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>> GEORGE: We have very good 
data from the CDC that came out 
on how children less than 17 
years old are experiencing 
Covid-19.
What happens to them.
How ill do they get, those kind 
of numbers.
That's important considering 
school starting.
Our nation we're still having 
about 1,000 people a day on 
average dying from this illness.
It is now the third-most common 
cause of death in the United 
States.
Back in April if you remember 
there was a time when we had 
over 2,000, 2,000 to 3,000 peep 
am day dying N a short period of 
time it became the most common 
cause of death.
But that was just for a short 
period of time.
This is for the last, if you 
look year-to-year where we are 
and projections, and for the 
eight months total, behind the 
heart disease number one, 
cancer, now Covid-19 is the 
third most common cause of death 
in the country.
It's important to remember.
The good news is that even 
though deaths have held stable, 
and increased in the last few 
weeks, the number of total 
infections and the number of 
hospitalizations seems to be 
tapering off in the country as a 
whole.
We start pockets that are 
different, but there is some 
encouraging numbers when you 
look at hospitalizations and 
total cases.
Montana, we like to talk about 
positivity rate.
That's an important number, it's 
not the only number and only one 
we use, but positivity is when 
you do 100 tests is what the 
percentage of them that are 
positive.
Montana right now, is 6.7%.
And that is similar to Carbon 
County, I think Carbon County is 
6.9%.
That's a 7-day rolling average.
Sometimes you will see spikes in 
it, like we were at 11% last 
week.
That's a lot of that is a 
collection of tests that hadn't 
been run, and then they're 
dumped all of a sudden.
We aren't getting consistent 
numbers.
Trends are important and overall 
positivity rate is important.
We live in the 6% to 7% range.
For a while there we were down 
into the 3% to 1% range, where 
we want to be.
Our goal for that is less than 
5%.
And I won't go into all of the 
reasons why that number is 5% 
but we see areas when it's over 
10% that's worrisome and tends 
to snowball at that point and 
really affect economies, 
stressing hospitals, et cetera.
Montana is, with 33 other states 
in the country, over 5%.
We're barely over 5%.
In that group is Mississippi, 
North Carolina, Idaho, they're 
in double digits.
Mississippi is 24%.
One out of four people who get a 
Covid-19 test, and a lot of 
people are getting Covid-19 
tests there because they're 
really struggling, one out of 
four are positive.
Yellowstone County continues to 
have the highest prevalence of 
infections.
It's only 16% of the population 
of Montana, yellow stone County.
Yet it accounts for half of the 
hospitalizations, there's about 
50 people in the hospital in 
both hospitals now total.
About 14 to 15 of them are in 
the intensive care unit.
Many of them are on respirators.
That's stressing those 
hospitalizations but not to the 
point where they have to create 
extra room or call in extra help 
at this point.
It's right there.
At that point where if we do get 
a big bump in numbers and 
hospitalizations in Yellowstone 
County they will be calling for 
help.
That's what we see with this 
virus.
We see the surges that affect 
hospitalizations, and that 
causes economies to start 
contracting.
To bring us further apart, 
create areas where we're 
together.
So 650 active cases in 
Yellowstone County, so active 
cases are interesting.
Those are cases that haven't 
gone -- positive cases that 
haven't gone through the 
ten-day.  Where we call them 
recovered.
After ten days it doesn't look 
like can you spread the virus to 
other people.
We know a lot of people, most 
people don't get tested.
This is a strange illness.
A lot of people don't have any 
symptoms at all but they spread 
it.
Some people have very mild 
symptoms.
We think, when you hear an 
active case number, you should 
multiply it by at least ten to 
know about how many cases are 
active and walking around in 
your area.
So 650, so there's probably over 
6,000 people in Yellowstone 
County that are infected with 
Covid-19 and can spread it.
So that 650 active cases in 
Yellowstone is over half of all 
of the active cases in Montana.
Yellowstone County has had 32 
deaths from this disease and 
that is out of 85 deaths in our 
state.
Our state continues to have much 
less impact than the rest of the 
country.
But there's certain parts of the 
state that are impacted.
One of them is bighorn County.
Bighorn County continues to have 
per capita the worst experience 
with these infections as far as 
death, hospitalizations, and 
numbers.
It's truly tragic what is 
happening in bighorn County.
One more thing about Yellowstone 
County, the hospitalizations in 
Yellowstone County, over half of 
them come from outside of 
Yellowstone County.
That's where Carbon County 
residents, we have had three 
hospitalizations for people in 
Carbon County, they've all gone 
to billings to be hospitalized.
We don't have respirators, 
intensive care units, 
specialists to handle those 
cases that are severely ill.
So Carbon County, we have a 
population of 10,000, we have 
had 80 total cases lately, we 
seem to be averaging, on a day, 
one to three new cases a day.
Positivity rate is about 6.9%.
We talked about why it's 
sometimes jumping, don't panic 
if you look at the number and 
it's up.
Look for trends on that.
We have about 11 active cases 
now, is that right?
>> BULLOCK: 12. 
>> GEORGE: 12 active cases now.
We have not had a super spreader 
event.
These are the events that really 
can hit small towns, especially.
And what a super spreader event 
is, it's just like it sounds, 
one person in a short amount of 
period of time will infect a lot 
of other people.
That's happened in Phillips 
County just recently.
I can talk about that if we have 
time.
We also have kept this virus 
thankfully so far out of our 
vulnerable populations, nursing 
homes, group homes, assisted 
living.
Where do most of our cases come 
from?
Most of our cases are coming 
from work groups, number one, so 
these are groups of builders, 
contractors, work groups that 
travel back and forth to 
Yellowstone County.
And they infect each other.
A lot of it is coming from 
vehicles I think.
Just try to keep that in mind if 
you're in work groups, take 
extra cars, space yourself out.
It's easy, a loft work groups 
work outdoors, it's easy to 
distance there.
But it's very hard in vehicles.
Definitely wear mask if you're 
unable to take your own vehicle.
Family gatherings is another 
area we're seeing a lot of 
contact spreading.
And also bars, like everywhere 
else in the country, bars, it's 
just an area, unfortunately, 
where we see spread of this 
virus.
People, as the night goes on, 
people let their guard down, and 
they're catching up with people, 
people get close and they talk 
louder.
People ask us always, ask Bill, 
they ask me, how about the 
rally, how about this event, how 
about that event, what did it do 
to our cases, how did we -- how 
were we impacted from that.
The way I answer that is 
anything like that, that brings 
more people into our area, and 
con agree gates us more will 
cause increased infections.
The question is where do these 
people come from and what 
happens after they're here and 
how long are they here.
For example, the rally, most of 
them are from out of state, out 
of County, and they're here for 
three days, symptoms usually 
start in five days, then they 
go.
Did they acquire Covid here, 
probably.
Did they bring Covid when they 
came?
Probably.
But we're not so affected by 
those because when I say "we" 
I'll preface that with the 
people that are impacted by 
that, is our service industry 
folks.
Bartenders, waiters and 
waitresses, folks that really 
have to deal with the visitors 
on a front line basis.
They're the ones that get 
impacted by the large events.
Just the fact that we have a 
tourist season here and we're 
always busy in Red Lodge, 
especially.
In most of the cases in Carbon 
County, they're coming from Red 
Lodge.
Other parts of the County have 
been impacted but they've been 
very focal, family gatherings, 
bar-related deals.
Yes, the events impact us but we 
have not had a super spreader 
event from those events.
I think that's the most 
important thing.
Bill?
>> BULLOCK: Okay, thanks, Bill.
So in the last week, we've been 
involved with this, since we put 
things together for our 
community back in March.
We put together an incident 
management team to provide the 
most accurate information to our 
County residents.
We've been dealing with this 
since then and it's hard to -- I 
can't imagine, this is awful.
Trying to manage this on a day 
in and day out basis.
The asks of our community, the 
asks of our neighbors, to try 
and get this taken care of.
To try and find some semblance 
of a normal life because a 
pandemic is not normal life.
One of the goals early on as a 
team, I think that the residents 
deserve the information we've 
been getting out, they deserve 
to be knowledgeable about what 
is going on, that's one of the 
reasons behind the formulation 
of the dashboard.
Very early on one of the primary 
goals of all of this was nobody 
was under the misconception that 
this would not come here.
This was going to be coming here 
regardless.
We were going to see some 
portion of Covid, the 
coronavirus in our County.
One of the goals being that how 
do we manage that.
Over the last few weeks given a 
lot of commentary in all sides 
of this, an a lot of 
politicalization of all of it.
From both sides, and all sides 
and every side you can imagine.
Trying to find some positive in 
the mix there.
Looking at the numbers and 
looking at the staged dashboard 
to see where numbers sit, you 
know, I actually take some pride 
in the fact we were achieving 
that goal we set early on in the 
process.
That goal is we're managing this 
pandemic in our County.
Yes, we have cases.
Yes it's awful that they're 
found and that people are 
quarantined and that it's being 
handled.
The difference when you look at 
our neighbors, I compare us to 
them because we have 
inter-connectivity in Montana.
We are very mobile society, 
whether you go fish on the 
bighorn or you go billings to 
grocery shopping or you go 
woodBINE camping.
When you look at Yellowstone 
County, 650-plus cases.
And since its inception, some of 
those active cases right now, 32 
deaths, you look at bighorn 
County with over 500 cases and 
deaths that are involved.
Stillwater County, they have 
smaller number of cases but they 
have a death involved related to 
Covid.
We're sitting with 12 active 
cases in Carbon County where 
public health has identified 
those involved and the persons 
related to the active cases have 
been quarantined and/or 
isolated.
It's not good being any of those 
things, it's not fun, it's 
awful.
At the end of the day we're 
sitting in a pretty good place.
Not in an awful place.
But this is being managed by our 
public health facilities within 
our County, within the confines 
of our borders.
Given the number of people that 
are up here in Red Lodge on the 
weekends, I'm sure those of you 
around to see that recognize you 
have a lot of people here.
Our main street is full pretty 
much every weekend starting on 
Thursday through Sunday.
A lot of the events and some of 
the things in Bridger and Joliet 
are kind of carrying on.
There's still a high volume of 
traffic, all things being equal 
our population, we're managing.
We're doing all right.
That doesn't -- that's not to 
say we're out of woods.
Schools are trying to start up.
Extra curricular activities are 
kicking off, trying to get a way 
to get kids back in school so 
that things work out all right.
It will be more trial and error.
We have good neighbors, we have 
a good community, counting on 
everybody to take that personal 
responsibility making the right 
decisions at the right time for 
the right reasons.
So there's going to be more 
challenges ahead.
This hasn't gone away yet.
If you're doing those right 
things at the right time for the 
right reasons and making those 
best decisions for you and your 
family I feel -- strongly feel 
this will get mitigated sooner 
and faster.
We can try and have a sports 
season.
We can try and have extra 
curricular activities and 
schools can open up, stay open, 
and get kids back to learning.
It's not great but all things 
being equal, I think that we're 
doing all right.
Patience, again, wearing a mask, 
I hate it, I get claustrophobic, 
I feel like I'm suffocating, I 
don't like it.
I go place, go into the gas 
station I put it on.
If I go to a restaurant, I 
follow what has to be done 
there.
It's an ask of that business, I 
don't have to like it, I just 
got to get by it.
That's kind of my approach to 
it.
Dr. George, do you want to start 
talking about a little bit of 
school, some of the plans you 
have looked at?
>> GEORGE: Yeah.
Before I do that, just -- echo 
what Bill says.
I do think we're doing good.
And we are in a very vulnerable 
position here.
Because of our tourist town, Red 
Lodge, also because how close we 
are, especially other parts of 
the County, how close we are to 
Yellowstone County.
This has a lot of infections.
So it's really remarkable that 
we hit this kind of linear 
growth that we thought we would 
have.
We're managing it well.
Why are we doing fairly well?
It's lot of different reasons.
We have really a crackerjack 
public health team there, so on 
contact tracing, isolating, 
notifying contacts, managing 
quarantines.
They look at data coming in late 
into the night because a lot of 
times these numbers trickle in 
after dinner.
And then just -- they don't wait 
until morning to call people.
That makes a big difference.
One of the most important tools 
we have to suppress this and 
make it manageable, is our 
contact tracing.
We have very conscientious, 
passionate staff with Roberta 
and Sheila kind of leading in 
effort.
The other reason we're doing 
well is I do think especially 
the service industry folks 
downtown and some of the larger 
places like Red Lodge, I think 
most people are noticing where 
they are in space, how close 
they are to people.
Most people are wearing masks, 
most businesses are wearing 
masks and requiring people to 
have masks on.
We're getting less and less 
complaints through our complaint 
process.
And I think all of that really 
makes a difference.
The hygiene makes a difference.
I'm proud of kind of, like Bill 
said, how we've done so far.
It seems like every season has 
its challenges.
CDC used the word grim 
expectation when is they think 
about flu season, cold season 
coming up in the late fall and 
winter.
Doesn't necessarily have to be 
that way.
But definitely as colds and flus 
and school, starting, more 
people together inside that 
will -- more people will be 
challenged.
But we'll make it through.
I wrote a piece this week, how 
we're doing, highlighting a new 
tool that we have, Amy can you 
put that up?
This is our County risk map.
Every County in the United 
States has an up to date 7-day 
rolling average of how many new 
cases are diagnosed -- I'm 
sorry, new cases are made per 
100,000 people.
Obviously we only have 10,000 
people here.
But it gives it a way to compare 
County-to-County and 
state-to-state.
We can compare ourselves to 
Syracuse or anywhere else.
It assigns a color to that.
We are color yellow right now.
Daily new cases per 100,000 is 
5.3.
They're saying in the last seven 
days on average we have not 
quite one case per day.
I think that's probably right.
We have had a couple -- three 
days where we didn't get any 
cases in because of a backlog of 
tests.
Again this is like that 
positivity rate.
You need to look at it, few 
times a week, get trends of 
numbers.
We were at orange level last 
week and I was kind of panicked 
about that.
These colors coordinate, I mean 
relate to the work it takes in 
order to not really impact your 
community as far as 
hospitalizations, front line 
workers, economies.
When you get up to that red 
level almost all of these 
counties in the red level, 
economies can't be open because 
they're just digging themselves 
out of a hole and their 
hospitals are full.
That's just important to realize 
that and keep an eye on that.
This is one thing that we use to 
answer the question how are we 
doing.
We have positivity rate, things 
that Bill talked about as far as 
how is our vulnerable population 
doing.
We looked to see whether we have 
had super-spreader events.
It's a nuanced answer to the 
question how we're doing.
But that's an important question 
for the public, as you make your 
choice, your choice whether to 
go out to dinner, go downtown, 
to have friends over, to get in 
vehicles with people.
If we're at that green level, 
New York city believe it or not, 
they hardly have any new cases.
They do 30,000 tests a day and I 
think they have less than five 
new case as day.
It's unbelievable.
But they can be more free, they 
can have less anxiety and their 
economies can start picking up.
Many places in the world that 
things are back to normal.
United States, we're still 
struggling here, eight months 
into this.
And a lot of theorys on why.
I've come to believe, tried to 
ignore this kind of 
politicalization of this.
That's one of the main reasons 
we're just stuck, and wallowing 
in all of these cases and 
stressed hospitals and economies 
that haven't opened.
There is a lot of pseudo science 
and conspiracy theories.
I do think it's really affecting 
how people behave in these 
pockets.
And that overall infection rate 
and overall infect us not just 
getting back to normal sooner.
Try to keep that in mind.
I want to talk a little bit 
about kids and Covid.
There's been like I said new 
data.
Kids are not immune from getting 
this disease.
Children can get Covid-19.
Most of the time their symptoms 
either don't have symptoms or 
they have mild symptoms.
So I'd like to talk about 
hospitalizations a little bit, 
when some one is ill.
A lot of people are going to get 
this and they're not going to be 
ill, that's not what we should 
be focusing on.
We should be focusing how 
affected are you from this 
infection.
So the ages 5 through 17 is the 
lowest rate of hospitalizations 
in our country.
We look at per 100,000 people.
8 per 100,000 people who are -- 
who go to the hospital are 
children.
This is compared to 136 per 
100,000 adults that go to the 
hospital.
The rate, if you get Covid-19 
and you're an adult that's 
listening to this, depending on 
your age all comers, it's about 
6% of people end up in the 
hospital with this.
Now as we collect more and more 
data that is becoming more 
accurate.
If you're over 65, 13% of people 
end up in the hospital.
As you get to about 75 or 80 
that number climbs drastically 
from there.
If you go to the hospital about 
one out of three of us will end 
up in the intensive care unit.
That number unfortunately is 
true for children who go to the 
hospital and adults.
But children will get, even the 
hospitalized children, the 
mortality rate is much, much 
better than it is for adults.
And most of them, majority of 
them do not become intubated.
If you look at -- to break down 
a little bit more of that 8 per 
100,000 people, children, that 
will go to the hospital with 
this, 24 out of 100,000 is less 
than two years old.
It seems that two years old and 
younger get a little more sick 
than older children do.
For example, 5 to 17 years old, 
that number changes from 6 to 
100,000 people, children will 
get -- go to the hospital.
I hope I'm making this clear, 
Amy.
A lot of numbers here, I 
apologize for that.
I was looking at influenza, as 
kids go back to school and I 
think teachers have a lot of 
anxiety and parents do, too, how 
does this relate to a regular 
flu season.
We all assume that some kids are 
going to get the flu and miss 
ten days of school.
Well the data we have now, this 
8 over 100,000, for influenza 
season it's in the 20s.
21 to 24 in the last flu season 
of influenza in children will 
end up hospitalized for that.
It kind of puts things in 
perspective, it truly does seem 
to be that kids have more mild 
illness, a lot of them don't 
have illnesses, that issue of 
transmission, can kids spread 
this infection.
We know they can, but how much 
do they spread it?
Do they spread it as much as 
adults spread it?
Those answers aren't there yet.
And even though these are up to 
date numbers, these numbers come 
from summer school stuff that 
happened, camps other countries, 
and now schools just starting in 
the last few weeks is where the 
data came from.
As everybody kind of starts 
school and all these kids are 
together, these numbers are 
going to change some.
I imagine they are going to 
rise.
But I think the truth of the 
fact that kids really don't get 
too ill from this, the majority 
of them, and it's a really 
exception to the rule.
End up in the hospital is going 
to end up being true at the end 
of the day.
We do have to have humility in 
the data because this is an 
evolving situation.
Okay, I guess one last thing 
I'll talk about before we open 
it up to questions, is testing.
As I said earlier, that is one 
of our tools.
What are our tools to keep this 
infection that we have to live 
with, which Bill talked about?
Our tools are distancing, 
wearing our masks, hand hygiene, 
avoiding large events is a 
really big deal.
If you cannot avoid a large 
event, wedding, those things, 
please quarantine yourself 
afterwards.
Have that event contain itself 
with new infections.
Chances are any large event over 
50 people in Carbon County are 
going to have a fair number of 
people carrying Covid with them 
actively.
And if you can just quarantine 
yourself afterward it will be a 
lot less of a problem.
So another tool that we have 
besides those is testing, 
tracing, and quarantine.
Unfortunately, our County, our 
state, like United States, is 
doing less testing the last few 
weeks.
So we heard about -- we hear 
about on the TV and news, we 
want more testing, we want more 
testing, better turnaround 
times.
As people are becoming more 
savvy, they're getting fatigue 
from this, people aren't going 
to get tested.
They're frustrated about the 
turnaround time in testing and 
they're frustrated what 
potentially may happen in you're 
positive.
You may lose more work and you 
can't afford to lose work now.
But I tell you, this is one of 
our most important tools here.
It is a sacrifice to go get a 
test at times.
Our quality of test is improving 
significantly.
Hopefully by the end of this 
week we will have. 
24-hour turnaround tests at 
Beartooth hospital from Monday 
to Thursday.
24 hour turnaround.
They don't run on it Saturday 
and Sunday.
If get tested on Friday it would 
be a delay.
The other are mountain view and 
Riverstone clinics, they have a 
little bit different process, 
but I think their turnaround 
times are 2 to 3 days.
We're encouraging them while we 
have this system at Beartooth to 
send people to the hospital 
especially the ones they need to 
get the test back right away.
Please, please, get tested for 
mild symptoms.
During school, we are going to 
be testing anybody with cold 
symptoms, fevers, headache, G.I. 
symptoms, diarrhea, nausea, 
vomiting, those are the things 
kids will show up with.
All of them need to be tested 
and we'll need quick turnaround 
times to be tested to have less 
disruption for 9 school year.
The other thing that people 
aren't doing recently is they're 
not paying attention to 
quarantine.
People, we tell them please stay 
home, you have Covid, you are a 
close contact, probably have 
Covid, waiting for the test 
results.
Please stay home.
People are not staying home.
They're just going out and 
infecting other people.
I don't understand that 
mentality.
But it's there.
You know, just if we can all do 
what we can do to remind these 
folks to please stay home, not 
come to, would, not come to 
school, we're all going to be 
better off.
>> BULLOCK: Just a quick 
correction before we go into 
other questions, the County dash 
word from this morning was a 
little inaccurate.
Did clarify with public health 
there are six active cases in 
Red Lodge district, three in the 
Joliet district, and three in 
the Bridger district bringing 
our County updated total to 12, 
not the 46 that was listed 
inaccurately.
It's been more current.
That is a correction.
If you want to move on to 
questions.
>> GEORGE: Sure.
Do we have any questions?
>> Lots of questions.
Start at the beginning.
So regarding testing what is 
your opinion on the reliability 
of the Covid tests being given?
>> GEORGE: The one we're using 
now, that's a change of game, is 
very reliable, very low false 
negative rates.
If it's negative you probably a 
negative.
Very low false positivity rates.
It's sensitive and it's 
accurate.
Doesn't miss too many people and 
it's accurate.
When a test misses people that 
are truly positive it's usually 
because they're very early in 
the disease and don't have a 
good viral role to be captured 
by the test.
We're really trying to stay away 
from some of the machines and 
the processes that are not very 
accurate.
It frustrates everybody.
>> Can you clarify that testing 
at the hospital is for 
symptomatic people only. 
>> GEORGE: Sure, sure.
Unfortunately Montana at this 
time, I'm sure this will change, 
there isn't a way for people 
without symptoms to get tested.
We get a lot of calls that 
people want to travel to Alaska, 
travel to a state that requires 
a Covid test within 72 hours.
Unfortunately, the process for 
that is handled by the state and 
the turnaround time is 5 to 10 
days.
Just because of the -- they 
don't have the testing capacity.
You would think eight months 
later we would, but we don't.
I refer a lot of those folks, 
people without symptoms, go to 
Wyoming, cody or Powell, they're 
doing a small number of tests, 
25 a day I think, in a short 
amount of time between 8:00 and 
8:30 presently.
So do your homework, call these 
places, hospitals in cody and 
Powell, ask if they're still 
doing tests without symptoms.
There is a way to get those 
tests.
But not in Montana at this time.
>> Is there a charge for 
testing?
>> GEORGE: So there is no charge 
for testing.
If you're evaluated by a 
provider, because they're 
concerned of your symptoms that 
you're showing up with, there 
will be a regular office visit.
As far as the testing itself, 
especially with the tests we're 
doing now in Beartooth, they're 
all done by the state and that 
is a paid service.
>> Why doesn't Beartooth 
hospital have the capacity to 
process the tests in-house?
>> GEORGE: We have a machine, 
we've ordered it, it was an 8 to 
10 week wait for the machine 
itself, we're looking forward to 
getting that, it's an excellent 
machine.
It helps sort out influenza and 
other viruss besides Covid-19.
We're looking forward to that 
arriving.
But as you might know, the 
problem isn't just the machine 
it's the reagents and the 
supplies.
The supply chain is difficult.
We're hoping that we get the 
machine soon, hoping we have the 
supplies and the reagents to run 
it.
>> Has Beartooth hospital 
increased capacity and staff in 
general related to Covid?
>> GEORGE: Yes.
So our hospital has done an 
excellent job, especially early 
on in the spring when we didn't 
really know, all of us didn't 
know what the impact would be 
and how quickly we would feel 
the impact.
All kinds of what's called surge 
capacity changes.
How can we turn this area of the 
hospital into a Covid area.
Can we decrease the load of 
patients coming in.
How can we change our outpatient 
management.
All that much work is done and 
written down and waiting at the 
hospital if we need it.
Including personnel.
>> That's also happened at the 
billings hospital. 
>> GEORGE: Absolutely.
>> Who decides what students get 
tested, in school.
>> GEORGE: So, our public health 
department has handed out to 
every -- of the seven school 
districts, they have all 
incorporated into the reopening 
plans, our process for who gets 
tested, when they get tested, 
what happens after they get 
tested, and then we'll also be 
doing contact tracing with the 
help of the school for 
positive -- people who are 
positive.
It's a public health, I guess, 
our part of that -- part of the 
reopening plan is public health 
plan is the testing part.
For staff and students.
>> What happens to those kids 
until a test result comes back?
>> GEORGE: So hopefully we'll 
get test results within 24 
hours.
Anybody with Covid-like symptoms 
and there's 11 symptoms believe 
it or not and they're asked to 
leave school or not to come to 
school they need to have a 
negative test before they come 
back to school.
If someone shows up with a 
symptom in school, there will 
be -- parents will be called.
There's a lot of other details 
that happen in between of where 
they go in the school and who's 
with them, won't go into the 
details.
But they're sent back home.
We tell them to please get a 
test before you go home or we 
tell them to see a provider, 
we're concerned about symptoms.
And then that person, that 
student will be waiting for a 
test result before they come 
back.
>> Will all kids showing a 
symptom in school be tested? 
>> GEORGE: Yes.
>> Thank you.
Clarification around the testing 
cost.
Apparently Beartooth billings 
clinic website lists a price of 
$119.
My understanding is that is 
covered by insurance.
Is the office visit also 
covered, and what about people 
that are uninsured?
>> GEORGE: I don't think the 
office visit is covered.
I don't think -- first off the 
office visit, like any -- if you 
have insurance, the office visit 
pertaining to anything.
Covid office visit is the same 
coverage as any other illness.
I hope I'm correct about this.
I know that the test itself, if 
insurance pays for the test they 
will accept insurance payment.
But if insurance doesn't pay or 
if they don't have insurance 
there's no charge for that, 
there's no charge for that test.
I know the hospital here, I 
can't speak for the other 
clinics, but the hospital here 
has a really good system to sit 
down with people and work on 
payments, those things for folks 
without insurance as far as the 
office visit is concerned.
>> Will the students that get 
tested, will they be charged for 
the test. 
>> GEORGE: They shouldn't be.
>> And if students are wearing a 
mask in class, around another 
student that potentially tests 
positive, will that impact 
whether those students need to 
be quarantined. 
>> GEORGE: At this time 
unfortunately not.
Initially, apologize if that 
information got into the 
community, having a mask on or 
off does not change your close 
contact status.
That is based totally on 
distance.
Less than six feet, for over 15 
consecutive minutes.
Whether both of you, the person 
is infected and you as a close 
contact have mask on or not, 
doesn't change that status as a 
close contact.
What it does do, however, it's 
pretty -- no one really refutes 
this at this time, who looks at 
the data which is very easily 
found on the CDC, you can google 
evidence for mask, it decreases 
transmission rate.
We're hoping with the governor's 
mandate and me signing on to 
this mandate of masks being used 
in schools, mandated, we're 
hoping that transmission rate 
will be low enough so less 
people need testing, less people 
in quarantine, less close 
contact, less disruption of 
school.
>> We have a lot have questions.
Trying to find the next one.
The question had to do with the 
kids are wearing masks at 
school, the parents and fans at 
games will wear masks as well, 
it has been stated numerous 
times that wearing masks also 
helps stop the spread.
If an asymptomatic person is 
wearing a mask then everyone 
should be safe, right?
Masks are worn for the mask 
wearer to protect them around, 
correct?
This has to do also with the 
idea of having people watching 
sporting events.
>> GEORGE: Yes.
So mask are what's called a 
source control.
So it controls the source.
Controls you from spreading it 
to other people.
It also protects you somewhat 
wearing a mask.
But I think people think about 
that more than they do the fact 
that they're not spreading it as 
much.
Will some one be safe with a 
mass okay?
You have to remember that masks 
are not 100% effective.
So really it changes the 
transmission rate in the 
community.
It's still possible to get 
infections when two people have 
masks.
It's really important to respect 
that distance which we know is 
the most effective way to 
decrease transmission.
As far as sports plans, I think 
specifically we're asking that, 
I have to look in the details 
Red Lodge sports plan, we're 
still waiting for some of the 
school districts to give us 
their extra curricular and their 
fans, spectator plans for this.
But I would imagine that I know 
from Red Lodge's plan, and I 
believe Bridger and I might be 
wrong with that, all fans are 
required to wear masks.
And all students that are not 
actively participating will be 
required to wear masks.
It's very difficult outside or 
inside to kind of stay six feet 
away from some one in that kind 
of environment.
Getting up, getting 
refreshments, walking back and 
forth, leaving for a game, 
coming back, all of that.
>> With regards to masks, in a 
business that deals with the 
public are employees supposed to 
wear masks all.
Time or only when customers are 
in the business?
Additionally, if employees 
cannot maintain social 
distancing in the absence of 
customers, should they be 
wearing masks all the time 
especially in business where 
food preparation and service is 
happening. 
>> GEORGE: That's difficult.
>> BULLOCK: Bill, maybe I'll 
give you a break.
You're getting a lot of this.
>> GEORGE: Sure.
>> BULLOCK: I equate this to 
some of our practices.
It's impossible to equate and 
come up with an answer for every 
single scenario.
If you have employees, if you 
get a business, there's a public 
display area, there's a private 
stock area, those persons in the 
private stock area could be in a 
less ventilated portion of the 
building, stocking, stacking, 
inventorying, receiving 
whatever.
If they're not facing the 
public, not interacting with the 
public.
Technically does it make sense 
for them to wear a mask, I don't 
think so.
I mean if you're segregated from 
the public and in a place that 
isn't public facing, is it 
essential to wear a mask.
>> GEORGE: Well, I agree with 
you, Bill.
If those two employees, say in a 
stock room and they spend all 
day in the stock room together, 
and even travel to work 
together, like a family unit 
almost.
If that's the time when they're 
just alone in an area they want 
to take a break, because we all 
need to take some breaks for 
this otherwise nobody will wear 
them.
I can see.
What the mandate says, and what 
we have signed on, is any public 
space, any space that public can 
walk in to, at all times, a mask 
is to be worn by the public and 
any employee working.
You have to use common sense.
Like Bill is saying.
If you are alone in a building, 
you haven't had a customer in a 
few hours, should you have a 
mass okay in that building, the 
idea of being -- can't you 
create aerosol in the air, and 
then some one eventually walks 
in, because you didn't have that 
mask on that person will become 
infected.
Theoretically can it happen, 
yes.
But we haven't seen much 
evidence of small aerosolization 
causing infection after a period 
of time in a closed indoor 
space.
We know some of it happens.
And the other problem most of 
the mask are not stopping 
aerosolization, they're stopping 
large droplets.
Aerosolization is going to 
happen anyway, masks seem to be 
effective, aerosolization isn't 
a huge cause of infections, it's 
more large droplets.
I think Bill is right.
Use your common sense.
But really, buy in to the fact 
that these are effective, they 
need to be worn most of the 
time, our kids need to have them 
on, in order for the school and 
teachers, and you're protecting 
other people.
It's a great tool.
Don't be caught up in some of 
the politicalization of mask, I 
still don't understand how it 
happened, or some people start 
with politicalization, and then 
go to masks are unhealthy and 
they'll make me or my child 
sick.
There's no evidence of that.
Can you find some one who gives 
evidence?
Sure, you can find anything.
As far as consensus of opinion, 
that masks don't make people 
ill.
Thanks, Bill.
>> With regards to some of the 
businesses that are putting up 
plexiglass, if there plexiglass 
do people need to continue to 
wear a masks or is the 
plexiglass enough?
>> GEORGE: So that's kind of, 
like common sense much it's like 
Bill was talking about.
Six feet is better than five 
feet but sometimes you can't be 
six feet.
Five feet is better than three 
feet.
A mask with Plexiglass is better 
than plexiglass alone.
But plexiglass alone, a big 
shield, is certainly better than 
not having anything in front.
There are some people that just 
cannot wear masks.
It causes anxiety, panic, they 
have underlying severe asthma.
So we're meeting those folks 
half way to at least use either 
a face shield or plexiglass when 
they're interacting at a 
distance from customers for a 
short amount of time.
We're doing that knowing that 
still we're getting that 
efficacy of being careful and 
lower transmission in the 
community.
>> Okay.
We do have one person that said 
that the school boards have 
stated that they cannot force a 
Covid test for students.
>> GEORGE: Correct.
You can't force anyone to have a 
test.
We have written in our 
guidelines what happens if you 
don't agree to a test, I believe 
it's 14 days quarantine is the 
maximum quarantine time.
>> With regards to businesses, 
how many businesses have been 
contacted for continuing to 
serve customers who are not 
wearing masks?
>> BULLOCK: I think that the 
count right now was, of those 
individuals, individual 
businesses that have brought 
forth complaints, there's been I 
think seven as of Wednesday.
The goal being public health is 
going to try and work with them 
to get everybody educated and 
try to get it resolved.
That's where it sits.
>> Can you speak a little bit 
more about that process, for the 
enforcement.
>> BULLOCK: There was one 
question that I had come in 
through an e-mail regarding, 
there was a publicized list of 
businesses that do or do not 
enforce mask mandates.
You know everything is being 
brought forward, if somebody is 
going to bring this forward, it 
can't be just anonymous call.
Whoever brings it forward has to 
sign their name, follow it 
through, through the entire 
process.
Then make it known that that's 
what they are complaining about.
Unfounded, random phone calls 
saying fix this, do this, or do 
this, are not going to be 
responded to.
It has to be initiated by a 
signed complaint.
And as I said, talking with 
public health yesterday, there 
was a total of seven since the 
15th of July.
>> Okay.
Question about Dr. George before 
you said that the numbers of 
positives, of active cases 
should be multiplied by ten.
Can you let us know more about 
why that multiplication factor 
is ten, what is the evidence to 
back that up?
>> GEORGE: I'm not sure.
It came from the CDC.
I think, I really don't know how 
they came upon that.
Certain sources that I just kind 
of hang my hat on.
I know they're not political, 
they're run by a bunch of 
scientists, university data, and 
that's one of them.
Is it possible that that is off, 
sure.
Is it possible that it's 20 
times or five times, yes.
I think the point being when you 
see, you shouldn't think in a 
County, there's four positive 
cases therefore there's just 
four people that are actively 
have Covid.
That doesn't make any common 
sense.
A lot of people don't get 
tested.
One of the problems with this 
virus is there's so many folks, 
we don't know why, that have 
just mild symptoms.
And spread it.
Those folks are not going for 
testing.
Unfortunately.
>> Okay.
If a test is given on day three, 
after being exposed, is that 
person considered safe to be 
around or should the test take 
place closer to the 14 days?
>> GEORGE: That's a very good 
question.
Many tests, if some one is a 
designated close contact, a lot 
of folks think they're exposed 
or from our definition of what a 
close contact is they're not 
exposed.
If some one is a true close 
contact, and they're advised to 
have that test right away, 
that's Montana's recommendation 
at the department of health and 
human services, that's where the 
state has fallen on that.
Other states say wait for five 
days for that person to be 
tested because we're going to 
get increased sensitivity.
Montana suggests that we're 
testing right away.
What we have seen in Carbon 
County many of those close 
contacts get tested negative 
right away, they still have to 
have a 14-day quarantine if 
you're a designated close 
contact.
It does bear out.
Oftentimes day six, day nine, 
days 11 they become ill.
And even in we'll test them 
again at that time and they're 
positive.
Then from then we can go to 
their close contacts.
That's why there's that 14-day 
quarantine period.
Even if you test negative as a 
close contact.
>> Do the business owners that 
are turned in via the complaint 
system, or that enforcement 
system, do they get to know who 
filed the complaint against 
them. 
>> BULLOCK: They will, yes.
>> GEORGE: I'm going to say 
something about enforcement.
Having mandates, you know, which 
is a shame that we need to do 
that, without some type of way 
to show the public that we're 
enforcing this and trying to 
create this atmosphere doesn't 
make sense.
I am proud of the process that 
we have put in for this.
Education is always the first 
line.
The person who's doing it, in 
charge of enforcement, is doing 
lots of education.
Going to a place saying this is 
how you're risking our 
community, these are the tools 
you can use to keep transmission 
down and help your employees and 
your patrons be more safe.
Through our folks there's a few 
players in the County that just 
don't believe.
They don't believe in the number 
of 170,000 deaths in our 
country, they don't believe that 
conservative states all across 
the country in the south and in 
the west have closed their 
economy because of the stress 
they're feeling from the actual 
virus, they don't believe any of 
that.
And they are going to dig their 
heels in.
They are not going to follow 
public health recommendations to 
keep our County and our 
community safe.
They are the folks that we want 
to know about.
We do.
We want to know about this.
They need more education or a 
higher level of enforcement with 
fines if needed.
We're not really interested, if 
some one sees somebody without a 
mask, of one employee in a 
business that overall is doing a 
good job and they understand the 
nature of this pandemic and the 
problems we're in.
We are interested in these 
businesses that are in denial 
that this is even a problem in 
our country and our community.
You agree, Bill?
>> BULLOCK: Well, I just, the 
inverse of that, though, there 
is a certain segment that feel 
that you should be masked from 
the time you are conscious in 
the morning and wake up to the 
time you go to Beth whether 
you're by yourself, in a group, 
otherwise walking down the 
street.
Here is the reality of it.
The way this was set up, there 
was a tremendous pressure put on 
our 911 dispatch center, 
sheriff's office, and the 
expectation.
This is a portion of this whole 
Covid-19 response.
We didn't have the sheriff's 
line talking about problems or 
issues with a mask.
That's why it was diversified, 
put into a different phone 
number, a different process, and 
everything with it.
There is still a Constitution, 
everybody is aware of that, that 
you're innocent until proven 
guilty and there has to be a 
complainant, an aggrieved party, 
a violator. 
That's how it is addressed.
Random anonymous complaints 
saying you need to do something 
about so and so because I said 
so, a signed complaint, 
following through the process is 
what is necessary.
>> When this all started, we 
shut down, gave us time to make 
sure we had the resources to 
deal with the virus.
It's been five months since we 
started this.
Everything I hear is that we 
have the resources to deal with 
this.
Why do you keep adding more 
restrictions to what we can do 
and how long are we going to 
quote unquote flattening the 
curve.
This is a virus that is not 
going anywhere.
>> GEORGE: Really good question.
Because in that early phase we 
were in what's called a 
containment phase.
We stopped, closed our borders, 
we closed every business that 
was defined as nonessential.
We could debate on what is 
essential and nonessential.
We had a much less aggressive 
closedown of our communities 
than they did in Europe for 
example or New Zealand.
They truly closed down.
Just left a few different 
business types and only certain 
people from the house could 
leave the house at a time.
Much more aggressive.
They drove numbers down very, 
very low.
In our country, with our, quote, 
springtime containment phase 
when this first came out, some 
areas of the country drove the 
numbers down low and some of 
them didn't drive them down low 
enough.
When our economies opened again, 
which we are in that phase now, 
it's that back to normal but we 
have open economies, it doesn't 
look normal.
But we do.
Now communities and states who 
weren't ready for that phase are 
suffering.
And especially hospitalizations, 
their nursing home rates of 
death, and that's causing more 
shutdown in these areas.
So if the question is now that 
we have flattened the curve 
can't we go back to normal, 
that's been tried and that's 
continuing to be tried in areas 
of our country.
We look that direction and we 
say what is happening, what is 
happening in your city, what's 
happening in your small 
community.
It's not good if we let the 
floodgates open.
That's the herd immunity 
approach, can't we all just get 
this.
The nature of this virus, it 
spreads so fast and there's so 
many people that don't know they 
have symptoms which causes that 
rapid spread, and the Lee that 
the, how many people are 
hospitalized is so great that 
communities get overwhelmed.
That's just the nature have this 
infection.
It's not like all other viral 
infections.
Most people who are apolitical 
who do this for a living who 
work on other pandemics think 
there would be millions of 
people dying in the United 
States similar to the panic flu 
epidemic, if we let the virus 
run its course.
That's the answer to that 
question.
>> Okay, just a couple more 
questions because we're coming 
up on an hour and then we need 
to answer questions offline.
What increases in mental health 
services are provided, how are 
we taking care of the whole 
person?
>> BULLOCK: Mental health is 
still an issue.
There's been a slight uptick 
talking with mental health in 
the County.
I can't legally speak to that, 
there is a bit of a rise but it 
doesn't seem to be 
astronomically noticeable.
If that makes sense. 
>> GEORGE: Let me answer this, 
the question was about mental 
health.
Doesn't lockdowns, which we're 
not really in that phase but 
back in the spring when people 
were told to shutter at home, 
there's parts of the country 
that people are told to do that 
because they're not doing well.
But in our area that isn't 
happening.
During that time, there's a 
question of increasing abuse, 
increasing violence, depression, 
suicide rate.
All of those things are probably 
true.
What we don't have is how much 
did it happen.
We don't have numbers on too 
much.
We have focused numbers in 
certain cities of increasing 
calls to help lines, suicide 
lines, those things.
Anything we do to slow the 
spread of this is going to have 
a negative effect on the other 
side.
The question is how bad is that 
negative affect and is it worth 
the lifesaving on the other 
side.
That can be debated.
As a public health officer, 
looking at the effects of this 
virus, how tragic it is, for 
families, dying alone, the 
amount of people that are ill, 
the overwhelming 
hospitalizations, that to me 
needs to be addressed.
Then on the other end we have to 
do more work to make sure 
people's mental health and 
safety is taken care of because 
their lives are different.
In our school systems, one thing 
that is required for every one 
of our schools, in our state, 
especially Carbon County, our 
schools need to have a plan for 
mental health of their students 
and staff.
There's a lot of anxiety walking 
around with masks, a lot of 
anxiety about whether people are 
going to become ill, their 
lives, it's an age group of 
children and teenagers that have 
a high suicide rate and high 
depression rate.
Every school we're making sure 
they're addressing what extra 
are you doing to help kids' 
mental health.
>> Next question was who all is 
on the health committee, and I 
assume that's the County health 
board.
Are they appointed, and do they 
sign of a on all submitted 
plans, school events, et cetera.
Or I will it just you, 
Dr. George.
>> GEORGE: You want me to answer 
that?
>> BULLOCK: I can answer to the 
consistent sieve the County 
board of health, County board of 
health consists of the three 
commissioners, of which we have 
two of three right now.
Dick Nolan, citizen member.
Becky Frank, veterinarian from 
Joliet.
And public health officer Bill 
George.
That's the consistency of the 
board of health. 
>> GEORGE: Is that the board of 
health.
We also have an incident 
management team that is dealing 
with this incident.
Amy is our public information 
officer, we have a team of how 
large is the incident management 
team?
About 7 or 8.
>> Ten or more.
>> GEORGE: Ten or more.
There's people skilled with 
technology, skilled with 
communications, myself on the 
medical side of things, our two 
public health nurses, are 
also -- as far as signing off, I 
weigh in on everything on the 
medical side.
We have a team that is kind of a 
school team from our two public 
health nurses, myself, and Jason 
Mahoney, how would you describe 
Jason in. 
>> He's an independent 
contractor contracted from 
billings clinic can his own 
firm. 
>> GEORGE: Experienced with 
other services. 
>> He's former law enforcement 
from Yellowstone County, EMT, 
worked for an ambulance service 
in billings, expansive knowledge 
base of emergency medical 
technician aspects and law 
enforcement.
>> GEORGE: We have a great team 
and I look at the plans for the 
schools and we do seen off on 
all plans.
>> Okay, we are at an hour.
There are a few more questions.
I'll try to deem with them 
offline.
Because I know we have people 
that need to go.
>> I do think I should weigh in 
on one thing that I have lots of 
questions.
Yellowstone County recently has 
had a no fan policy for their 
season of sports in the fall.
?
That is where they're starting, 
for all size schools.
That no fans are allowed at all.
They're getting a lot of 
pushback.
We have not settled in on that 
approach.
We have, we're smaller schools, 
we have some good facilities, 
and we think it can be done 
safely.
So there's a certain number of 
household numbers that will 
allowed to attend games.
So there's a lot of anxiety that 
we are going to also create a no 
fan policy.
At this time we are not.
This is a pretty fluid 
situation.
None of us really know what 
happening up schools is going to 
do as far as transmission rate 
in the communities.
No one knows yet.
We're starting with limited fans 
at sporting events.
Both volleyball, football.
>> Okay.
So we appreciate everybody 
getting in here.
I know there are a lot of 
questions about school.
And as you mentioned, you have 
plans from most of the County 
schools.
And they include information 
about how public health will 
interface.
Some of the questions people may 
have will be there.
I'll try to update those links 
to those plans on our website, 
carbonalert.org.
So you can find all of that 
information.
Of course you can still submit 
questions to us, via e-mail.
>> GEORGE: I have one more thing 
to say about schools, I think is 
important.
One thing that we are going to 
do right off the bat is keep 
data on what is happening in the 
schools as far as Covid-19.
We're going to have all seven 
school districts, all of the 
schools involved in the 
districts, how people a 
infected, how many students and 
staff are infected, how many 
close contact, how many 
quarantines happen.
Try to get an idea of what the 
effect of this virus has on the 
operations of school, how 
disruptive it is, how the 
schools' plans for mitigation, 
how effective they are.
We're going to have that data 
ongoing.
That's what we're going to use 
with Superintendents and the 
principals and help to adapt 
their environment to create a 
safer environment.
Our priority as public health, 
our Superintendent's priority is 
the safety of the students and 
safety of our staff.
As well as keeping our 
community's transmission 
manageable.
>> Okay.
We will continue with periodic 
updates, potentially every two 
weeks or as needed, and we will 
advertise it on Facebook and 
Instagram and our usual chance.
Thanks.






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