Jackson, Wyo. • Since early March the county’s top health official has been begging the state to support his restrictions to curb the spread of coronavirus in Teton County.
Emails obtained by the News&Guide through the Wyoming Public Records Act show a back and forth that became heated as Teton District Health Officer Dr. Travis Riddell pushed state officials to allow him to enact a stay-at-home order. Riddell initially sought the state's blessing for a stay-at-home order narrowly tailored to just the most vulnerable people — seniors and those with underlying medical conditions. But Senior Assistant Attorney General Jackson Engels fought back. Jackson Hole, he wrote, was not as unique as Riddell's order suggested.
"Other counties attract out of staters too — Park, Albany, Sheridan to name a few," Engels wrote. "I don't think Teton County's geographic spot (even with its out-of-state travelers) is enough to justify this order."
While stating "support" for county-level orders, Gov. Mark Gordon has avoided imposing a statewide stay-at-home order, leaving Wyoming as one of eight states without such a decree. On March 30 Gordon seemed to chide Teton County's efforts when he said a "more advanced" statewide shutdown would not be papered with "exemptions."
The emails, however, show Riddell chasing the orders because he believed other communities with more quickly imposed stay-at-home orders were effectively slowing the spread of COVID-19. He was, in part, basing the county's virus-related rules on those decrees, which also had exemptions, the Jackson Hole News & Guide reported.
"Emerging evidence from other communities suggests that community-wide stay-at-home orders, when implemented early in the outbreak, are effective at slowing spread," Riddell wrote, mentioning California and New York. On March 19, when California declared its stay-at-home order, it reported 331 new cases. A day later, when New York announced its decree, it reported 3,819. California is now reporting 22,348 cases. New York is reporting over 195,000 with a population half the size of California's.
Riddell, State Health Officer Alexia Harrist and state attorneys disagreed over the best way to enact such an order. As Riddell pushed for more stringent restrictions sooner, Harrist often pushed back, looking to use the minimum steps required to protect public health.
Riddell said their differences were "more a question of degree than two different philosophies."
"It's not like one is protecting public health and one is protecting the economy," he said. "It's not a question of one or the other. It's a question of finding the right balance to minimize the amount of death and despair."
A dogged approach
Riddell first notified Harrist on March 17 that he would consider a shelter-in-place order, saying that would happen when "we have local sustained community spread."
As he drafted the order Riddell kept Harrist apprised of its intent.
"A draft is on my desktop," Riddell wrote March 22. "If our current strategy is not slowing spread quickly enough we will be prepared to act quickly. In the meantime, I propose we move to protect the most vulnerable."
Harrist did not think the order was "necessary" because community spread had not been found outside of Fremont County.
Riddell acted on his promise on March 23, two days before community spread was confirmed in Teton County, with the order requiring vulnerable populations to stay home, visitors to leave and locals returning from travel to self-quarantine upon arrival.
On March 25, the day community spread was confirmed, Riddell followed up with Harrist, citing concerns about St. John's Health's limited ability to transfer patients as reason for the order.
"My hospital CEO just got off a call with the University of Utah health system," Riddell wrote. "They are at capacity and are no longer taking any transfers, regardless of medical indication. This means that all the hospitals in western Wyoming are on their own not only for COVID-19 ARDS cases, but also MI, CVA, and any other sort of critical illness. Can we revisit signing the proposed Teton County Order #3 I sent you last week?"
Harrist responded, "Given that this would be a big step, I'll need some time to go over the order in detail with the (attorney general) and make a careful determination."
The next day Senior Assistant Attorney General Jackson Engels emailed and said Harrist was not willing to authorize the order.
"I realize this is not what you wanted to hear," Engels wrote.
The state's reasons varied, motivating Riddell to offer a "point-by-point rebuttal" of the explanation.
Still, Riddell pared the order "way down" the next day at the state's suggestion and sent it again. On March 28 he did more, removing language from the order about ski areas and national parks.
"This order has been necessary from a public health standpoint since I began drafting it seven days ago, since we sent it to you five days ago, over the course of the many edits we have made at your request," Riddell wrote on March 28. "During that time, cases of COVID-19 in Teton County have increased by 600% and therefore I most certainly continue to feel it is necessary now."
The state signed the order that day, after five days of negotiations.
"It was the first shelter-in-place order we had looked at, and we wanted to make sure we got it right," Harrist told the News&Guide on Monday. "I totally understand his frustration. I just think taking some time to make sure we did exactly that — protect public health and only limit people's movements as much as we needed to — was important."
Dr. Riddell and the state have largely disagreed over business closures. While Riddell called for shutting things down, citing workplace clusters in Teton County, Harrist pushed back.
The goal, in her mind, is to "protect public health" but reduce the impacts of doing so.
"The types of orders that limit people's movement are very serious," Harrist said. "We want to write them in ways that protect public health but do the minimum necessary to protect public health."
From the beginning the state has emerged on top in many of those arguments.
In mid-March Riddell exempted businesses from the county's first health order, 20-1, which limited gatherings to 50 people, at Harrist's request. Riddell later told his statewide counterpart he thought that business exemption was a "gaping loophole." The exemption stayed in.
Two weeks on, Riddell and Engels sparred over which businesses — if any — to close while debating order 20-4, the only countywide health order that's still in effect.
Rather than working with the order Riddell had provided March 28, a copy of Jackson's municipal stay-at-home ordinance, the state had responded with an order of its own. The document was silent on business regulations, effectively deferring to statewide orders.
Riddell had insisted that local rules were necessary, but ultimately accepted the state's proposal, calling it a "compromise."
"The state was not ready to take that step to close more businesses other than those that have been closed by the state's previous orders," he said in an interview with the News&Guide after the order was signed. "It's a different approach. I feel like it's not quite as tight an approach, but it was what the state was willing to do, so here we are."
One of the reasons Riddell issued so many orders in Teton County was because, in some ways, he felt he had to get out in front of the state.
"As a county we felt a need to step in where the state hasn't and what we've seen is that we make orders and, at least until recently, the state has sort of followed behind us," Riddell said after order 20-4 was signed. "Whether that will be the pattern for this most recent order remains to be seen."
Gov. Gordon has not implemented a statewide stay-at-home order.
But in other cases, the state took action after Riddell did so or suggested doing so.
In one case, emails show, Harrist told Riddell the state had used one of Teton County's orders as a "template for other counties."
"Thanks for that," she wrote.
In response, Riddell let Harrist know that he'd received a lot of questions about "hairdressers, salons, beauticians, massage, etc." He suggested a step "between where we are now and a full-on shelter-in- place order" as "something for other businesses."
Six days later, on March 24, the governor issued an order closing "non-essential personal services" like hair and nail salons, massage parlors, and tattoo parlors.
Riddell has not, however, gained traction on a statewide stay-at-home order. In one email he offered to speak with the governor about doing so. The state didn't take him up on his offer.
Gordon has maintained that a statewide stay-at-home order isn't necessary.
"We're seeing a decrease in activity, we're seeing people socially distance," Gordon said April 8. He noted that he was trying to stop visitors traveling from Colorado to Wyoming.
"We're doing everything we can to make sure that Wyoming is taking all the precautions that it can to make sure that our population is safe and that we don't exceed our medical resources," he said.
Restrictions finally imposed
A statewide order requiring visitors to self-quarantine upon arrival was issued April 3, about a week after Riddell ended up having to issue visitor restrictions for Teton County through a non-enforceable recommendation rather than a legally binding order.
“I think Wyoming’s orders are far less aggressive than what’s happening in the rest of the country,” Riddell said. “Wyoming has a couple specific business closure orders and specific social gathering prohibitions, but it does not have anything more specific than that.”