Local COVID-19 response hindered by poor communication from state, report says

CEDAR RAPIDS — A gap in timely communication from state officials to county public health agencies and other local entities created challenges in those communities’ ability to respond to the spread of coronavirus, according to review of pandemic response commissioned by Linn County officials.

The Linn County Board of Health this week released the county’s COVID-19 report, a detailed analysis by a third party agency to identify successes and weak points in the county’s response to the pandemic between March 2020 and June 2021.

The public health agency paid Arizona-based Coll Consulting $43,651 to conduct the review using federal and state grant funds. The review took place between Sept. 2021 and Feb. 2022.

Among its findings, the report identified a communication gap between the state and Linn County Public Health as a major weak point. “There was a lack of strong, real-time decisions from the state as well as timely communication on decisions made,” the report stated.

Notably, the report found information sharing from the state to local officials occurred primarily during Gov. Kim Reynolds’ public news conferences — meaning county public health departments learned of new coronavirus response policies at the same time as the rest of the public. This “created challenges to plan for and implement initiatives,” the report states.

One example was the state’s decision in March 2021 to expand COVID-19 vaccine eligibility to include those with underlying medical conditions without giving prior warning to local public health departments managing vaccine administration. As a result, Linn County Public Health officials — as well as other officials across the state — had to work through the weekend to prepare for the influx in demand for shots.

Linn County Public Health Director Pramod Dwivedi said it also put the local health department in an awkward position when its employees received questions from the public about the newest guidelines, and they didn’t have an answer.

“In a very rapidly moving and changing disease outbreak situation, communication is so critical,” Dwivedi said. “As a local health agency, you are right there in the field responding to any outbreak, but when it comes to communication and resources, you’re in the back of the line. That needs to change.”

State says there was clear communication

The Governor’s Office said the Iowa Department of Public Health routinely met with local and county public health officials to share relevant information on Iowa’s COVID-19 response, they said, and did provide “a clear and direct line of communication.”

“In the constantly evolving pandemic, controlling information was critical to reduce the spread of false information from trusted sources,” Alex Murphy, spokesman for the Governor’s Office, said in a statement to The Gazette.

Communications challenges are often identified in after-action reports following emergencies, Iowa Department of Public Health spokeswoman Sarah Ekstrand said in response to the findings.

“IDPH looks forward to hearing more from Linn County about their (after action report) and to reviewing strategies with our partners to improve communication strategies across all levels,” Ekstrand said.

Local public health departments nationwide dealt with a lack of consistency in guidance between states and federal health agencies, with states often taking a patchwork approach to mask requirements, business closures and other mitigation efforts.

Early on in the pandemic, Dwivedi said the county public health department opted to follow guidelines from the federal Centers for Disease Control and Prevention — which often differed from recommendations made by the state.

Moving forward, Dwivedi said he hopes state and local health officials can create a cohesive communication strategy in the event of other emergencies.

“It would save lives,” he said. “We understand there may be hiccups and issues in a rapidly evolving situation, but we must have accountability and responsibility to our neighbors.”

State officials have not publicly said whether the state will conduct its own report on COVID-19 response, but the governor’s spokesman said the state is working to identify areas of improvement.

“The state continues to analyze our processes to determine if there are efficiencies and other areas of improvement needed, including communication, following the global pandemic, which had absolutely no playbook to follow,” Murphy said in an email to The Gazette.

Other improvement needs and successes identified

Overall, the report identified Linn County Public Health’s partnerships with other community stakeholders — such as hospitals, county and city governments, school districts and emergency management agencies, among others — as a major strength during the local coronavirus response.

“This teamwork was essential during such a large scope and duration event,” the report stated. “Linn County, local cities, the medical system and community partners all worked together in a collaborative environment to save lives and mitigate the spread of the COVID-19 virus.”

Dwivedi said this partnership with stakeholders outside the public health agency were “crucial to our success.”

“It’s a team sport,” he said.

However, the report did identify the need to better prepare staff to fulfill roles in the county’s incident command and emergency response centers. Early on in the pandemic response, it was clear not every staff member had enough training or experience in this type of disaster response, Dwivedi said.

“I think that was a shortcoming we need to address going forward so that we are well prepared in the future,” he said.

Dwivedi said Linn County Public Health will work to address improvements moving forward. In addition, local officials will look to build on its strengths identified in the report.

Comments: (319) 398-8469; michaela.ramm@thegazette.com