Just over two years ago, the first cases of COVID-19 were detected in the U.S. And while Wyoming wasn’t initially affected like other parts of the country were, cases eventually began to rise in Wyoming. Since then, several waves and variants have officially led to the deaths of 1,667 Wyomingites.
Smaller hospitals have especially felt the impacts of COVID-19 firsthand, such as those in Johnson and Weston counties.
“I’d say our staff is exhausted-Definitely we’ve got COVID fatigue,” said Kristina Duarte, an infection preventionist and employee health nurse at Johnson County Healthcare Center (JCHC).
Initially, the effects of COVID weren’t felt much in Johnson County. But that eventually changed.
“In the first year we kept calling it the ‘Buffalo Bubble’ because we just weren’t seeing a lot of cases,” Duarte said. “We were doing all of the things that we needed to do to prepare, and educating our community, and asking people to mask, and we just didn’t see a whole lot of it, and so that was really lucky. And so, then when it did finally hit us, I feel like we were a lot more prepared than some of those communities that saw the first cases.”
Smaller facilities can reach capacity quickly, necessitating transfers to larger hospitals with more beds, staff, and resources. The JCHC is a critical access hospital and doesn’t have an Intensive Care Unit (ICU), so staff has had to transport patients elsewhere for treatment at times.
“We would send patients to Sheridan, to Billings, to Gillette, Casper, Denver-kind of depends on what the patients’ needs and where there are open beds,” Duarte said. “But definitely one of the biggest challenges we have faced in all of this is transporting patients out that need a higher level of care, COVID and otherwise.”
Duarte added that patients can stay for a short time but can also choose to stay longer if need be. Some of their long-term care capacity has been filled by those whose COVID symptoms have resolved but are not well enough to return home and who may not be able to go elsewhere due to lack of capacity.
With the small number of staff, having any that have to quarantine or are otherwise unable to work has also created problems. There hasn’t been a lot of turnover during the pandemic thus far, but it has occurred.
“I think in the CNA level positions, I definitely think there’s been some of that,” Duarte said.
Even with all that has happened in the last two years, they do have pride in what staff has been able to accomplish.
“This new variant has added a lot of taxing to our current staff and keeping people out maybe longer than we expected when some of them had gone out originally,” said JCHC CEO Luke Senden. “I think as an organization we’ve done an amazing job of continuing to stay functional and be here to support our community and I think that’s something that maybe is hard to see for people who are just grinding day in and day out.”
Duarte said that approximately 80 percent of the staff is vaccinated, which is about double the rate for Johnson County as a whole, which is approximately 41 percent, according to the Wyoming Department of Health.
The situation in Weston County shares many similarities with the one in Johnson County.
“We really didn’t see much of COVID and the effects-it’s been the last six months to a year that we’ve actually been really hit hard with it,” said Deborah Hockett, an infection prevention and employee health nurse at Weston County Health Services (WCHS) in Newcastle.
The effects of the pandemic have caused some staff at Weston County Health to reexamine their career choices, but according to Hockett, there hasn’t been significant turnover during the pandemic.
“I think for the most part we’ve all been doing pretty good, but there are days that we question our careers and our choices, and I think that’s not unusual,” she said. “I think all of us that are in the medical field have faced that in the last couple of years.”
She says issues with burnout have been more prevalent with staff at the long-term care facility because of the higher number of cases that they’ve experienced.
“Our long-term facility is actually in an outbreak right now,” she said. “Since January first it’s been increasing in the numbers for a COVID positive with the residents, but [cases are] mainly with the staff.”
Hockett said cases have been most prevalent in staff, not residents, of which approximately 95 percent are vaccinated. Approximately 80 percent of the WCHS staff? are also vaccinated.
Since Weston County is also a critical access hospital without an ICU, transporting patients to other facilities has been a problem when they’ve reached capacity.
“We were sending [patients] to Billings,” she said. “Rapid City is our number one call, we have a Life Flight that comes out of there. Not too long ago, I mean we would call 15 facilities around us in Montana, South Dakota, Wyoming, Colorado and we would get nothing.”
She said there are options to place a few patients on ventilators, but resources are limited. Patients have been held at the hospital until a bed opens up at another facility and she said a patient’s stay in Newcastle has only been for a few days, if less before they’re able to be transported elsewhere.
Though COVID can be unpredictable, Hockett feels that Weston County Health would be able to weather a potential future wave of cases.
“We are pretty good at keeping up with our PPE [personal protective equipment]. We’re well equipped with the testing aspect of it, although our testing supplies are getting limited,” she said. “Some medications are hard to get, but as far as PPE and being equipped to actually handle one-on-one with a patient, we’re sitting pretty good.”
Currently, Northeast Wyoming has some of the lowest vaccination rates statewide. This is led by Crook and Campbell counties, where approximately a quarter of the residents in those counties have been vaccinated.