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WEST YELLOWSTONE — The streets are quieter than usual for early summer.

The town’s largest hotel remains closed. Businesses’ hours are limited and the customers are few. Most parking spots sit empty, but those that are filled have cars bearing license plates from states like Arizona, California, Colorado, Idaho, Texas and Wyoming.

On a recent afternoon, a group of kids walked out of a gas station holding slushies and longboards. A few others ran around the playground in West Yellowstone Town Park. Three people got out of a car with Utah license plates and posed for a selfie.

With the reopening of the three Montana entrances to Yellowstone National Park on Monday, West Yellowstone might be about to change.

In anticipation of more visitors arriving, town and county officials are working with local health care providers to increase coronavirus testing and treatment capacity.

Without adequate preparation, officials worry the town, which is home to 1,300 year-round residents and 55 minutes from the nearest hospital in Big Sky, could be overwhelmed.

“When the gates open, we’ll have a lot of people from out-of-state coming to town and they might bring the virus. That could be difficult,” said town manager Dan Sabolsky. “But at the same time, we need people to come here because our entire economy is based on tourism. Either way you look at it, we’re caught in a bad situation.”

West Yellowstone typically sees 1.4 million visitors between May and September. The mandatory 14-day quarantine for out-of-state visitors ends on Monday, which Sabolsky said could bring more people to town. But no one knows how many will come.

“We’ve got to be prepared,” he said. “But prepared for what?”

West Yellowstone’s main medical clinic, which is run by Community Health Partners, sits on Yellowstone Avenue in a small town-owned building.

Throughout the year, a physician visits from Big Sky Medical Center once a week to see patients. In the winter, the clinic offers medical and behavioral health services on weekdays. In the summer, the clinic expands, bringing on two additional workers and opening on Saturdays.

West Yellowstone COVID-19

A medical worker stands inside a viral triage room at Guy Hanson Medical Clinic Wednesday, May 27, 2020, in West Yellowstone.

As Community Health Partners makes regular preparations for summer, the non-profit is also transforming its clinic to safely serve COVID-19 and non-COVID-19 patients, said CEO Lander Cooney.

“We are doing the things we already do, but we are doing them in a bigger way,” she said.

Community Health Partners brought on a new staff member to screen visitors for COVID-19 at the clinic’s main entrance.

Visitors with COVID-19 symptoms will be sent to the back of the building. If they need to see a health care provider, they will enter the clinic through the ambulance entrance off Electric Street. The entrance leads to a small area with a few rooms that are separated from the main clinic by a wall and door that volunteers installed last weekend.

One of the rooms was previously used for behavioral health services, which moved online during the coronavirus pandemic. It will now serve as the clinic’s main COVID-19 exam room. Another room, which used to be an employee break room, could become a second COVID-19 exam room.

If a suspected COVID-19 patient doesn’t need to see a health care provider, they will likely be tested for the virus in their vehicle.

Community Health Partners will begin by testing those who are symptomatic.

Gov. Steve Bullock announced Thursday that the state will help tourist destinations like West Yellowstone conduct “community snapshot testing,” meaning testing some people who don’t have symptoms of the virus to understand how present it is in a given area at a given time.

“Part of our objective is to begin to test more and more of our population regularly, including those who interact with visitors, to help develop an early warning system and keep businesses open over the long haul,” Bullock said.

Depending on how the testing rolls out in West Yellowstone, Community Health Partners will likely set up a testing lane on Electric Street where drivers can line up to get tested from their vehicles. This may require hiring additional staff or bringing on people from Bozeman Health.

Tests would be sent for analysis to Bozeman Health’s lab in Bozeman or to the state-run lab in Helena. Results would be available within 24 hours, said Dr. Kathryn Bertany, president of Big Sky Medical Center and Bozeman Health Deaconess Hospital.

Bozeman Health is hoping eventually to analyze tests at Big Sky Medical Center, as well, which Bertany said could make the turnaround faster for tests from West Yellowstone.

If COVID-19 patients in West Yellowstone need more care than the Community Health Partners Clinic can provide, they will likely be hospitalized in Big Sky or Bozeman.

Big Sky Medical Center is a small hospital but has successfully treated COVID-19 patients, Bertany said. The hospital has also recently doubled its inpatient capacity to eight rooms.

If patients need more specialized care, they could be taken to Bozeman Health Deaconess Hospital.

In March as Montana saw its first COVID-19 cases, the Bozeman Health system prepared for a surge in patients. The surge didn’t happen, but the preparations gave the organization the resources needed to respond to a future outbreak in West Yellowstone or elsewhere, Bertany said.

Across Gallatin County, Bozeman Health is slowly reopening its facilities and offering care to COVID-19 and non-COVID-19 patients. The organization plans to return fully to normal operations by June and intends to stay open to all patients even if there is a surge in cases.

Even though Bozeman Health is prepared for whatever happens in West Yellowstone, Bertany said it’s always challenging to provide care in small, rural areas with few health care options.

“We know the overall resources around the entire perimeter of Yellowstone Park for medical care are fairly limited,” she said. “… It is going to put a strain on all of our towns around where guests will be looking for support, so we are trying to be mindful of that and be prepared and ready to step up.”

West Yellowstone and Gallatin County officials are also preparing. They are working to rent hotel rooms for people to stay as they await test results or as they recover from the virus.

“To contain the virus, we cannot have a seasonal worker who has contracted the virus returning to the housing they share with six roommates or have a tourist isolate or quarantine in a tent they’ve been sharing during their vacation,” said Gallatin City-County Health Officer Matt Kelley.

The town may need as many as 10 hotel rooms, which could cost about $28,800 per month, said Shane Grube, fire chief for the Hebgen Basin Fire District and a leader of the town’s COVID-19 response.

West Yellowstone likely can’t pay for the rooms because its budget is largely reliant on resort tax revenue, which has dramatically declined since the virus hit.

Town officials wrote a letter to the governor a few weeks ago asking for money for the rooms as well as for the work going on at the Community Health Partners clinic. They said they didn’t hear back.

Town officials then approached the county, which agreed to front the money for the town’s coronavirus response and is applying for reimbursement from the Federal Emergency Management Agency, Kelley said.

Bullock has set aside $5 million of the $1.25 billion the state received from the federal coronavirus relief package for local health departments and said on Thursday he is working to reimburse counties, cities and towns for expenses related to COVID-19.

Those who contract the virus — whether they’re staying in provided hotel rooms or at home — will need support. Grube said the town is working with the food bank and local restaurants to provide food to those with COVID-19. The Gallatin City-County Health Department will coordinate with the town on assisting those recovering from the virus.

Visitors who test positive may not stay in West Yellowstone. Grube said the town is developing educational materials on how to travel safely and will provide personal protective equipment for use on their return home.

Bullock unveiled a new Department of Commerce and Department of Public Health and Human Services program on Thursday that would use $15 million from the federal coronavirus relief money that Montana received to educate visitors on public health and safety protocols in the state.

“This has not been a quick process. We started talking about how the summer tourism season would be impacted back in January as COVID was building in China,” Grube said. “It’s difficult to think through all the scenarios when there are so many unknowns, but we have thought through this comprehensively because when we’ve opened, we want to stay open.”

For now, the town is waiting for the opening. Some businesses still have signs saying they’re closed for the winter. Some say they will open as soon as the park does. Others are operating as normally as they can. Many say they are struggling to get by.

Just outside of town, the park gate is blocked with orange cones and barricades. A variable message board broadcasts the closure.

But the scene is about to change. The cones, barricades and signs will be removed on Monday. Cars will likely begin lining up, waiting their turn to enter the park.

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Perrin Stein can be reached at pstein@dailychronicle.com or at 582-2648.