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The National Park Service’s decision to begin reopening Yellowstone National Park brings with it economic opportunity, along with significant risks to public health. Balancing those risks and opportunities will be a major challenge for our region during the summer of 2020.

This week’s reopening of Yellowstone on the Wyoming sides of the park will put pressure to swing the gates in Montana at West Yellowstone, Gardiner and Cooke City. The awakening of the park will bring tens of thousands of visitors from all over the U.S. and international destinations. Those visitors will spend money in hotels, restaurants, and gift shops and some are also likely arrive carrying the virus that causes COVID-19.

The risks and rewards of reopening are magnified in West Yellowstone, traditionally the busiest entrance to the park and also one of the most remote with limited health care services. The population of West Yellowstone grows exponentially in the summer, from a remote town of roughly 1,300 year-round residents to a bustling tourist hub with up to 15,000 people during high season. Even during non-pandemic times, the single health care clinic in West Yellowstone can, at times, be challenged to meet community needs during high season.

Those challenges will be much bigger during this pandemic. The obvious (and justified) concern is that some of the many thousands of visitors will bring new cases of COVID-19. Three people in West Yellowstone have tested positive for the disease so far in May. The challenge will be heightened by visitors suffering from altitude sickness and dehydration, both common ailments in the summer with some symptoms similar to COVID-19. Also concerning is that some seasonal workers live in close quarters, an environment that could accelerate an outbreak.

These challenges help explain Montana’s cautious approach to reopening.

To be sure, work is well underway to manage risks and respond to the challenge. The town of West Yellowstone is working with Gallatin County, local public health officials, and local health care providers – Community Health Partners and Bozeman Health – to expand local capacity for COVID-19 testing and clinical services. Those partners also are planning for isolation and quarantine of new cases.

Officials inside the park also are taking important steps. Those actions include laudable decisions to ensure that employees are provided single-occupant housing that avoids shared sleeping quarters. The Park Service will also prohibit large tour buses during its phase 1 and 2 of reopening, limiting the potential problem of quarantining dozens of people who have spent hours or days in close quarters with someone who has the disease. The Park Service also committed in its reopening plan to stepped up cleaning and disinfection and sharing information regarding infection rates, testing capacity, and the ability to isolate infected employees. The phased reopening of park services is also an important part of the park’s plan for managing the opening in a responsible way.

Looking ahead, certain other steps will be critical to opening the park as safely as possible. Those steps include:

• Expanded, ongoing and coordinated testing and public health surveillance inside the park and in gateway communities. This will require frequent and regular communication between health officials in Montana, Wyoming and inside the park to share data on new cases, testing capacity and health care access. This can be achieved through shared commitment from local public health, state health departments, health care providers, and the National Park Service.

• Continued limitations on the size of groups entering the park. It is well-established that large tour buses entering the park bring with them increased risk for outbreaks of diseases such as norovirus. In recent years, norovirus outbreaks have impacted hundreds of park visitors and staff at Yellowstone and other national parks, and tour buses have played a role in disease transmission. Local communities do not have resources to provide isolation and quarantine to dozens of tour bus passengers at one time. Prohibiting tour buses during phase 1 and 2 is an important first step to preventing disease transmission during the summer of 2020. Any move to allow large buses in 2020 should only happen if the Park Service and companies that run the buses have a clear plan for caring for sick passengers and their co-travelers.

• Shared commitment to a unified response and coordinated decision-making in the event that we detect sustained community spread of COVID-19 in the park or in the surrounding communities. This should include collaborative efforts to manage known cases and decision making on progressing through the park’s phased reopening plan, or re-closing operations if necessary. This should also include clear protocols for tourists who are diagnosed and who may be unable or unwilling to isolate or quarantine locally.

• Federal or state funding will be necessary to support the expanded testing and health care needs within some gateway communities. Even with the park’s reopening, the gateway communities will be cash-strapped and will need financial assistance to respond to the public health and safety challenges created by the park’s reopening. Without support from state or federal partners, the efforts to expand health care services will be constrained and risks will grow.

Our best chance to manage the risks and opportunities of reopening Yellowstone relies on a unified effort of local, state, and federal partners to increase testing, coordinate the use of limited healthcare resources, conduct careful surveillance, and take prompt and decisive action to prevent disease spread. The health of our communities, and the ability to keep the park open, depend on the success of this shared effort.

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Matt Kelley is health officer of Gallatin City-County Health Department; Lander Cooney is chief executive officer of Community Health Partners, the federally qualified health center serving Gallatin and Park counties.