Gov. Mark Gordon has called for an extension of the state’s public health orders as he mulls possible further action to deal with Wyoming’s surging COVID-19 numbers.
He also expressed concern and anger over the state’s deteriorating virus situation and how residents have responded to it.
Without specifying how the state’s public health orders could change in the future, Gordon said the state is considering all options and is “absolutely” going down the road toward more strict health orders if the spike continues.
While he didn’t say those include a statewide mask mandate, Gordon also didn’t rule it out. He also said people not following basic, common sense measures is exacerbating the pandemic in the state.
“We are being knuckleheads about this,” he said.
During a Friday morning press conference, Gordon said that county health officials shared with him that the state is on a rate toward 3,000 new cases per day, 2% of which would be hospitalizations.
“Imagine what that’s going to do to our hospital system,” he said.
Hospitals throughout the state are already reaching capacity. With neighboring states also filling and sending patients to Wyoming, Gordon portrayed a bleak outlook of what the upcoming months may hold.
As of Friday morning, there are 192 patients hospitalized with COVID-19 in Wyoming, according to the Wyoming Department of Health.
Wyoming’s increase in cases has been dramatic. As of Friday morning, the state Department of Health reported 17,442 confirmed cases in the state since the pandemic began, a 924-case increase from the day before. There have been another 3,037 probable cases and of the combined cases, 8,767 are active.
The state’s death toll stood at 127 deaths related to COVID-19 Friday morning.
Gordon also expressed concern for businesses across the state.
“We’ve had more businesses around the state closed because of sick workers then by of any of our health orders,” he said.
Businesses and chambers of commerce will be consulted with when considering further public health orders, Gordon said, emphasizing that all options are being considered at this point.
“As your governor, I’m very concerned at what we do to see businesses survive through this winter,” he said.
Gordon also confirmed that he did not contract COVID-19 after a recent scare that caused him to enter a self-quarantine earlier this month. He used it as an example at the effectiveness of wearing masks and following public health guidelines.
“It’s time that Wyoming woke up and got serious about what it’s doing,” Gordon said.
To live in Wyoming is to face a fundamental existential question: Does the state exist and if not, what does that mean for those who live here?
Much like Shakespeare’s famous rhetorical “to be, or not to be,” residents of an assumed state may exist on an unconscious level. But does that assumption hold when applied to an entire state?
Can we be, but still not be Wyomingites?
Wyoming residents reading a Wyoming newspaper, presumably within the rectangular allotment of land labeled on most maps as “Wyoming,” are likely to believe in their own existence. And to that point, they would probably be right.
But for a growing subset of the internet — comprised of some who live in Wyoming, but mostly those who don’t — the idea that Wyoming doesn’t exist is gaining traction.
The r/Wyomingdoesntexist subreddit on the popular online forum Reddit has boomed over the past few years. Standing at about 24,000 members, it has almost twice as many as the subreddit dedicated to the actual state of Wyoming.
“The argument really is, have you ever met anybody from there? And it being so small, the answer is probably not,” said Wyoming native Dalen Brazelton, 21.
He is one of several moderators of the r/Wyomingdoesntexist subreddit, who basically patrol the message board and make sure users are following the rules.
“I think that’s why it’s so prevalent in the U.S. is that it’s such a big state, but such a small population that it’s really easy to imagine in a far off land there not being anybody there,” he said.
The argument almost becomes metaphysical. There are people who argue strongly for and against the existence of higher powers or religious certainty, but whether or not those beliefs are true, when the argument is broken down to pure reason and language, there are holes to be poked.
Those who conspire about the Cowboy State not existing are the hole-pokers.
Have you ever been to Wyoming?
Do you know anyone from Wyoming?
Then it must not exist.
The glory of the theory is that it can’t be disproved, Brazelton said. There are many Wyomingites or rhetoricians who would argue against the claim, and many “Wyoming doesn’t exist” truthers who would gladly take up the debate.
The theories get zanier the more they are are explored. Some of the popular ones involve the likes of alien cover-ups, residual Cold War one-upmanship and general befuddlement at the absurdity of a state so big, with such a relatively small population, existing.
“This is the only thing that Wyomingites have,” Brazelton said. “We’re not super prevalent in the media for anything else. This is our thing. I know a lot of people from Wyoming are super interested in this idea because it’s finally our chance to be in the spotlight, but I also think it’s just fun for people to be part of a quote-unquote ‘conspiracy theory’ that doesn’t harm anybody.”
Throes of conspiracy
When Wyatt Brisbane, 21, was a high school student growing up in Delaware, or as he calls it, “the other mostly forgotten state,” he and his friends had an epiphany.
“It started off completely away from Reddit,” said Brisbane, another r/Wyomingdoesntexist moderator.
“When I was in high school, me and my friends, we just had a running joke of, ‘Wyoming, it’s not real,” he said. “Lowest in population, last in the alphabet, lowest of all the lists ... it’s not real, it’s all a big conspiracy.’”
After high school, he discovered that he was not alone in his thinking. In a moment that supports the possibility of a collective unconscious, he learned that there were others all around the world who came to the same conclusion.
“It was just our own little inside joke and then it just kind of blew up into I found this whole other community of people who have independently gotten there as well,” Brisbane said.
There are many possibilities as to why those who are drawn to conspiracy theories buy into them.
In an internet era where misinformation can be easily manufactured and spread, new conspiracy theories from innocuous topics such as Wyoming and the JFK assassination to more serious dot-connecting about Jeffrey Epstein’s fate and the possibility of voter fraud have become fairly common.
Sometimes, a conspiracy may be constructed to provide an answer or some sense of closure for something that is unanswerable or unresolved. The Wyoming doesn’t exist theory is much less serious than that.
In the case of Wyoming, there is simply a natural sense of mystery about the state because of how little is known about it from people who live in the other 49 states and beyond, Brazelton said.
“When people are thinking of Wyoming from an outside perspective, it is the most stereotypical answers that you (can) think,” he said, drawing on his years of experience entertaining theories about the state.
“Some people still think that we go to school riding horses and they’re being dead serious. Very empty, very deserty. Lots of cows, which, yeah, given that’s true,” he said. “But it’s just a very stereotypical, almost Wild West feel from people that are out of state looking at the conspiracy stuff.”
Douglas Reitinger is a professor of English and Humanities at Sheridan College who has lived in Wyoming off and on for about 30 years.
“To me, personally, philosophically, it exists in the same way everything exists or doesn’t exist,” he said. “There are some postmodern philosophers who would say it’s all a construct, so there is that line of thinking.”
There are stereotypes and preconceived notions of the West that still persist in parts of the world. Overall, Wyoming does not pop up in the national consciousness very often, Reitinger said. When it does, antiquated and inaccurate ideas of the Wild West are not unheard of.
“They hold in their mind a sort of mythical quality of what Wyoming is,” Reitinger said. “So maybe that’s what it’s making a joke of too.”
Brazelton said most of the people who join the Reddit community and share ideas about what’s really going on in the alleged state of Wyoming are in on the joke.
Still, there are some who sincerely believe the state does not exist.
“It’s usually people from the East Coast or Europe and they’re thoroughly convinced,” he said. “I can kind of understand with people from Europe because they haven’t been here, so they’re not entirely sure, but we will get people who vehemently deny its existence for real.”
The birth of Wyoming denial
Oddly enough, the theory that Wyoming does not exist may have originated with a 1980s television cartoon.
In an episode of “Garfield and Friends” that aired in 1989, the titular cartoon cat explains to an audience that the square on the map labeled “Wyoming” does not denote a real place, but rather expresses an Italian word for “no state here.”
Wyoming is not an Italian word and Garfield did not help map the United States. Nonetheless, the movement either began or gained national exposure at that time, when it implanted into the passive minds of kids watching television who grew up to be adults who ponder the reality of state borders on the internet.
Eventually, the idea that Wyoming does not exist took on the shape of a similar conspiracy regarding a small German town named Bielefeld.
The Bielefeld conspiracy may sound familiar: Have you ever been to Bielefeld? Do you know anyone from Bielefeld? Then it does not exist.
“That one is a lot less serious,” Brazelton said. “Everyone is in on the joke. Germany is, like, the size of Wyoming, so it’s a lot smaller than the U.S. So, I feel like everybody in Germany is like, it’s an inside joke almost, whereas Wyoming not existing has become this global thing.”
In addition to moderating the subreddit, Brazelton also has made a short film on the topic of Wyoming not existing, which is on YouTube. He said people from Germany have reached out to him over the shared connection between the Wyoming and Bielefeld conspiracies.
“Germans don’t take the Bielefeld one too seriously,” he said. “I’ve actually had people from Germany messaging me after they watch my video or they check out the subreddit.”
The subreddit formed in 2016, but it wasn’t until 2018 that its popularity took off. After a couple of years of growing among the “meme community,” the theory spread more widely when it was discovered by another, more popular subreddit and shared across the internet. The combination of the online word of mouth and his video serving as an introductory course to the theory helped it proliferate, Brazelton and Brisbane said.
“Within about a week of that video coming out, the subreddit exploded to about a couple thousand people and now, four years later, we’re at almost 24,000 people,” Brazelton said.
The idea even reached the Wyoming state Legislature, when a Wisconsin high school student decided to test the theory by asking the state’s 60 legislators via email whether their state — and presumably the people who elected them — exists.
Rep. Sara Burlingame, D-Cheyenne, hit him with discourse on Plato and the Great Chain of Being, positing in a response email that if existence cannot be proven for anyone, then not only may the state not exist, but he and his snarky homework assignment may not exist either, as reported by Cowboy State Daily earlier this year.
But does it exist?
The fact that more than 20,000 people are part of an online community that claims the state he grew up in is an illusion does not come as a complete surprise to Campbell County Commissioner Rusty Bell.
“Nothing on the internet would surprise me, I don’t think,” Bell said after learning about the theory. “It would not surprise me that there are 20,000 people on a site that (think) Wyoming doesn’t exist.”
Between the COVID-19 pandemic and economic downturn, it has been a difficult year for the Cowboy State. Like the rest of the country and most of the world, the state faces a lot of uncertainty ahead.
“Obviously, we’re in a challenging time, no question,” Bell said. “But interestingly enough, it seems like more people want to live in Wyoming from other places, maybe because of our values and what we believe and we seem like we’re living in a freer place than other places.”
Bell said that he has been hearing from Realtors that despite the pandemic and economic uncertainty, more people are moving to Wyoming.
“Apparently more people are finding out that it does exist and are wanting to come here,” he said.
With heels dug in the ground, both sides of the debate over whether Wyoming exists remain firm.
Regardless of where one stands on the divide, it is becoming an idea more and more people are at least exploring, if not adopting.
So, does Wyoming exist?
“It’s kind of a contentious topic,” Brazelton said, on behalf of the Wyoming doesn’t exist community. “There’s a lot of theories as to what’s actually going on there.
“We’re pretty convinced that at the moment, no, but we’re looking into it.”
Jessica Paul and her family are living between the cracks.
When her husband Cody Critel, 30, first started feeling sick earlier this week, it was during his off days. He is the sole source of income for his family and does not get paid for sick time at his job, Paul said.
On Tuesday, the day before he was due back for work, the family went searching for a COVID-19 rapid test to decide whether he was fit to go back to work or not. If all he had was just a cold, he would fight through it and work. If it was COVID-19, then there would be a greater social responsibility to stay home and quarantine.
She said they all had recently been exposed to positive cases of COVID-19 in the community.
Their problem Tuesday was they couldn’t get tested quickly enough.
Campbell County Public Health had a multiple-day wait period for a test, then the results would take even longer. That was before about half its 13-member staff got COVID-19 and shut down its testing this week.
The walk-in clinic also offered rapid testing, but only for its patients and for people needing the tests for travel purposes. The one private practice in town offering rapid tests charges a $90 fee up front, which Paul said her family could not afford.
“We barely make it as is when he makes it to work every single day,” she said.
The state offers free at-home testing, but by the time it’s shipped to a patient and sent back for testing, days have gone by.
Eventually, their choices became clear: Go to work sick or stay home and lose needed income.
“When it affects us and our ability to pull in a wage, keep our home, pay our bills etc., they should make an exception,” Paul said about getting a quick turnaround on a test. “We live paycheck to paycheck. In a situation like this, you’re torn between doing the right thing and staying home and doing what’s considered the wrong thing and going to work.”
Paul does not blame local health care workers who she knows are overworked and on the front line of an unprecedented challenge, but her family’s struggle to get tested reveals a hole in the system.
It’s one she and her family fell neatly into.
“I know we’re not the only family that has that issue,” she said.
There have been 457 new confirmed COVID-19 cases in Campbell County in the week between Nov. 6 to Thursday for an average of 65.3 new cases per day. Thursday set a new county record for daily new cases when it added 147.
Since the pandemic began, there have been 1,748 confirmed COVID-19 cases in the county, along with 146 probables, as of Friday morning.
The 1,020 active cases in the county is the first time Campbell County has passed the 1,000-case threshold of actives, according to the Wyoming Department of Health.
Two deaths were recorded in the county as well over the past week, bringing its count to six deaths in the county and 127 deaths statewide, according to the Wyoming Department of Health.
Campbell County’s positivity rate also has surpassed 30%, the highest point since the pandemic began. That means 30% of people tested in the county come up positive. Wyoming’s overall positivity rate is above 11%.
“We’re concerned about what’s going on all across the state,” said Kim Deti, Wyoming Department of Health spokeswoman. “We have several counties that are seeing high levels of illness.”
Among those are Campbell County, she said, which has had the fifth-most cases in the state and is quickly gaining on the next two counties ahead of it. Since Oct. 1, Campbell County’s confirmed cases count has ballooned by 471%, from 306 to 1,748.
Hospitalizations continue to peak as well. On Thursday, there were 192 COVID-19 patients in Wyoming hospitals, including 12 at Campbell County Memorial Hospital, according to the Wyoming Department of Health.
“We’re very concerned by the number of hospitalizations and the increase that we see,” Deti said. “None of Wyoming’s hospitals are that large (so) when they get impacted, they can get impacted quickly.”
This week, Gov. Mark Gordon made $10 million in CARES Act funding available for helping hospitals bring in temporary health care personnel to compensate for ongoing staffing shortages. Throughout Campbell County Health, there have been widespread staffing shortages due to illness or quarantine.
Ultimately, Critel masked up Wednesday, brought hand sanitizer and did his best to stay away from his co-workers. After a short shift, he went back home sick, where he stayed through Thursday.
“We’re debating whether or not he’s going to go back into work tomorrow,” Paul said.
Paul, Critel and their 5-year-old son Leo all were finally able to get tested Thursday and are awaiting results.
She and her family are faced with a losing proposition. They either have to play it safe, stay home and not know how they’re going to cover their basic needs or go to work and risk spreading an infectious disease but protect their sole source of income.
Paul said they still are not sure what to do.
“It’s a scary situation,” she said. “You want to do the right thing and it leaves you feeling really guilty if you don’t.”
Changes in the health care field and disruptions from the ongoing COVID-19 pandemic have led to a turbulent year for Campbell County Health.
Financially, it is projecting a higher-than-expected net loss at the end of the current fiscal year, said CFO Mary Lou Tate at a recent hospital board retreat.
“Right now I’m projecting, as everything sits today, of losing $6.5 million for this next year,” she said. “Our budget was a loss of $2.9 (million).”
Despite the major service cuts CCH made this spring in response to the pandemic, the organization managed to do well in fiscal year 2020 because of a healthy stream of CARES Act funding.
“Had 2020 been a more normal year, we would’ve been at about a $2.5 million loss,” Tate said.
Hospital administration and the CCH Board of Trustees discussed the organization’s financial situation at the retreat, particularly regarding a change in how it receives payments, finding ways to make operations more efficient and the increased projected loss this year.
“As a not-for-profit, our income that we make is invested back into the facilities in equipment, in pay raises, in various forms that we use,” Tate said in a phone interview with the News Record after the retreat. “So, knowing that we weren’t going to make money this year, or we had budgeted to lose money this year, we cut back on capital. As we continue to lose more money, we’ll have to continue to cut back on capital, cut back on investments and staff.”
Payor mix slide
A recent change in CCH’s payor mix has contributed to the decreased revenue.
Health care payments come from a variety of sources. Recently, CCH has seen a sudden shift in where its money comes from.
Revenue from Blue Cross and commercial insurance dropped from a combined 40% in fiscal year to 2020 to 37% so far in FY 2021. Concurrent with that change, Medicare rose from 33% to 34% of its payments, according to CCH.
While that change may seem slight, it is part of an ongoing trend in shifting from private insurance payments to Medicare, which has major financial implications in the overall financial outlook.
If last year’s payor mix of 2% more Blue Cross and commercial payments were applied to this year, CCH’s bottom line would be $5 million higher, Tate said.
“So, in one year we’re losing $5 million on the payor mix shift.” she said.
The reason that ostensibly subtle percentage change matters so much is because of how the hospital is reimbursed for its services. Blue Cross and commercial insurance now gives the hospital 74 cents for each dollar it charges. Medicare pays only 32 cents on the dollar.
“(With Medicare), we’re losing 42 cents for every dollar as we shift,” Tate said.
CCH’s current cost of doing business is 48%, or 48 cents of every dollar it charges.
The shift has been something that’s been happening gradually over the past few years, but it became more pronounced in the first quarter of this fiscal year, Tate said.
“I think it’s dynamics with the community. With all the shutdowns with COVID, with all of the businesses closing, mines laying people off, I think there’s a loss of commercial payers in the market,” she said.
With the unexpected loss in revenue, CCH is exploring ways to make up some of that deficit.
“Unfortunately, I do think this is going to continue to be our story for the foreseeable future,” Tate said at the retreat.
One area of exploration is in trying to make each department more efficient. Tate talked at the retreat about having each department head view their jobs as department CEOs. Some departments have budgets larger than some local small businesses.
“I think there are absolutely efficiencies to be made, but the thing is that we’ve done it the way we’ve been doing things in some departments for years, in some departments for longer than that. It’s hard to change behaviors and attitudes overnight,” she said. “It’s going to take a lot of discussions, a lot of forethought.”
Tate said that without cutting personnel or supplies, there is only 14% of the budget to work with. With that narrow margin, finding ways to increase revenue and maximize the most profitable service lines is essential.
“Anytime you change a process, the fear of the unknown is difficult,” Tate said. “So, really having paradigm shifts with staffing and with managers to have them think about things differently is hard to do in any change management process.”
Along with the organization’s financial squeeze, recent staffing shortages caused by employees missing time due to illness or quarantine have added another layer of complexity.
Inpatient hospice services at the Close to Home Hospice Hospitality House will remain suspended for the next three to six months as the organization works towards a sustainable long-term plan for the facility, CCH CEO Colleen Heeter said.
In the meantime, the Close to Home inpatient staff have been redistributed throughout the organization to help with staffing shortages.
A recurring topic of conversation between the hospital administration and the board of trustees has been the prospect of an affiliation or partnership with another hospital or health care system.
The terms of an affiliation can vary depending on the nature of the agreement, but Tate emphasized that any potential affiliation would be a partnership, not a transaction.
“We’re working with pros and cons, whether we affiliate or not, and who do we affiliate (with) or not,” she said. “There are pros and cons on that side as well.”
The pros are mostly focused on the concept of economies of scale. For hospitals, this can materialize in the form of more cost savings through increased purchasing power, sharing the cost of overhead expenses and the ability to share and maximize service lines, Tate said.
“Same thing with supplies. As a standalone entity, when we’re buying PPE or medical supplies for just our patient population, we don’t have much buying power,” she said. “But if we’re combining and doubling, tripling, quadrupling the buying power, then we have that opportunity to get better pricing on discounts with the vendors.”
While there are changes to be made that could move CCH’s finances in the right direction as is, recent history has been hard on rural hospitals operating as stand-alone facilities.
“I think if you look at the industry as a whole, there have been 130 rural hospital closures in the last 10 years,” Tate said.
Tate said that finding ways to benefit from economies of scale as a rural hospital is a national and statewide trend for those organizations to gain stability.
“I do personally think that standalone hospitals are finding it harder and harder to meet their bottom lines because they don’t have those economies of scale,” she said.
If or when an affiliation may happen with Campbell County Health is unknown, but it is something that has been discussed among trustees, administration and potential suitors over the past few years.
“I know that we have had discussions throughout the last couple years with potential partners just to find a little bit more about who they are and what kind of potential offerings they could bring forth for us,” Tate said. “We are not interested in a purchase, though. We want to remain independent, but we want to be aligned with someone that can help us continue to serve the community.”
Tate emphasized that CCH does not want to, nor can it, “cut its way to greatness.”
Whether enough of the projected loss can be overcome by operating within the budgetary margins that avoid cutting staff or equipment is unclear.
The declining value of the tax levy in Campbell County, which CCH assesses 3 mills of annually, is another looming shortfall in the millions that will have to be made up somehow.
“Campbell County as a whole is going to start taking a haircut on services and the expectations that we have as residents in Campbell County, because we’re not going to be able to live off of mineral extractions anymore,” said Hospital Board Trustee Adrian Gerrits.
“It’s more going to be a conversation about what services people really value and what we can actually expect for the future of Campbell County,” he said. “I think it’s going to have to be a community conversation.”