The Salt Lake Tribune News: How a rural doctor and his staff are helping a Utah county divided over masks see the danger of the coronavirus

August 04, 2020

Jeff Chappell despises wearing a necktie to work nowadays.

It used to be a staple for the Wayne County physician’s uniform. But now that he has to wear a mask and a face shield, he skips the tie. And when he is in his office by himself, he sheds his personal protective equipment, takes a deep breath and tries to kick back — moments that are becoming all too rare these days.

As the only medical doctor at the Wayne Community Health Center, he and a team of physician assistants and nurses care for many of the 2,700 residents in this southern Utah county. They also treat other Utahns and tourists at the center’s three locations — in Bicknell, Hanksville and Escalante.

For months, the tightknit community had dodged the coronavirus. Then, on Sunday, the Central Utah Public Health Department reported Wayne County’s first case, a child, between age 1 and 14, followed the next day by an adult, age 25 to 44. Both patients contracted COVID-19 from someone outside the county and are recovering at home.

“I actually am a little bit surprised that it took so long,” said Shay Dean, a 26-year-old Loa resident, “with how many people come and go through all of those tiny towns.”

Even before the cases popped up, the virus had divided the rural county — home to Capitol Reef National Park, Goblin Valley and the Robbers’ Roost hideout of the legendary Butch Cassidy — between pro-maskers and anti-maskers, between newcomers (more inclined to don face coverings) and long-timers (more disposed to shun them).

And county residents are still split on the issue.

“For the most part, and nothing is absolute, the people who moved here from elsewhere, we wear masks when we’re out and about,” said Barry Morgenstern, a transplant to Torrey from New York City. “People who preceded us here don’t seem to. We communicate with each other; sometimes we’re friends. But there’s a real divide.”

What is essential?

Wayne County is in the green, or “new normal,” safety level of the pandemic. But even when it was under stricter limits, most businesses did not shut down, according to County Commission Chairman Stan Wood.

“How do you decide whose business is essential?” Wood said. “Every business is essential to the people that own the business.”

Only recently have several area shops seen their employees or customers start to put on protective gear.

For Chappell and his clinic colleagues, the biggest challenge has been trying to help residents understand the threat from the virus. Driving around the area, the physician knows that if certain patients get infected, they likely won’t survive.

“I’ve said all along,” he said, “that it’s all kind of fun and games — though it’s not fun and games — until people start dying.”

Chappell has been practicing medicine for 27 years and worked in Richfield before moving to Wayne County in 2004. Now, he spends about 12 hours a day on the job, putting out coronavirus-related fires and treating mostly elderly patients. He returns to Richfield at least twice a month to work at the Sevier Valley Hospital emergency room.

He has picked up extra administrative work due to the coronavirus. He also receives several emails related to his position on the county’s school board and as a medical director of other local facilities.

While Chappell is busy with his patients, the rest of the team is tending to the walk-ins, including those who need emergency care. Staffers also see patients remotely via telehealth.

Nurse Josie Moosman, the clinic’s manager and “get-it-done person,” said most staffers wear “different hats in the community” and educate people about the coronavirus.

They do COVID-19 testing, too. The center has administered about 250 tests overall, giving as many as 15 on one day, a significant amount for such a small county.

“The days have just been really, really long, especially in our clinic, where we’re the only medical care in the county,” Chappell said. “… It’s a very busy job, very demanding. And then throw in the — I call it the ‘COVID fog,’ just kind of working in the fog and uncertainty.”

Torrey is a gateway to Capitol Reef, so some residents are surprised it took months for the virus to arrive.

Chappell referenced a group of tourists who tested positive at the clinic in June yet did not spread the virus in the county. Some residents also had contact with people infected by COVID-19, but they did not contract or spread the virus either — for whatever reason.

“A lot of it,” Chappell said, “has just been luck.”

Chappell and Moosman say the lack of coronavirus cases in Wayne County can be attributed largely to its rural surroundings. After all, there is only one person for every square mile, making social distancing not only easier but also a fact of life.

“When this all started, I would talk to patients and say, ‘Well, you need to socially isolate,’” Chappell explained. “And they just kind of chuckled [and said], ‘That’s kind of the way we live.’”

Although the virus now has reached his region and schools are poised to reopen, Chappell remains optimistic that it won’t spread widely. If it does, he warned, “we’ve got a lot of vulnerable patients.”

Nearly a quarter of the county’s populace (22%) is 65 or older.

‘Let’s get together’

Lisa Jeppson oversees a Wayne County senior citizens group, which shut down its social functions in March. The 55-year-old Loa resident avoided contact with friends for about two months, but she eventually decided to get out more, meeting with friends about once a week.

“If we’re going to get it, we’re going to get it,” she reasoned. “Let’s start socializing again. Let’s do our dinner parties; let’s do our game nights; let’s have barbecues. It’s summertime. Let’s get together, and let’s just have some fun.”

Jeppson doubts the virus will spread in Wayne County, believing the two residents who tested positive will follow doctor’s orders and self-isolate.

“I’m still not really terribly worried about it,” she said. “I know it’s out there, and I know that the older population should be worried about it. But it’s just one of those things. I’m like, ‘You cannot be afraid to live your life.’”

Jeppson said she usually doesn’t attempt to social distance or wear a mask because most of those she interacts with have stayed in Wayne County. If residents have traveled to a place with a significant number of coronavirus cases, she encourages them to quarantine for a couple of days.

Wood, the county commissioner, echoed that sentiment, urging his constituents to live freely and not shelter in place. He believes most residents will continue to forgo masks unless the governor mandates them.

Not all Wayne County residents are so unconcerned.

Mask appeal

Morgenstern, the 75-year-old “newcomer,” said he spends his time alone in his house with his two dogs.

“I realized, very soon, that this was not something that I wanted to get,” he said. “I was afraid I wouldn’t survive it.”

While Morgenstern is cautious, he said some in the community dismiss COVID-19 as a hoax. Most transplants, like himself, were drawn to the region by its scenic beauty and, unlike many longtime residents, don face coverings while out and about.

Morgenstern is optimistic, though, that more residents will mask up as they continue to learn about COVID-19.

“Each of the two groups sees what the other one does as being a political statement,” he said. “Well, I can say for myself and my friends that I don’t wear a mask for a political statement. I wear it because I don’t want to get sick, and I know how devastating this [virus] can be.”

Kirsten Johanna Allen is not so sure the community will migrate toward masks.

The 54-year-old Torrey resident fears shopping because few patrons wear masks. That disheartens her because she would like to support local businesses.

When people say, “If you’re scared, then stay at home,” Allen explained, “well, that kind of keeps us from being a community together. If other folks aren’t going to protect me and depend on me to protect me, well, I have to not engage in the community.”

Moosman and Chappell are confident their health center can handle a certain number of coronavirus patients. Staffers, with the help of CEO Evan Christensen, have been adapting to the expanding workload and uniting so they can best help the county’s residents.

But they are not equipped to take on a huge surge of cases.

“It’ll stretch our system,” Chappell said, and the nearest hospital is about an hour away, in Richfield.

Moosman and Chappell don’t know how the coronavirus ultimately may play out in Wayne County. But they’ll be there, lifting each other, their colleagues and their patients.

“What helps me through … is knowing that what we’re doing is saving lives, and how we’re doing it is caring for our community,” Moosman said. “... In the end, I’m helping my community and my co-workers — my family, essentially.”

The Salt Lake Tribune article can be found here:

COURTESY PHOTO / Salt Lake Tribune & Jeff Chappell -- Dr. Jeff Chappell, the only doctor at a community health center in Wayne County, relaxes in his office, a rare moment nowadays amid new responsibilities, challenges, and worries due to the coronavirus.