State health officials need to tone down the orders they’re issuing to those infected or suspected to be infected with COVID-19, Park County commissioners say.

The isolation and quarantine letters being sent by public health workers around the state generally tell people to stay home for a certain period of time and to avoid close contact with others, warning that, “if you do not comply with this order, you may be subject to criminal prosecution under Wyoming Statutes …”

At a Tuesday meeting with public health officials, Commissioner Lloyd Thiel took issue with the threat of criminal penalties.

“You are taking their private rights and basically putting them in jail,” Thiel said.

Park County Public Health Nurse Manager Bill Crampton responded that, “We’re trying to prevent the public as a whole from getting sick.”

“Sometimes you have to give up a little bit of yourself in order to make sure that your grandmother doesn’t get sick,” Crampton said.

“And I have no problem with asking these people to do that,” Thiel said. “The problem I have [is] with a threatened prosecution — ‘if you do not comply’ — when they have done nothing wrong.”

Crampton noted that prosecutions have been effectively nonexistent in Wyoming and that he doesn’t expect any egregious violations that would require local prosecutions.

Still, Commissioner Lee Livingston said the wording of the letters “is pretty heavy-handed,” and he has asked the governor’s office to look at revising them.

“It’s pretty scary for someone to receive a letter saying, ‘... if you don’t comply, you will be prosecuted,’” Livingston said. “This is Big Brother talking to you.”

Added Commissioner Jake Fulkerson, “you expect a letter like that to come out of Chicago or something, you know. You don’t expect it in Wyoming.”

Billin said he “totally” agreed that the language “comes across heavy-handed,” though he noted that the wording comes from state officials — and from state statute.

“Once a quarantine order is issued, it is state law as much as any other state law; once a state public health order is issued, it’s just as much state law as any other state law,” he said.

Billin noted that enforcement is up to law enforcement — not health officials — and he said there have been many conversations with Park County Attorney Bryan Skoric about the right approach.

“We don’t want to appear to be jackbooted thugs,” Billin said, “but we want people to do the right thing.”

Testing negative doesn’t help

Thiel was particularly concerned about people receiving the letters after testing negative for COVID-19.

“I mean, to me that’s real close to getting into their private rights — of quarantining a healthy person,” Thiel said, adding, “I think there’s a line there that’s being crossed that, in my opinion, should not be.”

However, Crampton disputed the idea that someone is safe just because they tested negative for the disease after being exposed.

“We don’t know they’re healthy,” he said. Crampton noted that the virus has a two- to 14-day incubation period, meaning it can take up two weeks for someone to begin showing symptoms of the disease.

“[It’s] at the end of that period where we’re really concerned, where people may become sick — and they think they’re free [and clear], and they’re not,” Crampton said.

He referenced a local case in which a man and his son tested positive for COVID-19, while the man’s wife tested negative. The woman separated herself from her family members, and the father and son finished their quarantine with basically no symptoms, Crampton said.

However, “at 13 days, she came down with symptoms, tested positive and ended up hospitalized,” Crampton said. “She’s home now, but, you know, those are the kinds of things we’re trying to prevent.”

The current criteria generally hold that someone should be quarantined if they’ve been within 6 feet of an infected person for 15 minutes or more, within 48 hours of that person showing symptoms of COVID-19. Contact tracers employed by public health interview both infected people and potentially exposed people about their contacts to determine who should be restricted.

Inconsistency?

Billin noted that, counterintuitively, it’s possible for someone infected with COVID-19 to have their movements restricted for a shorter period of time than someone suspected of being infected. That’s because a person can be released from isolation when 10 days have passed since the onset of symptoms and the person has been fever-free for 24 hours. Under a quarantine order, however, a person must wait 14 days.

Speaking strictly from a standpoint of public health restrictions, “it’s better to get it [COVID-19] than to be a close contact, because you’re back in action sooner,” Billin said. “But that’s just the science of it.”

However, there’s no guarantee of a quick or easy recovery from COVID-19. The Powell Valley Healthcare doctor noted that, particularly for those who are older or have underlying health conditions, the disease can hang on for a long period of time.

Thiel also complained of people being restricted with little notice and with inconsistency. He said a woman was quarantined on June 27 for working in the same building as an infected person — even though she worked in a separate office — while the infected person’s spouse was never ordered to quarantine.

Crampton said there were some mistakes made by state workers, before the county hired its own contact tracers in July. Now, he said, it’s generally local workers “knowing what local folks are doing.”

Thiel has pushed for some kind of process for people to appeal quarantine orders and Billin said he has made a couple of exceptions: for some law enforcement officers in Powell and a CT technician, who were needed on the job for, respectively, public safety and for spinal surgeries at a local medical facility.

However, in all the other cases where people have protested, “they just don’t believe it; they don’t want to be quarantined,” Billin said, adding that inconvenience is not a valid medical reason to modify an order.

‘Protect your neighbor’

As for the wording in the letters, Thiel warned that inaccurate information will be provided to contact tracers due to the “the heavy-handed threat of prosecution.”

“The word is out,” he said, adding, “Those people are not gonna be telling you who they were with, where they were at.”

However, Crampton said it’s not a new problem for public health.

“When we do the contact tracing for gonorrhea, we get ‘Mickey Mouse’ as a contact,” he said. “People aren’t telling us stuff; they’re lying to us; we know this. We are trying to do the best we can for the community as a whole.”

Commissioners hope state health officials will modify the language.

Fulkerson said it would be better to say something like, “protect your neighbor … do the right thing, rather than ‘you will be prosecuted.’”

Added Livingston, “This is Wyoming: Ask us to do stuff, we’re probably going to do it. Tell us to do stuff, you might get a negative response there.”