Nine months into the pandemic that has killed more than 320,000 people in the U.S., Kim Larson is still trying to convince others in northern Montana that COVID-19 is dangerous.
As director of the Hill County Health Department and county health officer, Larson is hearing people say the coronavirus is just a serious case of the flu. Around the time the Montana governor announced a front cover in July, her employees saw calls tapped in the windows of several businesses spouting the state’s right to issue such emergency orders.
For a while, the county with a population of 16,000 near the Canadian border saw little evidence of the pandemic. He had only one known COVID case until July. But that changed as the country moved into the third outbreak of the virus this fall. By mid-December, Hill County had recorded more than 1,500 cases – mostly since Oct. 1 – and 33 people there had died.
When Larson hears people saying that pandemic safety rules should end, she talks about the infectiousness of the COVID virus, how some people are affected and how hospitals are overcrowded. and that care for any illness could delay them.
“In public health, we’ve seen the battle before, but it’s usually your time to pick up your evidence, research shows that this really saves lives,” Larson said. “In the midst of a pandemic, you don’t have time.”
Public health laws usually come long after the shift of social norms, reinforcing the widespread acceptance that a change in public good practices is worthwhile and that it is time for stragglers to fall accordingly. But even when decades of evidence show that the rule can save lives – such as wearing seatbelts or not smoking indoors – the debate continues in some respects. places with the familiar argument that public restrictions violate personal freedom. But this rapid pandemic is not giving society a good time. State orders have made local officials responsible for changing behavior while a common understanding is captured.
Earlier this month, U.S. Physician General Jerome Adams stood by the governor of Montana in Helena and said he hopes people will wear masks because that’s the right thing to do – especially as COVID hospitals rise.
“You don’t want to be the reason a working woman can’t get a hospital bed,” Adams said, adding a vaccine along the way. “It’s just for a little longer.”
He spoke days after state lawyers went against masks when most Republican lawyers came to a naked committee meeting and at least one person was touched by false information about the dangers posed. was in a mask. On Dec. 15, the Republican majority had not requested masks for the upcoming legislative session, which was due to begin on Jan. 4.
And now an anti-mask group from the Gallatin and Flathead counties has filed a lawsuit urging a Montana judge to suspend safety rules related to the state’s pandemic.
Public health laws usually provoke political fighting. It’s hard to change people’s habits, said Lindsay Wiley, director of the health law and policy program at the American University in Washington, DC Despite the misconception that there was a universal purchase for masks at the time of a pandemic. 1918 release, Wiley said, was deliberately picked up by some rap activists. sheets of arrest for going without a mask in the name of freedom.
She said health officials understand that any health restrictions among a pandemic require the trust and cooperation of the public for success.
“We don’t have enough police to walk around and make everyone wear a mask,” she said. “And I’m not sure we want them to do it.”
Local officials have the best chance of winning over that support, Wiley said. And seeing elected leaders like President Donald Trump get over his own federal health guidelines makes it harder. At the same time, a public outcry such as calling people not to register themselves rude or silly can go back, Wiley said, because if they introduced mask clothing, they would necessarily take to these leaflets.
In the history of public health laws, even rules that had taken time to gain widely accepted evidence did not guarantee support.
It is illegal in Montana to go without a seatbelt in a moving car. However, as in 13 other states, authorities are not allowed to pull people over for unrestricted access. Every few years, a Montana lawyer, backed by a gathering of public health and law enforcement agencies, proposes a law to stop seat belt traffic, arguing that it would save lives. In 2019, that request did not even out of committee, overwhelmed by the arguments about personal choice and not giving too much power to the government.
Key points of challenge against public health laws – whether it’s masks, seat belts, motorcycle helmets or smoking – can be similar.
When Missoula County became the first place in Montana to ban indoor smoking in public places in 1999, opponents said the change would destroy industries, it would be impossible imposing and breaking people ‘s freedom of choice.
“They are the same arguments in many ways,” said Ellen Leahy, director of the Missoula City Department of Health. “Public health was right at that intersection between what is good for the community as a whole and the rights and responsibilities of the individual.”
Montana banned indoor smoking in 2005, but many bars and pubs were given until 2009 to fall in line with. And, in some places, court debate and fights continued for a further ten years as to how the ban could be enforced.
Among the COVID pandemic, Missoula County was once again ahead of much of the state when it passed on its own mask prescription. There are two hospitals and a university in the county that reduce the population with students and travelers.
“If you have to see to believe it, you’re probably going to see the effects of a pandemic first in a city,” Leahy said.
Compliance has not been perfect and she said the need for strict enforcement has been limited. In early December, out of more than 1,500 complaints that followed Missoula’s health department since July, it issued closure notices to four businesses that enforced the rules.
In Hill County, when the health department receives complaints that a business is violating pandemic prescriptions, two part-time health professionals, who conduct health checks on businesses, speak to the health service. property about why the rules exist and how they can live by them. It often works. At other times the objections will continue to come.
County attorney Karen Alley said local health officials had reached out to her office with complaints of non-compliance about COVID safety measures, but she did not see enough evidence to prosecute a civil case. industry. Unlike other health laws, she said, mask rules do not yet have case studies to offer a framework for their enforcement through Montana courts. (A handful of cases against businesses following COVID rules were still in play since mid-December.)
“Someone has to be a test case, but you never want to be a test case,” said Alley, who is part of a team of three. “There’s a lot of resources, a lot of time.”
Larson, with the Hill County Department of Health, said she remains focused on winning across the community. And she’s excited about some progress. The city’s annual live scene, which usually draws crowds with hot cocoa, turned into a driving event this year.
She does not expect everyone to follow the rules – that is never true in public health. But Larson hopes people will do enough to slow down the virus. That could be the case. By mid-December, the number of daily active cases in the county was declining for the first time since its spike began in October.
“You’ll just try to find out the best way for your community and get the input,” Larson said. “Because we need the community’s help to stop it.”
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