While the rest of the state reopens and Missoula remains closed, local health officials and epidemiologists are urging patience and caution, saying the virus remains in the community and could surge again.

Missoula has recorded 41 cases so far, and they've been evenly split between males and females, according to epidemiologists at the University of Montana. Cough and shortness of breath have been reported as the most common symptoms in Missoula throughout the pandemic.

Dr. Ethan Walker with the School of Public Health and Community Health Sciences said the bulk of the local cases were confirmed toward the end of March and included a lag period, meaning they likely contracted the virus earlier.

Eight of the local cases were considered community spread.

“It's an important reason to remain cautious in your social interactions,” Walker said Thursday. “As time progresses, we might to see more confirmed cases.”

Broken down by age, Walker said most of the cases in Missoula County have occurred in the 20-29 age group, followed by 30-39. The fewest cases were reported in those aged 70-79.

Over half those infected in Missoula County contacted 5 or fewer people, making it easier for health officials to conduct contact tracing. As the economy slowly reopens, contact tracing and testing will be key to keeping the virus at bay, they said.

“It's important because public health officials have to do contact tracing, where they follow up with individuals who may have been exposed and assess their potential for becoming infected,” said Walker. “When there are few contacts by each case, it puts less of a burden on public health officials. It decreases the potential for the virus to spread.”

Health officials in early April reported signs of community spread in Missoula, and Walker confirmed those suspicions. Testing has been limited throughout the pandemic, and health officials believe there are more cases than were confirmed.

As the restrictions are eased and people get back to business, it's possible the virus will resurface.

“Although things are opening up and we're beginning a phased lifting of the restrictions, it doesn't mean COVID is gone from the community,” Walker said. “We've already seen community spread within Missoula and cases from unknown sources. Young age groups are contracting and potentially spreading COVID, and testing to this point has been limited, so there are likely more cases than have been confirmed at this point.”

That's part of what has local health officials concerned. Most other counties in Montana have followed Gov. Steve Bullock's plans for a phased reopening, though Missoula has not and remains closed.

Ellen Leahy, the local health officer, said the health department is fully staffed to conduct contact tracing and has gathered more testing supplies. But she has reservations about the weeks ahead.

“Would we be able to keep up if a number of cases came in and they happen to have a large number of contacts?” she said. “I can't say we would, but we are planning for that type of surge if we need it. But you can't contact trace someone until you have a case, and you don't have a case until you have a test. The testing part of that entire response is still the weakest link.”

Health officials realize that local residents are going elsewhere for business, as most counties have begun to reopen. They're also aware that residents from other counties, including those that have taken fewer precautions, are coming to Missoula.

“It's definitely something we think about,” said Leahy. “The virus has spread the globe and doesn't recognize political boundaries. But one of our incident objectives is to protect our healthcare hub.”

To date, Montana has reported 453 confirmed cases of COVID-19 and 16 deaths. Yellowstone County has reported 80 cases and Gallatin County, initially considered the state's hot spot, has reported 146 cases.

Still, both counties have moved to a phased reopening.

“I think every large county has a different set of circumstances,” said Leahy. “Part of it is science and part of it isn't. At the time of the reopen, we had nine active cases and (Bozeman) only one. Second guessing that is really not helpful.”

Missoula City Council President Bryan von Lossberg urged caution as Missoula does move toward a phased reopening, which is expected to begin next week, though that remains subject to change.

“We're not out of this – we're not at the other end of this by a long shot,” he said. “There's still a risk, but we want the sacrifices people have made to matter as we move forward. We've had community spread, and we want to keep additional cases to a minimum as we open back up.”

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