The worst-case scenario

CHEYENNE – As the battle against COVID-19 entered another week, Governor Mark Gordon pleaded with Wyomingites to stay home and socially distance themselves, while Dr. David Wheeler, a Casper neurologist, laid bare what the worst-case scenario could look like in Wyoming if the protocol and methods recommended by the Centers for Disease Control and Prevention aren’t followed. 

Wheeler, President of the Wyoming Medical Society, urged Wyoming citizens to take social distancing recommendations and universal safety protocols seriously to avoid what he described as “a grim outcome.

“We vigorously support any and all efforts at national, state and local levels to encourage everybody to stay safely in their homes,” Wheeler said.

“We’ve seen over and over again the horrific effects that have happened in other communities that waited too long to enact such policies. If we wait until people start to show up in our emergency rooms, gasping for breath – we have waited too long. 

“If we do not act now, it is certain that we will use up all of the available resources for healthcare in our state. Because of our smaller population, COVID-19 is coming to us later than other parts of the country. This means we have had more time to prepare and more time to encourage you to limit personal contact and stay in your homes.”

Wheeler said a mass surge of COVID-19 conditions could result in people dying alone in their homes because hospitals and clinics would be depleted. 

“Because of our small population, we are severely limited in terms of hospital beds, equipment and manpower,” he said. “If our doctors and nurses fall ill – and they will – there is no backup. If we let this happen, people will die alone without access to care. 

“People suffering from everyday maladies like heart attacks and strokes, even people in car accidents or with appendicitis, they will die, too, because there would be no room for them in our hospitals.”

That worst-case scenario, though, is avoidable if people listen to the numerous pleas to stay home and observe social distancing. 

“This is a grim outcome, but we can avoid this if we start working together today,” he said. “If we flatten the curve now, our hospitals will have more time to prepare. If we flatten the curve now, fewer people will be sick at any given time. If we work hard during this time to surge hospital capacity and at the same time slow the spread of the disease, many more of us will make it through to the other end of this.”

Wheeler encouraged physicians statewide to immediately stop seeing patients in person and to utilize telehealth services as much as possible. He also called for a halt to all elective surgeries to save personal protective equipment for doctors and nurses on the frontline of the pandemic. 

Gordon said Wyoming has received two shipments of PPE from a national strategic stockpile, and recognized private businesses and citizens who have stepped up to aid in the hunt for PPE. 

“We are working to get those supplies out to tribes and counties,” Gordon said. “We’re also working with outside resources to secure additional supplies. We do want to recognize Wyomingites who have taken it upon themselves to assist in those efforts.”

He cited the University of Wyoming as being particularly helpful, as well a Sheridan man who is 3D printing masks and face shields. 

“We also have volunteers around the state who are willing to sew masks and donate PPE on their own,” he said.   

But one legislator, Scott Clem – a state representative from Gillette – is worried the measures taken to flatten the curve are worse than the disease itself, which has killed more than 40,000 people across the globe. Clem penned a letter to Gordon asking for a clear path forward that isn’t more damaging economically than the disease itself. 

“I understand the logic behind quarantines and self-isolation to flatten the curve of infected individuals,” Clem wrote. “An estimated 10-20% who develop symptoms require advanced medical care. With our limited resources in the medical sector, prudent actions were necessary to limit the strain on these resources to preserve life. This obviously comes at a cost to society, the economy, and state revenues. While we do not want to lose one life to this disease, we must consider that lives are also damaged or even lost by our present efforts to slow the spread. While it may not be possible to quantify, it is conclusive that forced business closures and self-isolation will result in permanently lost jobs, bankruptcies, suicides, increased mental health conditions, increased crime, loss of liberty, a decrease in government revenues, an increase in utilization of government resources, and an increase in domestic disputes among others.”

Clem also wrote that he is urging Gordon to find ways to send people back to work and school, and to bolster the medical community. 

“I am suggesting you develop plans to send people back to work and back to school, while directing state resources to bolster our medical community as we deal with the influx of those who need care,” Clem wrote. “This could include funding for additional field hospitals, the purchase of medical equipment and PPE, or the manufacturing of such. We need increased medical personnel. This could come through temporary rule changes or legislation that would allow medical students, nurses, CNA’s, retired physicians, and volunteers to care for those who are sick. Along with this is the need to test, track and quarantine infected individuals, while healthy individuals return to normal activities.”

But Wheeler, who Gordon said is on the frontline of the pandemic, said people’s lives are more important than saving businesses. 

“All of us have been, and will continue to be, affected by this pandemic,” he said. “Businesses are going to fail, jobs will disappear, and goods and services are going to become more scarce. These problems can only be made worse if we fail to act now and limit the death toll. My company, like yours, is struggling, but the health and wellbeing of my family, my friends and my community is infinitely more important than the money we are losing.”

The only way to beat COVID-19, Wheeler said, is to take social distancing recommendations seriously and to stay home as much as possible, and it could require several months to get a handle on it. 

“Then there’s an additional multiple week tail-off on this,” he said. “It’s very important to understand that even once you hit the apex on this, you can’t then relax your social distancing standards. If you do that it will immediately start to grow again and all the hard work and sacrifice that we put in getting up to that point will be lost and things will get much worse again.”