Being a female firefighter is not necessarily easy, but Lea Bossler was blazing her career path.
“You have to work really hard to make it a livelihood that's not just seasonal employment here and there,” Bossler said in a recent interview. “I’d gotten to that point, pretty much.”
Advancing toward being an incident commander type 5, which means a position doing fire management, Bossler was also in line to be put into a crew boss class and start helicopter training. Those are all certificates that open the door to better jobs and a career in fire, rather than being a seasonal tool swinger.
“I had gotten to that point and then found out I was pregnant and COVID happened. I don’t want to blame it on COVID or being pregnant, but it’s just one of those life circumstances that made my trajectory impossible,” Bossler, 30, of Missoula, said.
Bossler got COVID-19 in July 2020. About the same time she became pregnant. She delivered a baby girl in January extremely premature.
Like many Montanans, Bossler’s life was abruptly and dramatically pushed off course, with all the subtlety of a semi crashing into a sedan, by the pandemic that’s gripped the world for a year.
Since the first four in-state cases were reported March 13, 2020, more than 101,726 Montanans have been sickened with the virus. That’s over 9% of the state’s population.
Nearly 1,400 have died. That number is made up disproportionately of Native Americans (17% of deaths), the elderly (the median age of death is 79) and those in long-term care facilities and assisted living facilities (nearly 35% of deaths).
“The easy part of my year was not dying from COVID,” Bossler said.
It was impossible to forecast, even for those in charge, that the coronavirus would rise to become what one public health official said was the third-leading cause of death in Montana for 2020, only behind cancer and cardiovascular disease.
“Nobody knew what (COVID) was going to mean,” said retired Maj. Gen. Matt Quinn, the executive director of the state’s COVID-19 task force since the beginning. “We knew we had to do preparations, but we didn’t know how big this was going to get. The federal messaging was ‘this isn’t going to be much, we’re keeping it off the shores.’ And then the governor declared the state of emergency March 12.”
In a hastily-called press conference that day, former Democratic Gov. Steve Bullock said he was putting the state on “the highest alert.” It was time to prepare for what lay ahead, he said.
“Now is the time to continue to plan, not panic, just like we do with any challenging situation when it hits our communities,” Bullock said then. “We stick together, we make sure that we mitigate the impact.”
From mid-March on, the state faced challenges getting enough supplies, from personal protective equipment to keep health workers and the public safe to sufficient testing media and laboratory capacity.
Back then masks weren’t for sale in every hardware store and gas station. Grocery store shelves emptied with items Montanans had never previously thought to hoard. Hospitals ran short on gowns, gloves and really just about anything scooped up by larger medical facilities on the coasts already being battered by the virus.
“We started working supplies hard,” Quinn said, recalling that the situation was “just a bugger.”
Most of the general population had never heard of N95 masks, and then everyone wanted one. Existing supply chains weren’t going to work, Bullock said during an interview last week.
“Two things became apparent: first it was clear that our hospitals and frontline workers weren’t getting the supplies they needed and second that, from the beginning, the federal administration said this would be a locally executed, state-managed and federally supported public health emergency, and the federal support wasn’t there,” Bullock said.
“We didn’t really have any understanding or expectation of what this might become, but we knew we had to start building the plane while it was taking off.”
A donation of 50,000 N95 masks from North Dakota in March “got us over a pretty big hurdle,” Quinn said.
Bullock reached out to other governors to see if they had potential leads, knowing a mask that used to cost 90 cents might now go for $4, but that was the price to pay to protect health care workers. The state would think it had secured supplies and then get out-bid.
“I’m telling you, it was just every day trying to see where we could get enough supplies for the hospitals, the nursing homes, to be able to safely take care of those patients,” Quinn said.
One of those facilities was in Toole County, the site of one of the state’s first major outbreaks at the Marias Heritage Center assisted-living facility and Marias Medical Center. The state stood up the National Guard, one of many times that would happen.
“We traveled up to Marias Heritage and walked along the outside and waved and spoke to the residents inside and it truly was a recognition that not only is there a health risk to those individuals but once they go into isolation in the facility, there’s certainly a price to be paid for their mental well-being,” Quinn said.
The state went under a stay-at-home order from March 26 to April 27 to help slow the spread of the virus and give Montana time to prepare for the surge that proved to be inevitable.
While Montanans howled for health care workers from their front porches, Quinn and his teams ran down every supply lead they had.
It took months to develop a sufficient supply chain. At one point, Quinn said he took a call from former U.S. Sen. Max Baucus, who was once ambassador to China, with a potential line on supplies. Quinn was calling military suppliers, and at one point a plane was chartered from China. Finally, manufacturers were able to ramp up production.
“It was truly a remarkable effort by some dedicated individuals that got us beyond those initial weeks of ‘Where in the heck are we going to find those supplies’ to where we are now,” Quinn said.
Testing was an equally high stumbling block out of the pandemic gate.
“Initially we even had symptomatic people that were being turned away, so we wanted to overcome that to ensure we were identifying positives early on and give communities the comfort that we could actually get folks tested,” Bullock said.
At the start, the state lab was doing all the testing, what Bullock called a “heroic effort” running seven days a week.
But all the worker power in the state was no match for a bigger problem — supply issues. Again the state relied on the federal supply chain, which faltered.
“It was almost a daily strain to make sure that we had even that base capacity testing of 700-1,000 a day,” Bullock said. There were machines in hospitals around the state that could have helped, but without the supplies they were useless. At one point the state of Montana even bought a 3D printer to start making nasal swabs.
“I go back to the wakeful nights, lying awake saying ‘How in the hell are we going to do testing tomorrow reliant on the supplies that may or may not come in?” Quinn said.
In late April, Bullock set a goal that seemed nearly unattainable at the time: 60,000 tests a month. Contracting with private laboratories helped alleviate the problem, but then the state hit a snag with delayed results from Quest Diagnostics.
“We really did take it on the chin with Quest on unacceptable delays of test results going on 10-14 days. Montanans were right to say ‘What the heck? If I get tested, if I’m potentially positive, by the time I get my test results back, I could have infected everybody,’” Quinn said.
The state canceled that contract and signed one with Mako Medical in North Carolina. Quinn said they've been a good partner ever since.
Over the first half of this month, nearly 57,000 residents had been tested, putting Bullock's once pie-in-the-sky goal in perspective.
Somewhere around the time the state was looking to find a replacement for Quest Diagnostics was when Bossler tested positive for COVID-19.
Two days after she came back from working a fire in Arizona, her boyfriend, Marcus Cahoon, was exposed to the virus. The couple was told to stay home for 14 days to quarantine and Bossler got sick.
“There weren't a whole lot of cases in Montana then and the advice was just to stay home if you’re young and healthy,” Bossler said. “Everything online said it should just be like a bad flu if you’re under 40 and in good shape.”
But that wasn’t how her illness went.
“I got it really bad. I got it to the point where my body would forget to breathe,” Bossler said. “I could breathe fine if I was thinking about every breath consciously, but if I got to a resting point, I would stop breathing. My boyfriend would stay up and watch me sleep because there would be periods where I would stop breathing and he’d have to wake me up and when I’d wake up finally it would feel like I'd been drowning. My body knew it wasn’t getting enough oxygen.”
There were a lot of other symptoms too.
“I had lung and breathing issues, but the weird part is I had a lot of neurological symptoms,” Bossler said. “I got to the point where I couldn't finish a sentence. I’d have a train of thought and by the time I got words out, I would have lost my train of thought.”
Her eyesight also got blurry and it felt like her spine was swelling “from the inside out.” That all came in addition to nerve pain in her fingers and toes, and her right leg went numb.
Bossler said she probably should have gone to the hospital, but she wasn’t sure if she was covered by insurance at the time.
Had Bossler gone for care, she’d have encountered an incredibly stressed state hospital system.
Dr. Shelly Harkins, chief medical officer at St. Peter’s Health in Helena, started her career as an Air Force physician and has worked in hospitals in five different states. Last week she described the pandemic’s effects on her facility for state lawmakers.
“This past year has been the toughest in my career to date,” Harkins said. The hospital called its first COVID-19 Incident Command meeting a year ago, before Lewis and Clark County even had a case of COVID-19.
“In hindsight, we had no idea what was coming,” Harkins said. “Personal protective equipment shortages such that we had to rely on our community members to make masks to protect us. Total cancelations of hundreds of elective surgeries for almost two months and a significant reduction procedures for months ... and reductions in clinic visits.
“(We had) COVID-19 patients beyond capacity and workforce shortages beyond belief and unbridled fear and anxiety unlike we’ve known in health care. It’s really impossible to describe what we've been through.”
A year into the pandemic, Harkins said the hospital still doesn’t know the full impact of COVID-19, but is starting to see the long-term effects on the state’s health care system.
“That’s sicker patients,” Harkins said. “Community members over the course of the past year have been hesitant to seek medical care. Community members have had advanced stages of their chronic illness like we've never seen before. They've had to delay diagnoses that are now much more advanced than had they been diagnosed a year or more earlier. Mental health service needs are higher than they have ever been.”
More than 4,660 Montanans have been hospitalized for COVID-19 over the last year.
It’s likely that Bossler became pregnant during her illness and quarantine in July, though she was using a form or birth control that was 99.8% effective.
And like Harkins described, getting health care was a terrifying prospect for Bossler, like tens of thousands of other Montanans.
“The hardest layer with that was the anxiety of going to a doctor’s appointment, because people go to a medical center when they are sick, so the idea that every time I was going to a doctor’s appointment I was increasing my exposure to potentially get COVID again, because I knew it was possible to get COVID a second time, that was really stressful,” Bossler said.
Plus a pregnancy in a pandemic, with access to friends, family and support networks restricted, was incredibly isolating.
“I literally stopped even seeking any sort of blog or book or audio book resource on pregnancy advice because all of the sudden there was no pregnancy advice that applied to being pregnant in COVID, especially during the time when we peaked,” Bossler said.
There was also the added financial concerns with Bossler being a seasonal employee, whose hours would at some point inevitably run out.
“On top of all that, I still had a lot of symptoms from COVID. I was having a lot of symptoms from being pregnant. I wasn’t sure if I was going to be able to keep working,” Bossler said.
The brain fog and fatigue were the worst. She didn’t get her sense of smell back until recently, but that wasn’t a huge loss since she wasn’t as susceptible to the smoke from the summer fires she rolled on.
Still, she “got lucky” and was switched at the end of fire season to a timber strike team, which gave her an extra few weeks of employment in a position where she could come home every night.
That ran until the end of October, and Bossler worried about going on unemployment too early because her benefits could run out right as she would need them most after giving birth. That was supposed to be early May.
Bossler found a stopgap job on the front desk of a guest ranch, which was low-impact on her body and an easy adjustment even battling the brain fog and fatigue left by COVID.
“My plan was to do that for the remainder of my pregnancy,” Bossler said.
But on Jan. 8, everything changed. Bossler was admitted to the hospital just 23 weeks into her pregnancy. Her daughter Maesyn was born Jan. 19 at 11:48 p.m.
While Bossler went home two days later, Maesyn stayed in the hospital's neonatal intensive care unit, where she is expected to stay for a very long time.
Maesyn was 1 pound, 6 ounces and 12 inches long when she was born. Upon entering the hospital, Bossler and her boyfriend had to have the difficult conversation with a doctor that the baby might not make it. Bossler also tested positive for COVID-19 again upon admittance, though two successive tests were negative.
It’s impossible to tell if the positive was a faulty test or antibodies from her earlier illness. Or she could have had a second infection and didn’t notice.
Even with the lack of clarity, when Bossler gave birth, there were signs of something wrong. The umbilical cord was shredded and the placenta was full of clots. Her symptoms align with the virus, but there's just not good data to explain much of anything yet. Though a year, especially this last one, seems incredibly long, it’s nowhere near enough time for medical research.
“When you look at the anecdotal information out there of what pregnant women who have compilations who have COVID are dealing with, it perfectly matches what I’m going through and what Maesyn is going through,” Bossler said.
Because of Maesyn's situation, Bossler is unable to go back to work. She’d be unable to care for her daughter in the NICU if she was potentially exposed to the virus through a job or other contact. And the risk to other NICU babies is too high.
But Bossler doesn't qualify for unemployment because her job loss isn’t directly tied to the pandemic.
“It’s hard to look at my situation and say that COVID did not have a role in me losing income, because it did. … It’s not tied to something that has data because the data doesn’t exist,” Bossler said.
Without unemployment and the paltry $30 Maesyn gets a month for a presumed disability because of her low birth-weight, Bossler and her boyfriend are stuck on the edge of a financial cliff.
In a press conference Friday, Todd O'Hair, head of the Montana Chamber of Commerce, said the pandemic had been a mixed bag that harmed businesses in the state as employees and customers changed their daily lives.
Though some businesses have closed for good, O'Hair said things were looking hopeful for the summer as businesses share stories of "unprecedented inquiries" into hotel accommodations, fishing guide trips and more.
"There is a high level of what I would consider cautious optimism, a bit of a pent up demand if you will, about the Montana economy," O'Hair said.
More than 125,000 Montanans filed for unemployment since the start of the pandemic, according to a January report from the state Department of Labor and Industry.
Early on, when businesses were shuttered, about 30% of the state’s workforce was able to keep at their jobs while doing their work remotely, according to data from the National Bureau of Economic Research.
About 64% of the state's workforce can't telework, according to DLI. And of those who filed unemployment claims in 2020, 76% couldn't work anywhere else but their job sites.
Women were also hit especially hard by job loss from the pandemic, as they make up a larger portion of fields such as retail trade and leisure and hospitality, among the hardest hit. Because of school and daycare closures, women disproportionately had to leave the labor force and filed more unemployment claims than men.
In 2019, women made up 35% of unemployment claims, but that rose to 47% in 2020. In August and September of 2020, the amount of prime-age women participating in the labor force fell by 1% but went up slightly for men.
The pandemic also shined a light on existing lack of child care options in the state, where capacity only meets about 47% of demand. If that situation doesn't improve, the labor department estimates at least 20,000 Montana parents will be unable to return to work.
There’s no way to know what Maesyn’s needs are going to be in the future, which makes Bossler’s job search more challenging.
“I don’t know if she’s going to be sent home with a breathing tube and an oxygen tank. I don’t know if she’s going to have some other issue that comes up in this developmental time that creates a different disability,” Bossler said.
Some of the options presented to her aren’t safe for Maesyn, and others are frustrating to consider after working so hard to build a career.
“It’s incredibly unfair to women, to moms, because what I’ve found is a lot of people will say you could drive Uber or you could get a part-time job or you could work at a daycare,” Bossler said. “But none of those things are what I’m good at and none of those things fit a career trajectory that fits me. I’m a wildland firefighter. Why is it that I should be something else?”
For now, things are moving in the right direction with Maesyn. She weighs 3 pounds, 2 ounces, and recently stopped needing a type of ventilator she’d been on.
Maesyn is also weaning off a gas used to help the oxygen exchange in her lungs, and she’s eating through a feeding tube. Still, it’s almost two months from what would have been her due date.
As a Montana winter that seemed especially long makes its achingly slow transition into spring and the days incrementally get longer, it increasingly feels like there’s a light at the end of the tunnel when it comes to the coronavirus with the arrival of three vaccines.
"Through it all, we've seen the resiliency of Montanans," Republican Gov. Greg Gianforte said in a press conference last week after acknowledging the death toll and economic effects of the virus. "As has been the case for several weeks, we're making encouraging progress in Montana combating this pandemic. Our trend lines remain promising."
Gianforte pointed to data points like averaging less than 200 cases a day for the fourth straight week. For the first time since July the number of active cases was below 1,000 statewide. Hospitalizations are also at their lowest level since the summer.
Gianforte was sworn into office Jan. 4. Since then, he’s rescinded many of the mandates put in place by former Gov. Bullock, the most high-profile of which was the statewide mask mandate.
Matt Kelley is the public health officer in Gallatin County, one of the first COVID-19 hot spots in Montana and location of the first variant strains of the virus reported in the state earlier this month.
Kelley has expressed concern over the easing of those mandates at the state level, and his community has kept many in place. While he said he understands fatigue over the virus, just because people are exhausted with the pandemic doesn’t mean it’s done.
“I just hope that the public continues to understand that this continues to be a really serious virus,” Kelley said. “While our numbers are better than they were in November, they're still fairly high. We still could have a surge in the spring or early summer. We need to really bear down, use the vaccine that we get in a timely way when we do get it, but continue doing those things that help reduce spread.”
On March 5, the governor’s office tweeted that the number of fully vaccinated people in the state had eclipsed those sickened by the virus. The state's online dashboard, which now reports vaccination data before new cases, shows that 138,042 Montanans had been fully immunized by Saturday, outpacing the state's 101,726 cumulative cases over the last year.
The addition of the Johnson and Johnson vaccine has quickened the pace of getting shots in arms. Families that are vaccinated are cautiously gathering following CDC guidelines.
Gianforte often talks of the day Montanans can “take off their masks and throw them away.” And to him, that day is coming soon through increased vaccinations.
"I encourage Montanans to receive these safe and effective vaccines as soon as their turn comes up," Gianforte said. "Getting a vaccine will help us stop the spread of this virus. Getting one will help us get back to a normal life. And getting one will help us put this public health and economic crisis fully behind us."
Kelley’s eyes are cast toward the summer and the potential it holds for the long-hoped for return to a more normal life. On Thursday, Democratic President Joe Biden said he wants to make the vaccine available to all adults by May. He also anticipated the possibility of a more normal Fourth of July holiday.
“The next 60, 90, 120 days, they’re going to be bumpy. We’re going to continue to have scarcity and we’re going to continue to have competition for vaccines. I think as we move through the summer, there’s going to be more supply and there’s going to be fewer people in need of the vaccine and things are going to even out a bit,” Kelley said.
“We've been through a lot together. We're not done yet. But with this vaccine, with summer coming, with the immunity that we're building naturally, I think we have a reasonable path into a summer that perhaps will be more normal. But if we don't do the things now, if we don't pay the price now, we may not get that dividend in the summer the way we want to.”
But for some, like Bossler, the promise of a vaccine doesn’t mean things will go back to the way they were before.
When Bossler saw news last week that there were thousands of vaccine doses in Missoula County unused and up for grabs, she planned to try to get one.
“Technically we would qualify for the next tier, but at the same time we are physically a part of Maesyn’s care team,” Bossler said. “Maesyn is immunocompromised. She has lung disease. She only weighs 3 pounds.”
Everyone else that works with Maesyn had gotten the vaccine, so also being vaccinated makes sense to Bossler.
“I didn’t push the issue at first because I want the sensitive people to get the vaccine if they can, but if there’s vaccine doses that aren’t being used right now …” Bossler said.
And she is hopeful too about the future, though she’s playing a delicate game of keeping her family afloat financially while keeping her baby safe. And normal looks nothing like it used to.
“This isn’t the first stressful thing I’ve gone through in my life. I’m the kind of person where I don’t take no for an answer. I look at everything like it’s a puzzle and I’m going to find a solution,” Bossler said.