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‘Boxing it in’ brings challenges
Crowding, misinformation and asymptomatic spread challenge efforts to contain COVID-19
In this file photo from a recent summer, friends enjoy a tubing trip on the Sugar River. (Times photo: Marissa Weiher)

GREEN COUNTY — The first weekend in June was perfect for floating down the Sugar River on a tube: sunny, calm, temps in the 80s.

After months cooped up during “Safer at Home” orders and a long, chilly spring, thousands of people converged on the river and in the village of Albany, a main access point, to go tubing under the blue sky.

Few took the advice of infectious disease experts to stay six feet apart or wear masks.

“There were so many people in Albany, so many people. And there was no social distancing at all, at all,” said Kari Hoesly, director of Albany EMS.

It caught the attention of the Albany police chief, Robert Ritter.

“People were shoulder to shoulder waiting for their tubes,” Ritter said. Already in June, the river is seeing typical July levels of tubers. “It’s way more people coming right now than it’s ever been.”

People are flocking to the Sugar River from outside the county and as far away as Chicago, Ritter noted. With unemployment rates at an estimated 20% in Illinois and close to that in Wisconsin and many recreation activities canceled, people have time on their hands and are willing to travel longer distances.

“It’s definitely a concern because the virus is out there,” he said.

He approached the county with his concerns, but beyond recommending the usual distancing and hygiene guidelines from federal and local health officials, “it didn’t seem like there was a whole lot we could do.”

Green County Sheriff Jeff Skatrud said that, overall, locals have done a good job of taking health precautions to avoid mingling in large groups.

“The tubers have not done a good job. I saw it myself. ... You could just about walk across the river on tubes,” he said.

But, he added “that’s beyond our control.”

“The concern exists greatly, but the tools for doing anything about it are not there. ... There is no order in place so it’s just guidance right now. So people have to either follow it or not follow it,” Skatrud said. In the meantime, the department will “do the best we can until the weather gets cold again.”

‘Like the Wild Wild West’

The situation highlights one of the current challenges of slowing the spread of the COVID-19 pandemic, three months after Green County reported its first confirmed case and one month after the state Supreme Court blocked Wisconsin’s “Safer at Home” extension. A replacement order at the county level was lifted after officials concluded it could not be uniformly enforced due to variances in zoning code.

Without a state or county public health order in place, and a patchwork across the country of local decisions on which businesses are open and activities are happening, everyone is left to figure it out on their own.

RoAnn Warden, director of Green County Public Health, said she’s encouraged Albany officials to address the issue at their village level. She worries about the risks that crowds of people not only put on each other but on first responders.

Eileen Althaus, a village board trustee, said crowding on the Sugar River is an issue the board has discussed but ultimately, it’s a county issue.

“We do need to continue addressing it,” she said, noting that S&B Tubing, the tube rental business in Albany, is doing everything they can to take safety precautions.

“S&B does a very good job of trying to separate people as they’re checking people in,” she said. “They’re doing what they can.”

If the crowding gets “out of hand,” the village could shut down the village-owned access ramp to the river. But the village can only control what happens within the village, not businesses, people and river access points outside village limits, Althaus said.

Hoesly said ambulance calls for people out tubing haven’t yet gone up this summer. Even that first weekend of June, when the river was “stacked full of people,” Albany EMS had only one call, for an intoxicated person.

“With what I saw visually, I am very shocked that we only had one river run,” she said. “We’re going to start gearing up for every weekend. ... I know we’re going to stock up with our PPE (personal protective equipment).”

The situation is frustrating for Jenny Bryant, owner of S&B Tubing. She said the business has hand sanitizer everywhere, has all windows open on the shuttle bus and fans going to keep air circulating. She has face masks for her staff and is encouraging customers to wear masks in the “inevitably close quarters” of the shuttle bus. In addition, her staff is checking in groups in the office one at a time.

Beyond those precautions, however, she said she’s not sure what to do and wishes she had more guidance.

“Nobody wants to give you any rules,” she said. With several lawsuits pending against county and state officials claiming the “Safer at Home” orders were unconstitutional, “they’re afraid to tell us what to do.”

“It’s like the Wild Wild West. ... I went from quarantined for two and a half months, and all the sudden it’s like that never happened,” she said. “Green County is just open, you can do whatever you want.”

As for what people do outside the business, “I can’t be out there patrolling the river. ... I can’t follow everyone around (saying) ‘Six feet apart!’ I’m doing all I can do, for what I can control.”

It is in situations like this — and with other summertime recreational activities like municipal pool reopenings — that a public health order would be helpful to get everyone in sync, Warden said.

But, “the pressure to open is really great.”

‘Boxing in’ the virus

There is one rule public officials do have the authority to enforce, under state law: an isolation order for anyone who has a communicable disease but refuses to isolate themselves.

Warden has issued one such isolation order. It was for a Monroe resident who tested positive for COVID-19 but was still seen “out and about” despite being told to quarantine, she said.

Capt. Jerry Dahlen of the Monroe Police Department said officers served the order on June 4. It’s the first enforcement of an isolation order he can recall in his 35 years with the department.

Ideally, the goal is for people to voluntarily stay home when sick and voluntarily follow health guidelines. As some activities resume and Wisconsin businesses continue reopening in the wake of the “Safer at Home” order, Green County Public Health is focused on tracking cases of COVID-19 and checking in daily with those who are sick or test positive for the disease.

Vicki Evenson, a public health nurse, said most people “really do appreciate the nurses calling.” Evenson is the former director of the county health department and retired in 2008, but came back to help out with the increased workload related to the new coronavirus pandemic.

“Boxing in” the virus is essential to slowing the spread, especially because even those who don’t yet have symptoms can transmit the virus, she said. That means testing as many people as possible and getting anyone who is sick or who may become sick quarantined as quickly as possible.

Warden explained, “When we were in the ‘Safer at Home’ order, people were in the middle and boxed in. When we switched, when the ‘Safer at Home’ order went away, then the strategy became we need to box the virus in. The way we do that is testing people, isolating people who test positive (and) doing contact tracing of those who are positive.”

“Without any kind of treatment or vaccine, that’s the strategy,” she added.

But nurses are sometimes up against misinformation.

“There’s all sorts of rumors, and people going around bragging they have COVID — and they haven’t even been tested,” Evenson said.

Education is the priority now of the Green County Emergency Operations Center (EOC), a group of local officials and leaders who come together weekly to address the health, social and economic impacts of the pandemic.

One of the challenges is how much we simply don’t know about the new coronavirus, said Mike Sanders, EOC public information officer. For example, epidemiologists anticipate the virus will peak again in the fall, but no one knows when, where and by how much.

“People are working very hard planning but there are also unknowns,” he said. “People will have a lot of good information — a year from now.”

What we do know is that physical distancing, handwashing and masks are currently backed by evidence as the best ways to slow the spread of the virus, he said.

These recommendations are for everyone, not just the vulnerable, Warden said.

“The elderly who are more at risk — are we just going to make them stay home and isolate themselves until (there’s a vaccine)? Is that really health equity?”

Public health is about more than what’s good for the individual, she added: “It’s (what’s) good for my community, my family, my friends and neighbors.”

Sanders said he’s noticed people tend to dismiss COVID-19 deaths in individuals who had underlying conditions.

“There is a tendency in people’s heads to think, ‘Well, that’s someone who is very sick already,’” he said. But underlying conditions — also called comorbidities — include common conditions like high blood pressure, obesity, asthma and diabetes that don’t typically on their own cause death.

“Technically I have an underlying condition. I have slightly elevated blood pressure,” Sanders said, adding that most Americans over the age of 50 have conditions that make them more vulnerable to COVID-19.

Three months in

Green County counted its first confirmed case of COVID-19 on March 20. Since then, 77 additional residents have tested positive as of June 18. Of these, one person died, 70 have recovered and none are hospitalized. There are seven active cases.

A recent uptick in Lafayette County has grown the number of active cases to 24. Of the 52 positive cases of COVID-19 identified since April 6 in Lafayette County, 28 have recovered as of June 19.

"Some cases have been identified via our contact tracing," said Elizabeth Townsend, director of the Lafayette County Health Department. "We know that this virus is very contagious and that some people carrying the virus may be asymptomatic, therefore it can be challenging to determine the source of exposure."

Townsend said her department "continues to highly recommend" following state and federal guidelines and "to social distance as much as possible."

Since March, both Green County Public Health and the Lafayette County Health Department have increased communications with the public. Green County Public Health has dramatically increased the amount of information available on its website related to the coronavirus, including guidance for businesses, an “Employer Toolkit” with ready-to-use posters and graphics and a “dashboard” where the latest numbers, charts, maps and other data are updated daily

Across the country, jails and prisons have been hotspots for COVID-19 outbreaks. So far, the Green County Jail has been spared. As a precaution back in March, the jail population was brought down considerably as courts postponed most hearings and sentences were furloughed or deferred.

The average daily population in the jail was 16 in May, compared to 45 in May 2019, Skatrud said. The jail’s maximum capacity is 68, although it rarely gets that high even under normal circumstances.

Now, the courts — and the jail population — are returning, slowly. Huber work release is reopening July 6. Any person coming into the jail as an inmate must still quarantine for 14 days, either alone or with other new inmates.

“We’re still very, very wary of (COVID-19) ... We’re crossing our fingers, knocking on wood and taking every precaution we can,” Skatrud said. One “blessing in disguise” of having a low jail population for several months is that the jail staff was able to do maintenance projects that had been put off for 15 years. The Huber dorm is repainted and “spruced up.”

This story has been updated from the print version with additional information.