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HEALTH

GUIDE 2020 October Your guide to Hi-Line Heath Information.

A Special Supplement to

Havre Daily News


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Flu vaccine more important than ever amid pandemic

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Hill County Public Health Director Kim Larson, who was recently appointed Hill County Health Officer, as well, said this year it’s more important than ever for people to get their flu vaccine. Larson said the reason for this urgency is, as might be expected, the COVID-19 pandemic, which she said still has the potential to strain the health care system, which would not be helped by a parallel outbreak of influenza. “We don’t want to strain our health care system any more than necessary, and the possibility of our health care system already being overwhelmed by COVID alone is pret-

ty high,” she said. “But if we add on to that a huge outbreak of influenza … then our health care system will be really overwhelmed.” Larson said hospitals are well-prepared for flu season when it comes around every year, and while some years are worse than others it’s a recurring and anticipated phenomenon. But a local rise in hospitalizations due to influenza wouldn’t just reduce the space facilities have for dealing with COIVD-19, it would also increase the amount of personal protective equipment that would need to be used and increase the possibility of hospital workers getting sick, further straining the system. She said no recent changes have occurred

in how the pandemic has been affecting the county, but the department is watching the situation closely as schools reopen and sporting events start back up. Larson said in mid-September that after two incubation periods — about two weeks — the health department will have a better idea of what recommendations to give institutions and how things may progress in the county as a whole. She said a smaller town like Havre may not have the same transmission dynamics as a place like Missoula, so it’s still hard to say what the effect of reopening will be locally, especially with those dynamics being different even between different schools in the area. She said she and the health department

at large are watching the situation as a whole, but if everyone made an effort to get their vaccine as early as possible, it would markedly reduce the risk of the system being overwhelmed in the case of a COVID19 outbreak. “Getting your flu vaccination is the best way to prevent the flu and protect yourself,” she said. Larson said, in a normal year, the health department, after obtaining the vaccine, would partner with local institutions to hold mobile clinics across the Hi-Line, first in Gildford and Rudyard, then take it to businesses in the Havre area to make it easier for people to get the vaccine. But this is not by any means a normal

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Vaccine

Patrick Johnston pjohnston@havredailynews.com

October 2020

Dentist: Professionals recommend keeping up with at-home care, as well increasing the pieces of personal protective equipment worn by staff, minimizing personto person contact, and have enhanced cleaning and sterilization." New check-in procedures, including screening procedures and social distancing strategies, are designed to protect patients and staff during a dental appointment. "Your oral and overall health is our priority, and we are asking patients a few screening questions in advance of appointments," Flamer-Caldera said. "We are also asking patients to wait outside or in their vehicle prior to the appointment, wear a mask within the office when not being seen or treated by the dentist, or stay home and reschedule if you are feeling unwell the day of your appointment." Second, delaying your dental care may result in additional and more costly problems in the future. "Scheduling that overdue dental appointment is more important than ever now, as dental offices are working to manage patients who put off treatment during COVID-19," Samaddar said. "Patients should visit the dentist regularly to ensure that dental problems are caught early. In addition to teeth cleaning, we screen patients for oral cancer and other conditions. This is an important part of taking care of your overall health. "You may end up having to undergo and pay more for procedures that professional intervention could have prevented early on," Samaddar added. "Early detection and rou-

Havre Daily News/Colin Thompson Tony Gabrielsen receives a flu shot Sept. 22 from nursing student Stephanie Moog at the Northern Montana Hospital drive-in flu clinic. Officials are urging people to get vaccinated to try to reduce any strain on the health care system during the COVID-19 pandemic. Health officials say reducing the chance of people getting the flu will provide more space and personnel to deal with COVID-19.

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are helping to protect them as well.” Larson said a directive issued by Gov. Steve Bullock lowered the age of people licensed pharmacies can give flu shots to, which she said will be helpful in the coming flu season, as pharmacies are often more convenient for people than the health department. The directive allows pharmacists to administer the vaccinations to people ages 3 to 18. “I think it’s just another way of ensuring that vaccinations are getting done,” she said. “A lot of health departments are kind of overrun with COVID-19 right now … and if the pharmacies can help with that, I think it will be great.” She said local health departments typically don’t have a huge employee base and amid the pandemic there is still plenty of contact tracing to be done. Larson also addressed concerns by some people that influenza could cause false positives while testing for COVID-19, but she said there’s no indication that that would be a serious concern, as influenza is not caused by a coronavirus, and the tests being used by Hill County look specifically for concentration of that virus itself. Larson said to set up a flu shot with the Hill County Health Department, people can call the office at 400-2415, but she encouraged to go to a pharmacy if that is more convenient.

tine professional care typically improve overall oral wellness outcomes." Third, feelings of anxiety caused by the pandemic may be difficult for patients, compounding fears and making it difficult for some to schedule an appointment. Talk to your dentist about your concerns. "We are familiar with dental anxiety and

helping patients work through their fears," Flamer-Caldera said. "Give your dentist a call to address your concerns, as many of your needs can be resolved simply by talking about them. Your dental team will inform you of what to expect and answer your questions to ensure your comfort during an appointment."

Of course, it's important to keep up with at-home oral hygiene as well, such as brushing for two minutes twice daily, flossing, and avoiding sugary foods and liquids. For more information on where to find guidance around visiting the dentist right now, people can visit http://www.agd.org/ seeyourdentist .


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Now is a good time to head back to your allergist

Biking: Together We Rise helps provide bikes to foster children ■ Continued from page 12

(BPT) — Since the coronavirus pandemic began, many Americans have canceled or postponed non-emergency doctor visits. At first, practices were temporarily closed, but later patients avoided visits out of fear of exposure to COVID-19. In a Kaiser Family Foundation tracking poll from May of this year, nearly half — 48 percent — of respondents said that they or someone in their household had p o s t p o n e d o r s k i p p e d m e d i c a l c a re because of the pandemic. Perhaps not surprisingly, 11 percent of adults overall reported that their or their family member's health condition had worsened due to delaying or canceling medical appointments. If you or your child suffers from a chronic condition like allergies or asthma, it is likely you could experience a further decline in your health and well-being by continuing to put off visiting your allergist. If you have allergies and asthma, you need to have your medications and your overall health monitored carefully — and regularly — by an allergist to keep symptoms under control. Allergists are specially trained to help patients manage these conditions effectively, so it's vital to keep up regular visits to maintain the best possible health outcomes. Health and safety procedures If you're one of the many Americans who haven't kept up with appointments out of concern for exposure to COVID-19, you can be reassured by the strict safety protocols being implemented by allergists' offices around the country to protect their patients, as well as their staff. "Our first priority as allergists is keeping all our patients and staff safe from COVID-19, while at the same time keeping patients' allergies and asthma under control," said J. Allen Meadows, M.D., president of the American College of Allergy, Asthma and Immunology. "When you Brandpoint

• It helps build self-confidence and relationships with others who like cycling, too. Help for foster kids who need bikes Unfortunately, not every kid has the opportunity to enjoy the many positive aspects of bike riding. Children in foster care, tweens and teens in particular, don't always have access to a bike, so they aren't able to experience this important milestone of growing up. To help address this issue, Honeycomb cereal recently donated $50,000 to Together We Rise, a national nonprofit dedicated to helping improve the lives of youth in foster care. The donation will provide 600 bicycles to tweens and teens in foster care

nationwide, helping them to build their confidence and experience the many physical and emotional benefits that having a bike brings. Bikes have been part of Honeycomb's history since the 1970s, featured in its advertising and promotions. Kids growing up in the '70s and '80s fondly remember collecting Honeycomb bike-sized state license plates, which were given away free inside cereal boxes each year. " We ' re t h r i l l e d to t e a m u p w i t h Together We Rise to give kids in foster care the chance to experience the fun and joy that biking brings," said Michelle T i t u s, s e n i o r b r a n d m a n a g e r o f Honeycomb cereal. "This donation will make the dream of owning a bike a reality

for these kids." Safety tips Kids heading out on their bikes should follow basic guidelines to protect their health and safety. Remind your tween or teen to: • Always wear a helmet, even for a short trip. • Be visible by wearing bright clothing and using reflectors or lights to ensure others can see you, especially in the early morning or around sundown. • Always use sunscreen to protect exposed skin from UV rays. • Stay hydrated by drinking plenty of fluids. • Stick to bike paths, if possible, rather

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than riding on the street. • Obey all traffic laws. • Stay alert while riding. • Don't use ear buds or headphones that could prevent you from hearing traffic or other dangers. • Don't use your phone or text while riding — stop and get off the trail to use any device. Now is the perfect time to get your kids biking and consider helping foster kids do the same. For more information about the To ge t h e r We R i s e B i ke s fo r Fo s t e r Children program or how to sponsor a bike for kids who need one, visit http:// TogetherWeRise.org .

come to the office, know that your allergist has put protocols in place to make your visit both comfortable and safe." Here are just some of the safety practices being employed by allergists: • Virtual visits for consultations when possible • Mandatory mask wearing by all patients, visitors and staff • Social distancing procedures throughout the office Extra time between patients for cleaning and disinfection • Remote check-in at arrival, so patients can wait in their cars until the doctor is ready to see them instead of in a waiting room • Some services — such as biologic shots — can be administered at patients' vehicles outside, in some practices Why you may need office visits While some issues can be discussed with your allergist using telemedicine, many of the most crucial allergy and asthma treatments and procedures must be performed in the office to ensure that you are getting the best possible health results. Allergy testing: Most patients are given an in-office skin test to detect sensitivity to common household animals (like cats and dogs), dust mites, grasses, trees, weeds and mold. If you're taking medicine that could interfere with allergy test results or if you have very sensitive skin or a serious skin condition, your allergist might perform a blood test instead. Allergy shots: If you are receiving allergy shots, these will need to be administered in person. Allergy shots are given on a schedule designed to increase the amount of the allergen on a regular basis. It's best not to interrupt, skip or postpone the timing of when you get them. Oral food challenges: To confirm or

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Health officials encourage getting flu shot Rachel Jamieson rjamieson@havredailynews.com Flu season is right around the corner and people can stop by the Hill County Health Department or at Bullhook Community Health Center to get their flu shots. Flu shots also can be given by pharmacists, and a directive issued by Gov. Steve Bullock now allows pharmacists to administer the vaccinations to children ages 3 to 18, as well as at other health facilities and at flu clinics sponsored by organizations and businesses.

The Centers for Disease Control and Prevention defines a flu shot as a vaccine against the influenza virus. On its website, https://www.cdc.gov/flu/ index.htm, it provides tips for people to prevent the flu, symptoms, treatment, and flu surveillance and activity in the United States.    Bullhook Community Health Center Medical Department Manager Desirée Norden said Bullhook will begin offering influenza vaccines to its patients during the last week of September or first week of

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Flu shot ■ Continued from page 3 October. Hill County Public Health Director Kim Larson said in mid-Septmember the majority of that department’s vaccine was delayed in shipment, but it had some doses. “If you are wanting a flu shot now, come in on Tuesdays during our regular hours (8 a.m. to noon and 1 to 5 p.m.) and we will gladly give you one,” Larson said. “We will have our schedule of clinics out to the community as soon as we can.” She said people can can call the Health Department office at 400-2415 to set up a shot. Norden said Bullhook’s fee scale applies to the shots. “If a patient is uninsured, Bullhook provides services on our sliding fee scale, or discount, depending on the patient's family size and income,” Norden said. Larson said the fees at the health center are, for children 6 months to 18 years of age, $20; adults 19 and older $25; high-dose flu shot for ages 65 years and older, $50, and the health department will bill the patient’s insurance. Norden said the risk of not getting a flu shot can range from hospitalization to death, serious illness, missed work and school, spreading illness to friends, family and community members. Larson said it’s especially important that certain people get vaccinated, either because they are at high risk of having

serious flu-related complications or because they live with or care for people at high risk for developing flu-related complications. People in those categories include: • Pregnant women • Children younger than 5, but especially children younger than 2 years old • People 50 years of age and older • People of any age with certain chronic medical conditions • People who live in nursing homes and other long-term care facilities • People who live with or care for those at high risk for complications from flu, including: o Health care workers o Household contacts of persons at high risk for complications from the flu o Household contacts and out-of-home caregivers of children less than 6 months of age — those children are too young to be vaccinated. “During the 2018-2019 influenza season, 13,576 cases, 767 hospitalizations, and 38 deaths, 1 pediatric due to influenza were reported, from all but one county in Montana,” Larson said. For more information, people can refer to the CDC website at https://www.cdc.gov/ flu , stop by Bullhook Community Health Center at 521 Fourth St. or Hill County Health Department at 302 Fourth Ave.

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The benefits of biking for kids

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(BPT) — For kids, biking is one of the gateways to growing up. Popular films and TV hits such as "E.T. the Extra-Terrestrial" and "Stranger Things" highlight the joy a bike can bring as a fun way to explore or spend time kicking around the neighborhood. Yet, according to a study from the Outdoor Industry Association, bike riding

among kids declined 19 percent between 2007 and 2019. There are plenty of good reasons for anyone to get outside and ride a bike. Especially during this time of social distancing, bike riding offers the perfect opportunity to shake off cabin fever and safely enjoy the fresh air.

Benefits of bike riding For tweens and teens, there are many benefits of owning and riding a bike, including: • It gets kids outside away from screens to enjoy fresh air and vitamin D-giving sunshine.

• It promotes cardiovascular health. • It builds muscles, while improving balance and coordination. • It improves mental health by helping to reduce anxiety or stress. • It is good for the environment, offering an emissions-free mode of transportation.

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Vaccine: Larson: The same precautions that prevent COVID-19 work for flu ■ Continued from page 1

Havre Daily News/Colin Thompson MSU-Northern nursing student Desiree Norden gives a flu shot Sept. 22 at Northern Montana Hospital's drive-in flu clinic. Officials are urging people to get vaccinated to try to reduce any strain on the health care system during the COVID-19 pandemic. Health officials say reducing the chance of people getting the flu will provide more space and personnel to deal with COVID-19. year, and she said she’s having trouble getting these mobile clinics to happen. Larson said it’s mostly a matter of staffing, and she’s looking to hire some temporary help to ensure that these clinics can happen, but until the issue can be resolved she doesn’t have information on when and where these clinics would be held. She said she feels these clinics are especially important given the COVID-19 pandemic, and that they are likely the safest method of getting the vaccine to people. “I feel like taking those flu shots to them is probably the safest way for us to do that,” she said. Larson said the health department itself should be getting the vaccine as normal in

early October, but the availability may be a bit more limited this year in part because the health department wants to limit the amount of people in their office at a time due to the pandemic. Despite the situation, Larson said, she’s relatively optimistic that it will end up being a tame flu season. She said the department typically uses Australia as a predictor since they tend to have very similar flu seasons, and the observations have been encouraging. She said this is likely because, vaccine notwithstanding, the methods of preventing the spread of COVID-19 are identical to that of influenza, as they are both spread through droplets produced by peoples’ mouths and

noses. Washing hands thoroughly and often, wearing a mask, coughing into the elbow, staying home when sick, all of these will help stop the spread of COVID-19 and the flu. “They work just the same for influenza,” she said. She said because people tend to do these things already, she thinks influenza won’t be as pervasive this year as most, although she did still stress the importance of getting the vaccine anyway. Larson said the state health department is also implementing a new flu-prevention program in partnership with the Centers for Disease Control and Prevention to provide

more vaccinations later in the year around December or early January of next year with an emphasis on getting more adults vaccinated. While the stakes are higher this year, Larson said, getting the vaccine would still be important anyway as there are people in Hill County and the U.S. at large who cannot get the shot due to personal health concerns and could get the flu which, while less deadly than COVID-19, can still kill someone. “There are people in our community who are not able to get flu shots because of certain health issues that they’re having, and you don’t necessarily know who they are,” she said, “And by you getting a flu shot you

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What to expect at your next dental visit (BPT) — Going to the dentist has always been an important part of the overall health care routine. Even now, regular dental appointments are critical to good overall health and it is safe to see your dentist. You have questions. Will I be safe? Is my dental office following precautions? What should I do if I'm still nervous? These are realistic considerations in the COVID-19 world we now live in. Dentists are taking all possible measures to ensure the safety of their patients, staff and themselves. It's important patients keep up with their preventive and routine dental care to support their overall health. The Academy of General Dentistry says it is normal to have anxiety and want to delay your routine dental appointment out of concern for coronavirus exposure. Before you decide to do so, contact your dentist and ask about their current operating procedures designed to ensure your safety. "Dentists have been applying extensive infection control standards in their practices for decades," said Sheila Samaddar, DDS, a general dentist in Washington, D.C., and member of the AGD. "Infection control tools such as masks, gloves and gowns have long been required in all practices. We followed strict procedures before COVID-19 and since have expanded those measures to ensure all spaces in dental offices are disinfected too." Here's what to know when planning and visiting your dentist during this time. First, your dentist's office has taken the recommended measures to make sure your visit is safe and they are ready to treat you. "We care about our patients and want to ensure their safety," Lorna FlamerCaldera, DDS, FAGD, a general dentist in Greenwich Village, New York, and a member of AGD, said. "Your dentist and their practice have put thoughtful procedures in place to make sure you and your family are protected, adhering to guidelines from the U.S. Centers for Disease Control and Prevention and other state and local agencies. They're altering check-in procedures,

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Pandemic: Focus at beginning of school year is on student vaccinations, screenings

Allergist: Allergy tests such as an oral food challenge help with diagnosis

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she said. She said after the immunizations, she works on the screenings to get those done prior to Thanksgiving. “Dental, vision and hearing makes an impact on how the kid learns,” Erickson said. She said on top of COVID she still does all of this. “Right now, school is going so well,” she said. “... Now, when I go into the classrooms to teach, instead of it being one day or two days of teaching, it’s now two days or four teaching because it’s split classes. So it’s going to take a lot more of my time to do that.” She said now she goes where she is needed and has provided a COVID-19 Screening Flowchart that was made in accordance with the Hill County Health Department that each school can follow.

“That makes it really easy, because if they follow my flow chart they don't necessarily have to call me every time,” Erickson said. “It hasn't been crazy yet, let's just say that.” She said if a student has any of the following symptoms they will be sent home no matter what: a fever of 100.4 degrees fahrenheit or greater, cough, sore throat, loss of taste or smell, shortness of breath or difficulty breathing, diarrhea, nausea or vomiting, muscle and body aches. Once the student presents any of those symptoms they are then escorted to an isolation room designated by staff, the student will have their temperature taken and a parent or guardian will come pick the student up. But if a student has fatigue, headache or nasal congestion they will not be sent home. They will be sent home if they have any those in combination with other symptoms.

“Students must remain symptom-free without symptom-reducing medication for 24 hours prior to returning to school,” the flow chart says. Erickson said she knows children are going to play with their friends outside of school and during school, but they just need to be safe. “If you're sick, don't go play with your friends,” she said. “If you're feeling anything at all abnormal (don't) go play, and stay home, distance yourself from people until you start to feel better.” She said the two biggest things are handwashing and staying home if sick. Those two things have been preventive measures before COVID-19, she said, but now they need to be more incorporated in people's thought process to get them thinking about safety. “I think kids are really good with it — kids are doing better than adults are with the whole social distancing, the mask wearing and remembering to wash their hands,” Erickson said. ”I feel like they are just doing amazing and it's really surprised me.” She said she thinks everybody's goal is to keep the students in school as long as possible. In order to do that, she said, the students need to be washing their hands, social distancing, and wearing their masks properly and she thinks that's what is going to keep them in school for the longest time possible.

If an outbreak occurs within a school, she said, it depends on the circumstance, it depends on the age of the student, depends on the building, depends on where that child has been and have they been socially distancing in their classroom and more. Erickson is a Havre native, born and raised here, she said, and she also started working on her nursing degree at Montana State University-Northern. She ended up graduating from Flathead Valley Community College in Kalispell, where she received her licensed practical nurse degree then received her registered nurse degree at Aaniiih Nakoda College in Fort Belknap. She said she wanted to become a nurse to help people. “Originally, just to help people I guess to make a difference — pretty much for health maintenance to help people not get sick,” Erickson said. She has been a nurse for 10 years, she said. She added that she is also nationally certified as an asthma educator, which she does out of Bullhook Community Health Center. She likes to educate people so they can stay as healthy as they can, which also is what drew her to work in the schools, she said. Even though she is the only school nurse in the district, she said, it has not been overwhelming.

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rule out a food allergy, an oral food challenge — OFC — is performed. For an OFC, a person is given a very small dose of a food by mouth at first, followed by increasing doses under the supervision of a board-certified allergist to confirm tolerance or a reaction to the food. Biologics: To receive biologic therapy to treat allergic disorders such as asthma, atopic dermatitis — eczema — or chronic sinus disease, treatments are given by injection in your allergist's office, at least at first. If you're behind on appointments to monitor and treat your allergies or asth-

ma, call your allergist today. Ask about their current health and safety procedures so you'll know what to expect when you arrive. Also, if you plan to visit an allergist for the first time, you will need to provide a history of your symptoms, and then the allergist will perform an in-office physical exam. Using this information, the allergist can determine appropriate allergy testing. Need to find a board-certified allergist in your area? Use the ACAAI allergist locator online at https://acaai.org/locatean-allergist .


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Erickson talks about COVID-19 pandemic and being a school nurse Rachel Jamieson rjamieson@havredailynews.com Havre Public Schools Nurse Jeri Erickson said in September that dealing with the COVID-19 pandemic in the schools, so far, has gone well. She said there are four main things she likes to talk to students about COVID-19, as well as to have the teachers talk to their students about: washing hands, which is the number one thing to prevent infection; proper use of face masks; social distancing, and not coming to school when sick. “We kind of have been working with those things with the kids, all of the teachers have those top four things, they know that they are supposed to bring those up to kids every single day,” Erickson said. “… The teachers know that they are to mention these things on a daily basis to the kids. Show them actually what social distancing is and what proper mask wearing looks like, and how you are supposed take it off and put on.” Everything is going great, she said. After this interview, by printing deadline last week, Havre Public Schools had reported one confirmed case of COVID-19, in a person associated with Sunnyside Intermediate School. Contact tracing was ongoing at that point. Erickson said the students were following guidelines well. She thought the masks were going to be a pain for the students to be wearing properly and that they would complain about it and Havre Daily News/Colin Thompson Havre Public Schools Nurse Jeri Erickson poses for a photograph Sept. 2 outside of the Robins School Administration Building. not be compliant — but the students have been amazing, she said.  “Every school that I go to, I haven't had to say one word to any child,” she said. “They have their mask on when they are supposed to, they are wearing it properly, it is over their nose, it is under their chin, they are doing amazing.” Right now, her job involves walking around the schools and room checking to see if social distancing is happening and if it is not happening to make sure the students have their masks on during that period, she said. She added that when students cannot social distance they have to have their masks on, if they are socially distanced they don't have to wear their mask in the classroom. “The teachers are doing an amazing job at that,” Erickson said. ”I'll walk by a classroom and I can tell it's not socially distanced perfectly by the 6 feet, and every kid in that classroom has a mask on. The teachers are doing an awesome job with it as well.” Before COVID-19, she said, she used to be at a different school every day of the week — generally, Highland Park Early Primary School Mondays, Lincoln-McKinley Primary School Tuesdays, Sunnyside Intermediate School Wednesdays, Havre Middle School Thursdays and Havre High School Fridays. Prior to the pandemic, she helped develop plans based on students’ needs, she said, adding that the nursing process goes into that with assessments, intervention, outcomes, evaluations out of those outcomes, seeing if

the plans are working and changing it if it needs to be changed on specific students. “We have a lot of kids in the district that have health conditions,” Erickson said. “So I do staff trainings for seizures, allergies, how to use an EpiPen, diabetes care, CPR, asthma, that kind of thing. I do teaching with the kids too — sex education, puberty, handwashing, I also teach them CPR at certain levels.” She said some teachers bring her into their class to do the whole CPR and first aid curriculum with the students. She also does dental, vision and hearing screenings, she said. She said she works with health care providers locally and around the state to assist with children who have diabetes and asthma or seizures, “so that we can provide the best care that we need to do in the school setting and see what those doctors want us to be doing in the school setting.” “I make sure all of that gets implemented and evaluate that to see if it's working,” Erickson said. At the beginning of the year, she said, she works on immunizations. All kindergartners coming into school have to have their kindergarten immunizations up to date, she said. If they are not up to date, she’ll send letters out to the parents, she added. Students entering seventh grade have to have a TDP —  tetanus, diptheria and pertussis, or whooping cough — immunization,

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Erickson talks about COVID-19 pandemic and being a school nurse Rachel Jamieson rjamieson@havredailynews.com Havre Public Schools Nurse Jeri Erickson said in September that dealing with the COVID-19 pandemic in the schools, so far, has gone well. She said there are four main things she likes to talk to students about COVID-19, as well as to have the teachers talk to their students about: washing hands, which is the number one thing to prevent infection; proper use of face masks; social distancing, and not coming to school when sick. “We kind of have been working with those things with the kids, all of the teachers have those top four things, they know that they are supposed to bring those up to kids every single day,” Erickson said. “… The teachers know that they are to mention these things on a daily basis to the kids. Show them actually what social distancing is and what proper mask wearing looks like, and how you are supposed take it off and put on.” Everything is going great, she said. After this interview, by printing deadline last week, Havre Public Schools had reported one confirmed case of COVID-19, in a person associated with Sunnyside Intermediate School. Contact tracing was ongoing at that point. Erickson said the students were following guidelines well. She thought the masks were going to be a pain for the students to be wearing properly and that they would complain about it and Havre Daily News/Colin Thompson Havre Public Schools Nurse Jeri Erickson poses for a photograph Sept. 2 outside of the Robins School Administration Building. not be compliant — but the students have been amazing, she said.  “Every school that I go to, I haven't had to say one word to any child,” she said. “They have their mask on when they are supposed to, they are wearing it properly, it is over their nose, it is under their chin, they are doing amazing.” Right now, her job involves walking around the schools and room checking to see if social distancing is happening and if it is not happening to make sure the students have their masks on during that period, she said. She added that when students cannot social distance they have to have their masks on, if they are socially distanced they don't have to wear their mask in the classroom. “The teachers are doing an amazing job at that,” Erickson said. ”I'll walk by a classroom and I can tell it's not socially distanced perfectly by the 6 feet, and every kid in that classroom has a mask on. The teachers are doing an awesome job with it as well.” Before COVID-19, she said, she used to be at a different school every day of the week — generally, Highland Park Early Primary School Mondays, Lincoln-McKinley Primary School Tuesdays, Sunnyside Intermediate School Wednesdays, Havre Middle School Thursdays and Havre High School Fridays. Prior to the pandemic, she helped develop plans based on students’ needs, she said, adding that the nursing process goes into that with assessments, intervention, outcomes, evaluations out of those outcomes, seeing if

the plans are working and changing it if it needs to be changed on specific students. “We have a lot of kids in the district that have health conditions,” Erickson said. “So I do staff trainings for seizures, allergies, how to use an EpiPen, diabetes care, CPR, asthma, that kind of thing. I do teaching with the kids too — sex education, puberty, handwashing, I also teach them CPR at certain levels.” She said some teachers bring her into their class to do the whole CPR and first aid curriculum with the students. She also does dental, vision and hearing screenings, she said. She said she works with health care providers locally and around the state to assist with children who have diabetes and asthma or seizures, “so that we can provide the best care that we need to do in the school setting and see what those doctors want us to be doing in the school setting.” “I make sure all of that gets implemented and evaluate that to see if it's working,” Erickson said. At the beginning of the year, she said, she works on immunizations. All kindergartners coming into school have to have their kindergarten immunizations up to date, she said. If they are not up to date, she’ll send letters out to the parents, she added. Students entering seventh grade have to have a TDP —  tetanus, diptheria and pertussis, or whooping cough — immunization,

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Pandemic: Focus at beginning of school year is on student vaccinations, screenings

Allergist: Allergy tests such as an oral food challenge help with diagnosis

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she said. She said after the immunizations, she works on the screenings to get those done prior to Thanksgiving. “Dental, vision and hearing makes an impact on how the kid learns,” Erickson said. She said on top of COVID she still does all of this. “Right now, school is going so well,” she said. “... Now, when I go into the classrooms to teach, instead of it being one day or two days of teaching, it’s now two days or four teaching because it’s split classes. So it’s going to take a lot more of my time to do that.” She said now she goes where she is needed and has provided a COVID-19 Screening Flowchart that was made in accordance with the Hill County Health Department that each school can follow.

“That makes it really easy, because if they follow my flow chart they don't necessarily have to call me every time,” Erickson said. “It hasn't been crazy yet, let's just say that.” She said if a student has any of the following symptoms they will be sent home no matter what: a fever of 100.4 degrees fahrenheit or greater, cough, sore throat, loss of taste or smell, shortness of breath or difficulty breathing, diarrhea, nausea or vomiting, muscle and body aches. Once the student presents any of those symptoms they are then escorted to an isolation room designated by staff, the student will have their temperature taken and a parent or guardian will come pick the student up. But if a student has fatigue, headache or nasal congestion they will not be sent home. They will be sent home if they have any those in combination with other symptoms.

“Students must remain symptom-free without symptom-reducing medication for 24 hours prior to returning to school,” the flow chart says. Erickson said she knows children are going to play with their friends outside of school and during school, but they just need to be safe. “If you're sick, don't go play with your friends,” she said. “If you're feeling anything at all abnormal (don't) go play, and stay home, distance yourself from people until you start to feel better.” She said the two biggest things are handwashing and staying home if sick. Those two things have been preventive measures before COVID-19, she said, but now they need to be more incorporated in people's thought process to get them thinking about safety. “I think kids are really good with it — kids are doing better than adults are with the whole social distancing, the mask wearing and remembering to wash their hands,” Erickson said. ”I feel like they are just doing amazing and it's really surprised me.” She said she thinks everybody's goal is to keep the students in school as long as possible. In order to do that, she said, the students need to be washing their hands, social distancing, and wearing their masks properly and she thinks that's what is going to keep them in school for the longest time possible.

If an outbreak occurs within a school, she said, it depends on the circumstance, it depends on the age of the student, depends on the building, depends on where that child has been and have they been socially distancing in their classroom and more. Erickson is a Havre native, born and raised here, she said, and she also started working on her nursing degree at Montana State University-Northern. She ended up graduating from Flathead Valley Community College in Kalispell, where she received her licensed practical nurse degree then received her registered nurse degree at Aaniiih Nakoda College in Fort Belknap. She said she wanted to become a nurse to help people. “Originally, just to help people I guess to make a difference — pretty much for health maintenance to help people not get sick,” Erickson said. She has been a nurse for 10 years, she said. She added that she is also nationally certified as an asthma educator, which she does out of Bullhook Community Health Center. She likes to educate people so they can stay as healthy as they can, which also is what drew her to work in the schools, she said. Even though she is the only school nurse in the district, she said, it has not been overwhelming.

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rule out a food allergy, an oral food challenge — OFC — is performed. For an OFC, a person is given a very small dose of a food by mouth at first, followed by increasing doses under the supervision of a board-certified allergist to confirm tolerance or a reaction to the food. Biologics: To receive biologic therapy to treat allergic disorders such as asthma, atopic dermatitis — eczema — or chronic sinus disease, treatments are given by injection in your allergist's office, at least at first. If you're behind on appointments to monitor and treat your allergies or asth-

ma, call your allergist today. Ask about their current health and safety procedures so you'll know what to expect when you arrive. Also, if you plan to visit an allergist for the first time, you will need to provide a history of your symptoms, and then the allergist will perform an in-office physical exam. Using this information, the allergist can determine appropriate allergy testing. Need to find a board-certified allergist in your area? Use the ACAAI allergist locator online at https://acaai.org/locatean-allergist .


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Vaccine: Larson: The same precautions that prevent COVID-19 work for flu ■ Continued from page 1

Havre Daily News/Colin Thompson MSU-Northern nursing student Desiree Norden gives a flu shot Sept. 22 at Northern Montana Hospital's drive-in flu clinic. Officials are urging people to get vaccinated to try to reduce any strain on the health care system during the COVID-19 pandemic. Health officials say reducing the chance of people getting the flu will provide more space and personnel to deal with COVID-19. year, and she said she’s having trouble getting these mobile clinics to happen. Larson said it’s mostly a matter of staffing, and she’s looking to hire some temporary help to ensure that these clinics can happen, but until the issue can be resolved she doesn’t have information on when and where these clinics would be held. She said she feels these clinics are especially important given the COVID-19 pandemic, and that they are likely the safest method of getting the vaccine to people. “I feel like taking those flu shots to them is probably the safest way for us to do that,” she said. Larson said the health department itself should be getting the vaccine as normal in

early October, but the availability may be a bit more limited this year in part because the health department wants to limit the amount of people in their office at a time due to the pandemic. Despite the situation, Larson said, she’s relatively optimistic that it will end up being a tame flu season. She said the department typically uses Australia as a predictor since they tend to have very similar flu seasons, and the observations have been encouraging. She said this is likely because, vaccine notwithstanding, the methods of preventing the spread of COVID-19 are identical to that of influenza, as they are both spread through droplets produced by peoples’ mouths and

noses. Washing hands thoroughly and often, wearing a mask, coughing into the elbow, staying home when sick, all of these will help stop the spread of COVID-19 and the flu. “They work just the same for influenza,” she said. She said because people tend to do these things already, she thinks influenza won’t be as pervasive this year as most, although she did still stress the importance of getting the vaccine anyway. Larson said the state health department is also implementing a new flu-prevention program in partnership with the Centers for Disease Control and Prevention to provide

more vaccinations later in the year around December or early January of next year with an emphasis on getting more adults vaccinated. While the stakes are higher this year, Larson said, getting the vaccine would still be important anyway as there are people in Hill County and the U.S. at large who cannot get the shot due to personal health concerns and could get the flu which, while less deadly than COVID-19, can still kill someone. “There are people in our community who are not able to get flu shots because of certain health issues that they’re having, and you don’t necessarily know who they are,” she said, “And by you getting a flu shot you

■ See Vaccine Page 15

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What to expect at your next dental visit (BPT) — Going to the dentist has always been an important part of the overall health care routine. Even now, regular dental appointments are critical to good overall health and it is safe to see your dentist. You have questions. Will I be safe? Is my dental office following precautions? What should I do if I'm still nervous? These are realistic considerations in the COVID-19 world we now live in. Dentists are taking all possible measures to ensure the safety of their patients, staff and themselves. It's important patients keep up with their preventive and routine dental care to support their overall health. The Academy of General Dentistry says it is normal to have anxiety and want to delay your routine dental appointment out of concern for coronavirus exposure. Before you decide to do so, contact your dentist and ask about their current operating procedures designed to ensure your safety. "Dentists have been applying extensive infection control standards in their practices for decades," said Sheila Samaddar, DDS, a general dentist in Washington, D.C., and member of the AGD. "Infection control tools such as masks, gloves and gowns have long been required in all practices. We followed strict procedures before COVID-19 and since have expanded those measures to ensure all spaces in dental offices are disinfected too." Here's what to know when planning and visiting your dentist during this time. First, your dentist's office has taken the recommended measures to make sure your visit is safe and they are ready to treat you. "We care about our patients and want to ensure their safety," Lorna FlamerCaldera, DDS, FAGD, a general dentist in Greenwich Village, New York, and a member of AGD, said. "Your dentist and their practice have put thoughtful procedures in place to make sure you and your family are protected, adhering to guidelines from the U.S. Centers for Disease Control and Prevention and other state and local agencies. They're altering check-in procedures,

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The benefits of biking for kids

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(BPT) — For kids, biking is one of the gateways to growing up. Popular films and TV hits such as "E.T. the Extra-Terrestrial" and "Stranger Things" highlight the joy a bike can bring as a fun way to explore or spend time kicking around the neighborhood. Yet, according to a study from the Outdoor Industry Association, bike riding

among kids declined 19 percent between 2007 and 2019. There are plenty of good reasons for anyone to get outside and ride a bike. Especially during this time of social distancing, bike riding offers the perfect opportunity to shake off cabin fever and safely enjoy the fresh air.

Benefits of bike riding For tweens and teens, there are many benefits of owning and riding a bike, including: • It gets kids outside away from screens to enjoy fresh air and vitamin D-giving sunshine.

• It promotes cardiovascular health. • It builds muscles, while improving balance and coordination. • It improves mental health by helping to reduce anxiety or stress. • It is good for the environment, offering an emissions-free mode of transportation.

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Flu shot ■ Continued from page 3 October. Hill County Public Health Director Kim Larson said in mid-Septmember the majority of that department’s vaccine was delayed in shipment, but it had some doses. “If you are wanting a flu shot now, come in on Tuesdays during our regular hours (8 a.m. to noon and 1 to 5 p.m.) and we will gladly give you one,” Larson said. “We will have our schedule of clinics out to the community as soon as we can.” She said people can can call the Health Department office at 400-2415 to set up a shot. Norden said Bullhook’s fee scale applies to the shots. “If a patient is uninsured, Bullhook provides services on our sliding fee scale, or discount, depending on the patient's family size and income,” Norden said. Larson said the fees at the health center are, for children 6 months to 18 years of age, $20; adults 19 and older $25; high-dose flu shot for ages 65 years and older, $50, and the health department will bill the patient’s insurance. Norden said the risk of not getting a flu shot can range from hospitalization to death, serious illness, missed work and school, spreading illness to friends, family and community members. Larson said it’s especially important that certain people get vaccinated, either because they are at high risk of having

serious flu-related complications or because they live with or care for people at high risk for developing flu-related complications. People in those categories include: • Pregnant women • Children younger than 5, but especially children younger than 2 years old • People 50 years of age and older • People of any age with certain chronic medical conditions • People who live in nursing homes and other long-term care facilities • People who live with or care for those at high risk for complications from flu, including: o Health care workers o Household contacts of persons at high risk for complications from the flu o Household contacts and out-of-home caregivers of children less than 6 months of age — those children are too young to be vaccinated. “During the 2018-2019 influenza season, 13,576 cases, 767 hospitalizations, and 38 deaths, 1 pediatric due to influenza were reported, from all but one county in Montana,” Larson said. For more information, people can refer to the CDC website at https://www.cdc.gov/ flu , stop by Bullhook Community Health Center at 521 Fourth St. or Hill County Health Department at 302 Fourth Ave.

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Now is a good time to head back to your allergist

Biking: Together We Rise helps provide bikes to foster children ■ Continued from page 12

(BPT) — Since the coronavirus pandemic began, many Americans have canceled or postponed non-emergency doctor visits. At first, practices were temporarily closed, but later patients avoided visits out of fear of exposure to COVID-19. In a Kaiser Family Foundation tracking poll from May of this year, nearly half — 48 percent — of respondents said that they or someone in their household had p o s t p o n e d o r s k i p p e d m e d i c a l c a re because of the pandemic. Perhaps not surprisingly, 11 percent of adults overall reported that their or their family member's health condition had worsened due to delaying or canceling medical appointments. If you or your child suffers from a chronic condition like allergies or asthma, it is likely you could experience a further decline in your health and well-being by continuing to put off visiting your allergist. If you have allergies and asthma, you need to have your medications and your overall health monitored carefully — and regularly — by an allergist to keep symptoms under control. Allergists are specially trained to help patients manage these conditions effectively, so it's vital to keep up regular visits to maintain the best possible health outcomes. Health and safety procedures If you're one of the many Americans who haven't kept up with appointments out of concern for exposure to COVID-19, you can be reassured by the strict safety protocols being implemented by allergists' offices around the country to protect their patients, as well as their staff. "Our first priority as allergists is keeping all our patients and staff safe from COVID-19, while at the same time keeping patients' allergies and asthma under control," said J. Allen Meadows, M.D., president of the American College of Allergy, Asthma and Immunology. "When you Brandpoint

• It helps build self-confidence and relationships with others who like cycling, too. Help for foster kids who need bikes Unfortunately, not every kid has the opportunity to enjoy the many positive aspects of bike riding. Children in foster care, tweens and teens in particular, don't always have access to a bike, so they aren't able to experience this important milestone of growing up. To help address this issue, Honeycomb cereal recently donated $50,000 to Together We Rise, a national nonprofit dedicated to helping improve the lives of youth in foster care. The donation will provide 600 bicycles to tweens and teens in foster care

nationwide, helping them to build their confidence and experience the many physical and emotional benefits that having a bike brings. Bikes have been part of Honeycomb's history since the 1970s, featured in its advertising and promotions. Kids growing up in the '70s and '80s fondly remember collecting Honeycomb bike-sized state license plates, which were given away free inside cereal boxes each year. " We ' re t h r i l l e d to t e a m u p w i t h Together We Rise to give kids in foster care the chance to experience the fun and joy that biking brings," said Michelle T i t u s, s e n i o r b r a n d m a n a g e r o f Honeycomb cereal. "This donation will make the dream of owning a bike a reality

for these kids." Safety tips Kids heading out on their bikes should follow basic guidelines to protect their health and safety. Remind your tween or teen to: • Always wear a helmet, even for a short trip. • Be visible by wearing bright clothing and using reflectors or lights to ensure others can see you, especially in the early morning or around sundown. • Always use sunscreen to protect exposed skin from UV rays. • Stay hydrated by drinking plenty of fluids. • Stick to bike paths, if possible, rather

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than riding on the street. • Obey all traffic laws. • Stay alert while riding. • Don't use ear buds or headphones that could prevent you from hearing traffic or other dangers. • Don't use your phone or text while riding — stop and get off the trail to use any device. Now is the perfect time to get your kids biking and consider helping foster kids do the same. For more information about the To ge t h e r We R i s e B i ke s fo r Fo s t e r Children program or how to sponsor a bike for kids who need one, visit http:// TogetherWeRise.org .

come to the office, know that your allergist has put protocols in place to make your visit both comfortable and safe." Here are just some of the safety practices being employed by allergists: • Virtual visits for consultations when possible • Mandatory mask wearing by all patients, visitors and staff • Social distancing procedures throughout the office Extra time between patients for cleaning and disinfection • Remote check-in at arrival, so patients can wait in their cars until the doctor is ready to see them instead of in a waiting room • Some services — such as biologic shots — can be administered at patients' vehicles outside, in some practices Why you may need office visits While some issues can be discussed with your allergist using telemedicine, many of the most crucial allergy and asthma treatments and procedures must be performed in the office to ensure that you are getting the best possible health results. Allergy testing: Most patients are given an in-office skin test to detect sensitivity to common household animals (like cats and dogs), dust mites, grasses, trees, weeds and mold. If you're taking medicine that could interfere with allergy test results or if you have very sensitive skin or a serious skin condition, your allergist might perform a blood test instead. Allergy shots: If you are receiving allergy shots, these will need to be administered in person. Allergy shots are given on a schedule designed to increase the amount of the allergen on a regular basis. It's best not to interrupt, skip or postpone the timing of when you get them. Oral food challenges: To confirm or

■ See Allergist Page 7

Health officials encourage getting flu shot Rachel Jamieson rjamieson@havredailynews.com Flu season is right around the corner and people can stop by the Hill County Health Department or at Bullhook Community Health Center to get their flu shots. Flu shots also can be given by pharmacists, and a directive issued by Gov. Steve Bullock now allows pharmacists to administer the vaccinations to children ages 3 to 18, as well as at other health facilities and at flu clinics sponsored by organizations and businesses.

The Centers for Disease Control and Prevention defines a flu shot as a vaccine against the influenza virus. On its website, https://www.cdc.gov/flu/ index.htm, it provides tips for people to prevent the flu, symptoms, treatment, and flu surveillance and activity in the United States.    Bullhook Community Health Center Medical Department Manager Desirée Norden said Bullhook will begin offering influenza vaccines to its patients during the last week of September or first week of

■ See Flu shot Page 13

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Flu vaccine more important than ever amid pandemic

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■ Continued from page 6

Hill County Public Health Director Kim Larson, who was recently appointed Hill County Health Officer, as well, said this year it’s more important than ever for people to get their flu vaccine. Larson said the reason for this urgency is, as might be expected, the COVID-19 pandemic, which she said still has the potential to strain the health care system, which would not be helped by a parallel outbreak of influenza. “We don’t want to strain our health care system any more than necessary, and the possibility of our health care system already being overwhelmed by COVID alone is pret-

ty high,” she said. “But if we add on to that a huge outbreak of influenza … then our health care system will be really overwhelmed.” Larson said hospitals are well-prepared for flu season when it comes around every year, and while some years are worse than others it’s a recurring and anticipated phenomenon. But a local rise in hospitalizations due to influenza wouldn’t just reduce the space facilities have for dealing with COIVD-19, it would also increase the amount of personal protective equipment that would need to be used and increase the possibility of hospital workers getting sick, further straining the system. She said no recent changes have occurred

in how the pandemic has been affecting the county, but the department is watching the situation closely as schools reopen and sporting events start back up. Larson said in mid-September that after two incubation periods — about two weeks — the health department will have a better idea of what recommendations to give institutions and how things may progress in the county as a whole. She said a smaller town like Havre may not have the same transmission dynamics as a place like Missoula, so it’s still hard to say what the effect of reopening will be locally, especially with those dynamics being different even between different schools in the area. She said she and the health department

at large are watching the situation as a whole, but if everyone made an effort to get their vaccine as early as possible, it would markedly reduce the risk of the system being overwhelmed in the case of a COVID19 outbreak. “Getting your flu vaccination is the best way to prevent the flu and protect yourself,” she said. Larson said, in a normal year, the health department, after obtaining the vaccine, would partner with local institutions to hold mobile clinics across the Hi-Line, first in Gildford and Rudyard, then take it to businesses in the Havre area to make it easier for people to get the vaccine. But this is not by any means a normal

■ See Vaccine Page 6

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Patrick Johnston pjohnston@havredailynews.com

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Dentist: Professionals recommend keeping up with at-home care, as well increasing the pieces of personal protective equipment worn by staff, minimizing personto person contact, and have enhanced cleaning and sterilization." New check-in procedures, including screening procedures and social distancing strategies, are designed to protect patients and staff during a dental appointment. "Your oral and overall health is our priority, and we are asking patients a few screening questions in advance of appointments," Flamer-Caldera said. "We are also asking patients to wait outside or in their vehicle prior to the appointment, wear a mask within the office when not being seen or treated by the dentist, or stay home and reschedule if you are feeling unwell the day of your appointment." Second, delaying your dental care may result in additional and more costly problems in the future. "Scheduling that overdue dental appointment is more important than ever now, as dental offices are working to manage patients who put off treatment during COVID-19," Samaddar said. "Patients should visit the dentist regularly to ensure that dental problems are caught early. In addition to teeth cleaning, we screen patients for oral cancer and other conditions. This is an important part of taking care of your overall health. "You may end up having to undergo and pay more for procedures that professional intervention could have prevented early on," Samaddar added. "Early detection and rou-

Havre Daily News/Colin Thompson Tony Gabrielsen receives a flu shot Sept. 22 from nursing student Stephanie Moog at the Northern Montana Hospital drive-in flu clinic. Officials are urging people to get vaccinated to try to reduce any strain on the health care system during the COVID-19 pandemic. Health officials say reducing the chance of people getting the flu will provide more space and personnel to deal with COVID-19.

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are helping to protect them as well.” Larson said a directive issued by Gov. Steve Bullock lowered the age of people licensed pharmacies can give flu shots to, which she said will be helpful in the coming flu season, as pharmacies are often more convenient for people than the health department. The directive allows pharmacists to administer the vaccinations to people ages 3 to 18. “I think it’s just another way of ensuring that vaccinations are getting done,” she said. “A lot of health departments are kind of overrun with COVID-19 right now … and if the pharmacies can help with that, I think it will be great.” She said local health departments typically don’t have a huge employee base and amid the pandemic there is still plenty of contact tracing to be done. Larson also addressed concerns by some people that influenza could cause false positives while testing for COVID-19, but she said there’s no indication that that would be a serious concern, as influenza is not caused by a coronavirus, and the tests being used by Hill County look specifically for concentration of that virus itself. Larson said to set up a flu shot with the Hill County Health Department, people can call the office at 400-2415, but she encouraged to go to a pharmacy if that is more convenient.

tine professional care typically improve overall oral wellness outcomes." Third, feelings of anxiety caused by the pandemic may be difficult for patients, compounding fears and making it difficult for some to schedule an appointment. Talk to your dentist about your concerns. "We are familiar with dental anxiety and

helping patients work through their fears," Flamer-Caldera said. "Give your dentist a call to address your concerns, as many of your needs can be resolved simply by talking about them. Your dental team will inform you of what to expect and answer your questions to ensure your comfort during an appointment."

Of course, it's important to keep up with at-home oral hygiene as well, such as brushing for two minutes twice daily, flossing, and avoiding sugary foods and liquids. For more information on where to find guidance around visiting the dentist right now, people can visit http://www.agd.org/ seeyourdentist .


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