patients who do not have the flu and who physicians believe may have COVID-19. The clinic, which accepts walk-ins but asks you to call ahead, can be reached at 307-233-0291. It’s located at 245 S. Fenway St. in Casper.

The hospital has also launched a telehealth screening hotline. Patients who are experiencing respiratory illness symptoms such as fever, cough, nasal and chest congestion and sore throats can call the hotline, where they can speak with a registered nurse. The hotline number is 307-233-7288 and is available from 8 a.m. to 5 p.m. Monday through Friday.

Patients who believe they’re sick are asked not to go to the emergency room to avoid overwhelming the facility. They are asked to either call Wyoming Medical Center’s clinic or the patients’ normal health care providers. Only patients who are having trouble breathing should go to the ER.

The Casper-Natrona County Health Department has established a local hotline that potential patients can also call. People can also call the number for information about COVID-19. That number is 307-577-9892.

Photos: Casper restaurants pivot to delivery and takeout after coronavirus closure

Business
top story
Backwards Distilling to begin making hand sanitizer

Distillers and brewers throughout Wyoming, including Backwards Distilling Company in Natrona County, are making hand sanitizer to help remedy the shortage caused by customers trying to slow the spread of COVID-19.

The initiative got the state’s backing Tuesday, but it began as a local one. Backwards co-founder Amber Pollock had been approached by a few local entities about the possibility of making hand sanitizer, which needs to be at least 60 percent alcohol to meet the Centers for Disease Control and Prevention’s standards. Given that she and her family own a distillery, she’s in a unique position to help provide a product that medical professionals and grocery stores alike haven’t been able to keep stocked.

She began asking around to get ideas on how the process would work, what she’d need, how she’d pay for it. She mentioned the idea to a friend on the Wyoming Business Council, as well as a few others.

“That message got to the governor’s office pretty quickly, and I got a call from them the next day,” said Pollock, whose distillery is based in Mills.

Before the state got involved, Pollock had already been looking around for the materials she would need to mass produce the sanitizer. The main ingredient is ethanol, which is the part Backwards is precisely poised to handle. The rest of the ingredients have been hard to find, Pollock said. She needs glycerol, isopropyl alcohol and hydrogen peroxide. Not exactly products she has in bulk quantities.

Plus, she isn’t the only one trying to buy these ingredients.

“It’s been more of a supply chain thing,” she said. “Sourcing the supplies is a challenge.”

Pollock said she’s seeing the same thing with distillers out of state, as well. She sits on the board of the American Craft Spirits Association and has been hearing similar things from other members.

“This is an issue that’s coming up for our members all across the country,” she said.

And that’s where the state came in. The Wyoming Business Council and the governor’s office have teamed up with small distilleries across the state to facilitate a program that will employ at least eight different distilleries and breweries in the manufacturing of hand sanitizer. The Wyoming Business Council will allocate money to pay for the raw materials needed to make the sanitizer, as directed by Gov. Mark Gordon.

“This collaborative effort represents the Wyoming spirit we all know and love,” Gordon said in a statement Tuesday. “Folks banding together in challenging economic times to support public health and advance the greater good. We also recognize that other industries are stepping up and that this situation is temporary.”

“It is exciting to see the private and public sectors come together,” Wyoming Business Council CEO Josh Dorrell also said in the release. “The WBC is here to help facilitate the collaboration of businesses and state agencies to cut red tape and act quickly and decisively.”

The partnership will allow distillers to focus on making the product while the business council handles the supplied. Pollock said the private-public partnership that’s been put on course in a matter of days has been encouraging, and in a time when most people have been relegated to the sidelines to social distance, she’s glad to have a novel way to help.

“I’m really excited to see this be a coordinated effort,” she said. “It feels really good to be contributing; it’s a nice position to be in.”

The money to pay for the supplies the distillers need will come from the “Imminent Threat Grants” funds available through the “Community Development Block Grant Program.”

In addition to Backwards, which closed its downtown Casper tasting room because of coronavirus concerns before the state mandated it, Koltiska Distillery in Sheridan, Chronicles Distilling in Cheyenne, Pine Bluffs Distilling, Melvin Brewing in Alpine, Wyoming Whiskey in Kirby, Jackson Hole Still Works and Grand Teton Distillery in Jackson will join in the effort.

The details of how the hand sanitizer will be distributed are still being worked out.


Cayla Nimmo, Star-Tribune 

Tourists take photos in front of a geyser in Yellowstone August 13.


Health
breaking top story
Pharmacy board: Providers may be writing prescriptions for potential COVID-19 drugs for themselves, relatives

After receiving “a number of concerned emails and calls,” Wyoming’s board of pharmacy is encouraging its licensed providers to “use their professional judgement” when presented with prescriptions for one of the medications that’s being touted as a possible treatment for the novel coronavirus.

The board’s guidance to pharmacists is a move being mirrored across the country as providers express alarm about doctors and dentists writing prescriptions for medications that have shown some potential to treat the virus that’s spreading rapidly across the state and country and have been trumpeted by President Donald Trump, among others.

A New York Times story published Tuesday listed seven states — including Kentucky, whose policy the board here is mirroring — that have issued emergency restrictions and guidelines to stop any hoarding. The Times reported that physicians in those states have also been writing prescriptions for the drugs for themselves and their relatives. The Wyoming pharmacy board’s executive director, Matt Martineau, suggested that had been reported in Wyoming too.

“The Board of Pharmacy has heard from several pharmacists in Wyoming specifically about practitioners writing prescriptions for medications that may anecdotally treat COVID-19 for themselves and family members,” he told the Star-Tribune in an email.

In a statement to the New York Times, the president of the American Medical Association decried the prescribing habits.

“The A.M.A. is calling for a stop to any inappropriate prescribing and ordering of medications, including chloroquine or hydroxychloroquine, and appealing to physicians and all health care professionals to follow the highest standards of professionalism and ethics,” Dr. Patrice Harris said, per the Times.

The drugs are Azithromycin, an antibiotic used to treat such common maladies as sinus infections; chloroquine, which treats malaria; and Plaquenil (or its generic version, hydroxychloroquine), which treats malaria, lupus and rheumatoid arthritis. Their popularity in a world starving for a way to stem the tide of infection and death from COVID-19 has skyrocketed since Trump backed their potential.

Physicians and pharmacy boards have urged caution, noting that the medications have not been rigorously tested. The indication of their potential efficacy in treating COVID-19, the respiratory disease caused by the new coronavirus, was demonstrated in a European study with just a few dozen test subjects.

An Arizona man died earlier this week after taking a non-medical product that had chloroquine as an ingredient. Several people have overdosed on the medications in Nigeria.

The Wyoming board of pharmacy said “there is not yet enough clinical evidence that it’s effective in humans for the management of the disease.” The board stressed that pharmacists have a responsibility — as do the providers — in filling the prescriptions and that pharmacists should use their own judgment whether to fill them or not.

The guidance also recommends pharmacists consider if the diagnosis “is consistent with the evidence for its use from the prescriber; is this a routine medication for this patient; limited what is dispensed to no more than a 14-day supply” for new patients or patients who don’t have diagnoses that typically are treated with the medications.

Eric Saul, a pharmacist at Medicap in south Casper, said there’s “been a lot more interest” in the drugs lately.

“A lot more phone calls about it, but our supply went away pretty quickly,” he said.

He added that there’s been an “uptick” of providers who can write prescriptions requesting medications that are “outside of their scope of practice.” Dentists, for instance, have requested the medication, he said, as have doctors who don’t treat the rheumatic diseases that one of the drugs treats.

He warned that the rush is going to make it harder for patients who have long been established on the drugs to get their supply. He added that he’s talked with pharmacists in other locations across Casper and that the clamoring is common.

The problem with the rush is there’s just not strong proof the drugs are certain treatments. While testing in the United States has begun in earnest, supplies are still limited and the Food and Drug Administration has not approved the drug cocktail as either a preventative measure or a proven treatment.

Dr. Andy Dunn, Wyoming Medical Center’s chief of staff who’s running a respiratory and coronavirus clinic in Casper, said it was “really bad” that providers were rushing to write prescriptions for the medications. He said researchers needed more time to nail down efficacy and appropriate dosing. He said his clinic hasn’t had many requests for the meds, and if it had, he’d be hesitant at best. He said he’d want to monitor patients’ hearts, which some of the drugs can hurt, and the infrastructure isn’t there to do that on a large scale.

He added that some of the drugs have significant side effects, primarily to the heart but also to the kidneys.

Dr. Mark Dowell, Natrona County’s health officer and an infectious disease physician, said the situation was difficult because researchers are scrambling to find treatment as the virus spreads. All of this is happening in real time, he said.

“So what happens is we’re desperate enough, we’re looking for something,” he said. “And in an ideal world, you would do a trial so no (test subjects) know what they’re getting, half get it, half don’t. You have to have a few months. Unfortunately, that’s not the situation in an outbreak.”

Dowell said there was potential the drug could help shorten the length of the disease, which has implications across the board, from treating patients to preserving desperately dwindling supplies of protective gear.

“But this has to be in concert with ability to test more frequently,” he said.

“So when you hear on national press conferences that we found the wonder drug, we haven’t. When you hear anything Anthony Fauci say we need studies because we really are not sure, you gotta listen to that,” he added, referring to one of the nation’s top epidemiologists who’s appeared at press conferences with Trump.

Wyoming Medical Center is using the drug combination for a COVID-19 patient in WMC’s intensive care unit, a person who was transferred to the state’s largest hospital here in Casper from elsewhere in Wyoming. Dowell said that if more patients end up in the ICU, the hospital would likely continue to use the drugs.

“We don’t have anything better to offer other than great ICU care,” he said. COVID-19 currently has no approved treatments and no vaccine. “We plan on using it in the sickest people.”


Govt-and-politics
breaking top story
As President Trump talks about reopening economy, Cheney urges leaders to stay the course

Wyoming Rep. Liz Cheney broke with a number of her Republican colleagues Tuesday morning with a statement urging President Donald Trump to stay the course on aggressive measures to contain the COVID-19 outbreak — contrasting with a growing number of voices in Washington urging Americans to get back to work.

As calls have begun mounting among Republican lawmakers to reopen the economy amid a tanking stock market and rising unemployment, Cheney — the third-ranking Republican in the House of Representatives — seemed to offer a conflicting opinion to the president, who has stressed in recent days that the “cure cannot be worse than the problem” in fighting COVID-19.

“There will be no normally functioning economy if our hospitals are overwhelmed and thousands of Americans of all ages, including our doctors and nurses, lay dying because we have failed to do what’s necessary to stop the virus,” Cheney tweeted.

Cheney’s comments — which caused her to trend nationally on the social media site — signify a sharp contrast with some other GOP officials around the country. Pressure has been growing within the Trump administration for the president to urge businesses to end their social isolation policies and reopen their doors, and a growing number of voices in conservative politics have begun to suggest that the American economy cannot continue to exist in a state of an extended shutdown.

“In Texas, our governor and lieutenant governor have made some smart decisions that have allowed our local communities to really lock down where it made sense … and I think we’ve done an awfully good job of trying to contain this virus without locking down the entire community,” Texas Republican Rep. Kevin Brady — who represents one of the nation’s most populous cities — said in an interview on MSNBC Tuesday. “For those of us who are young and healthy, this virus loves crowds and attacks the elderly. I think the work we are doing, and social distancing and personal hygiene, is helping constrain this virus.”

“Let’s lock down this virus, don’t lock down the entire economy — we’ve still got some big challenges ahead,” he added.

While states have dictated much of the response, it is largely communities themselves that have had to take on most of the policy decisions, particularly the largest cities in those states. In places such as Denver, Houston and New York City, businesses have been ordered closed not by the federal government, but by state and local officials, resulting in significant disruptions to their own economies and revenues seen as a trade-off to reduce the amount of time the virus is in circulation.

The lost wages and the hit to economic activity seem dire enough that some have suggested a potential increase in the loss of lives would be well worth the benefits of doing business as usual: In Texas, the state’s Lieutenant Gov. Dan Patrick seemed to suggest that re-opening the economy was worth the lives that could potentially be put at risk by increased exposure to the virus (like senior citizens), telling Fox News’ Tucker Carlson “if that’s the exchange, I’m all in.” Others, like Liberty University’s Jerry Falwell Jr., made headlines by announcing plans to reopen their campus in conflict with Centers for Disease Control and Prevention guidelines.

Countries with hard-line social isolation policies have so far had the most success in combating the virus’ spread. Meanwhile, the United States — which has responded with a patchwork of approaches led largely by governors —has actually seen the number of cases accelerate in recent days, leading the World Health Organization to suggest on Tuesday that the U.S. could soon become the new epicenter of the global pandemic.

Cheney has been one of the most outspoken Republicans in Congress when it comes to taking the threat of the pandemic seriously. After speaking at the Conservative Political Action Committee’s annual blowout in D.C. several weeks ago — where an attendee tested positive for the virus — Cheney self-isolated and since has been vocal to pushing for an aggressive containment policy.

She was also among the first members of Congress to call for an end to tourist traffic in the United States Capitol and, as early as March 11, urged events to be canceled and for people to self-isolate — several days before Trump declared a national emergency over the crisis.

“We must slow transmission and get off this curve to save lives,” she tweeted at the time. “Social distancing and canceling events are crucial. We must do this now.”