Nearly 40% of the known COVID-19 cases in Montana are in Gallatin County, a scenario shaped first by the area’s allure for those inclined to travel and then by the virus’ spread within the community.
Montanans are used to seeing Bozeman and the surrounding areas highlighted on maps of fast-growing places or rapidly rising home prices, but now the narrow sliver in south-central Montana glows as an orange-red hotspot on the state’s website tracking the outbreak.
By Thursday evening, the county reported 93 cases of COVID-19, the disease caused by the coronavirus, out of 241 total statewide. The next-closest county, Yellowstone, has 45% more residents than Bozeman, but less than half the number of cases, at 35.
Matt Kelley, the health officer for the Gallatin County Heath Department, said last week the community’s “character and nature” are the tangibles reflected in those numbers.
"Gallatin County is a crossroads and a destination," Kelley said. "We're home to a diverse economy, a growing university, we have natural beauty and attractions. … And while some of those factors are probably also contributing to the number of cases we have, I think it's also important that we recognize that those factors provide enormous sources of talent and energy and community assets to help us respond collectively to this challenge."
Across the West, COVID-19 has struck places popular with newer residents to states and tourists, like Blaine County, Idaho, home to the resort town of Sun Valley. That community has more cases per capita than Italy or New York City, the Idaho Statesman reported Thursday.
About 34% of Gallatin County's residents were born in Montana, according to an analysis by the Montana Free Press. Many were drawn there by a booming tech industry. Others with the financial flexibility to pick where they lived decided to call the place home, making it one of the wealthiest counties in the state. Those factors mean Gallatin County residents are inclined to be mobile and can afford to travel, things that played into the virus’ arrival there.
In a press conference last week broadcast over the county health department's Facebook page, Kelley answered several questions all trying to get at “why Gallatin County?” without directly dipping into the “us-versus-them” undercurrent that so often steers conversations about Bozeman and Big Sky.
Instead, in his straightforward and clear manner that's drawn thousands of viewers to each of his appearances, Kelley painted the county as a cohesive community and not a mix of locals and outsiders.
“I think it’s important that we consider those factors as we think about the epidemiology of the disease,” Kelley said. “We shouldn’t be in denial about that, but we also have to be realistic that that’s who we are as a county. And we do have to deal with that, and there’s also some assets that come with that and some strengths that come with that.”
A week ago, Kelley said though it was a rough estimate, about half the county’s cases could be tied back to travel outside Montana, either nationally or internationally. On March 22, Gallatin County was the first in the state to say it had community spread of the virus, though now that’s the case in Missoula, Yellowstone and Lewis and Clark counties too.
The Bozeman Yellowstone International Airport, which is actually in Belgrade, has worked hard to become the hub for air travel in the state, and data from the Department of Transportation shows 39% of the people who got off a plane so far this year in Montana did so there.
While that might make it seem obvious that Gallatin County would be hit hard by COVID-19, Stacey Anderson, the lead epidemiologist in the Communicable Disease Epidemiology section of the state health department, said that wasn't necessarily a foregone conclusion.
“Some of it is a bit of bad luck. You’re going to have the opportunity for that in one of those locations, but that doesn’t mean that’s where it’s going to land,” Anderson said last week. “Someone just as easily could be traveling from an area of ongoing transmission who is returning to rural Montana and maybe has not a lot of symptoms but has the potential to pass it to people within that community just as easily as it would be if somebody landed in some of these resort towns.”
Jim Murphy, the chief of the Communicable Disease Control Bureau at the state health department, said focusing just on positive COVID-19 cases doesn’t tell the whole story of the virus’ effect on a community.
Statewide five people had died from the coronavirus, none in Gallatin County, and 24 have been hospitalized. Gallatin saw its first two hospitalizations Thursday, the county health department reported.
The county is younger, with an average age of about 33, and age is one of the risk factors associated with severe outcomes for COVID-19 patients. In Gallatin County, 77% of the cases are under the age of 60, a group generally thought of as less at-risk because of age.
“All those things have to be taken into account when you look at the severity in the community,” Murphy said. “It’s not just a numbers game; it has to be looked at a little more closely than that.”
To Kelley’s point that Gallatin County can’t ignore the good that comes along with wealthy residents, Bozeman Health, which operates the hospitals in Bozeman and Big Sky, is in a financial position to accelerate a construction project that will nearly double its bed capacity. And financial donors in Big Sky have backed an expansion plan that would double the emergency department and inpatient bed capacity there too.
Bozeman Deaconess will also soon have equipment to test people for COVID-19 on-site, with a turnaround time of less than an hour, the Bozeman Daily Chronicle reported.
Gallatin County took steps to shut down businesses where people congregate, like bars and gyms, before Gov. Steve Bullock issued a statewide directive doing the same. And now Montana is under a statewide stay-at-home order, a measure Bullock acknowledged was extreme but necessary to slow the spread of the virus and save lives. The governor has also ordered those traveling into the state to self-quarantine for two weeks.
Asked if there were things Gallatin County could have done earlier, given the high number of travelers there, Kelley said he thought the right steps were taken at the right time.
“I never thought that as health officer in Gallatin County that I would be writing a letter asking the superintendent of Yellowstone Park to shut down. And I never thought I would have the superintendent of Yellowstone Park be receptive and cooperative to that request. ... We’re doing everything we can think of to slow down that movement, but we also have to be realistic. We are people living in the world and people are going to move around and people have come here, and we have to recognize that and make the best of it.”