One of the first suspected cases of COVID-19 in Park County came back positive for the new coronavirus on March 17. The second confirmed case was expected to come within days.

However, despite roughly 200 local residents being tested for the new coronavirus in the weeks since then, health officials have yet to conclusively find another case of COVID-19 in Park County.

“Whatever we’re doing, it seems like it’s working,” Park County Public Health Nurse Manager Bill Crampton told county commissioners on Tuesday, referring to a host of precautions being taken at the local level to slow the spread of the disease.

From conversations he’s had with several public health officials, “statistically speaking, ... what we’re seeing shouldn’t happen,” Crampton said. “We should have had more positive cases.”

“We’ve defied the odds,” chimed in Commissioner Jake Fulkerson. “The state of Wyoming has.”

Park County, however, has been a particular anomaly, in the best sense of the word: The local ratio of confirmed cases of COVID-19 (1) to completed tests at the Wyoming Public Health Laboratory (192) is by far the lowest among the counties with at least one case. For instance, Sheridan County has run roughly the same number of tests (208) and found 12 confirmed cases as of Wednesday afternoon.

Additionally, although only a fraction of Park County residents have been tested for disease — far less than 1% of the population — it’s a relatively large percentage compared to the rest of Wyoming, county health officer Dr. Aaron Billin said earlier this week.

“Right now, the only Wyoming counties testing more individuals per capita than Park County are Niobrara and Campbell counties,” Billin said Wednesday.

In short, although local medical providers have gone looking for COVID-19, they haven’t been finding it among the patients they’re testing. Why that’s the case remains something of a mystery.

“We have noticed fewer than expected positive tests in Park County, and have been investigating this for some time now,” Billin said. “At this time we do not know the answer.”

He noted that the polymerase chain reaction test currently being used to check for COVID-19 returns a false negative result around 5% of the time. Crampton added in a Wednesday interview that it’s not particularly easy to get a proper nasal swab from a patient.

“We know the numbers are a little bit odd and we’re asking them [medical providers] to double-check their procedures, but in the meantime, we’re going to ride our wave of luck,” he said.

Crampton added that, “the important thing for us right now is that we don’t have anybody in the hospital with a positive diagnosis [of COVID-19].” The county’s lone confirmed case of the disease — a Cody Regional Health employee — has since made a full recovery.

There was some concern expressed Tuesday that complacency or frustration will set in as the restrictions continue amid few visible signs of the disease.

Commission Chairman Joe Tilden — who separately expressed his belief that “the economy has got to start opening up pretty soon” — said he thinks Park County has been “very fortunate” amid the pandemic. However, “my fear is that we’re going to have people out there that are going to start saying, ‘Well good God, we’ve only had one case in [the county], they’ve recovered, been that way for three weeks, why are we locked down?’” Tilden said.

Crampton said the lack of cases is “because of what we’re doing.”

“We may have started a little bit early,” he said, referring to restrictions on gatherings and certain businesses that the county put in place on March 19, “but I think that gave us an advantage.”

Billin and other health officials have also repeatedly cautioned that the number of confirmed cases understates the scope of the virus’ presence in Park County and Wyoming.

On Monday, he pointed to a recent study out of the University of Texas at Austin, which he summarized as saying “that rural counties with one case have a 51% chance of sustained community transmission.”

“The study authors estimated that for every diagnosed case, there were 10 case[s] undiagnosed,” Billin wrote. “Aggressive social distancing is as important as ever.”

The symptoms of the new virus — which can include a fever, cough, headache and muscle aches — are often difficult to distinguish from illnesses like the seasonal flu, bronchitis and common colds. The only way to know for sure whether someone has COVID-19 is to run a test, and testing is limited.

Commissioner Tilden mentioned a couple of friends who came down with a cough and fever after a trip to southern California and, although being sick for two weeks, they were denied a test for COVID-19.

Crampton said he would “love to be able to line people up, 6 feet apart, walk up, poke your nose [with a swab] and send it on” for testing, but “we just don’t have the capability.”

The Wyoming Department of Health announced last week that it was limiting its testing to a narrow group of patients and directed medical providers to send samples from other patients to private labs, which is a slower, more expensive process.

Tilden asked whether Wyoming will be getting any of the 1.1 million test kits that the CDC is preparing to distribute, prompting a chuckle from Crampton.

“‘W’ is usually at the bottom of those lists, I’m sorry to say,” he said of Wyoming.

Crampton said he knows of several people in the community that, although they weren’t tested, “whatever they had, they really didn’t want to share it with anybody.”

Regardless of whether they had the flu or something else, “they did the right things — they stayed home. So that’s the important part,” he said. “So for the most part, what we’re doing is the right thing.”