End of state proclamation isn’t the end of COVID-19, local public health officials say

As Iowa is set to scale back its statewide coronavirus response this week, local public health agencies are preparing to adjust how they monitor virus transmission at a community level.

The state’s coronavirus disaster proclamation will expire on Tuesday, just before midnight Wednesday, ending the public health emergency response that has been in place since COVID-19 arrived in Iowa two years ago.

The proclamation, which was signed by Gov. Kim Reynolds on March 17, 2020, reallocated state resources to focus on pandemic response and suspended certain state laws to support public health and health care entities on the front lines.

Starting Wednesday, managing the coronavirus will be “part of normal daily business,” similar to how the state public health department responds to influenza, according to Reynolds.

“We cannot continue to suspend duly enacted laws and treat COVID-19 as a public health emergency indefinitely,” the Republican governor said in a statement earlier this month.

“After two years, it’s no longer feasible or necessary. The flu and other infectious illnesses are part of our everyday lives, and coronavirus can be managed similarly.”

However, local public health officials worry this move could cause some Iowans to assume the pandemic is over. Linn County Public Health Director Pramod Dwivedi said the end of the proclamation should not be equated with the end of COVID-19.

“SARS-CoV-2 remains in the community with high transmission rate, and we all need to continue with efforts to protect ourselves and our neighbors,” he said, referring to the novel coronavirus.

Reynolds’ announcement comes as new COVID-19 infections, hospitalizations and deaths are on the decline after the latest surge driven by the highly transmissible omicron variant.

However, coronavirus outbreaks at long-term care facilities continued to increase to the triple digits in recent weeks. As of this past Wednesday, the most recent weekly coronavirus report from the state, there were 114 facilities recording three or more cases among residents and staff.

By comparison, Iowa has recorded no outbreaks of the flu within long-term care facilities so far this season. As of the week of Feb. 5, there were 120 influenza-associated hospitalizations and 15 deaths as a result of the virus.

The flu is endemic, meaning the timing of its appearance, the infection rate and the demand it puts on hospitals can be predicted. Many experts say COVID-19 eventually will become endemic, too, but Iowa — and the rest of the nation — are not there yet, said Lina Tucker Reinders, executive director of the Iowa Public Health Association.

“What’s happening now is the goal for coronavirus surveillance, where we do track it like other communicable diseases,” she said. “But the question is whether this is the right time to do this.”

Iowa Department of Public Health Interim Director Kelly Garcia agreed COVID-19 is not yet endemic, telling reporters earlier this month that while it ultimately will be the case, “we’re not there yet.”

Local public health adjusts coronavirus tracking

With the proclamation ending this week, one of the most notable impacts will be the shift in how the Iowa Department of Public Health reports it coronavirus data. And as a result, local public health officials say it may be more difficult to understand the severity of the virus’ effects in their communities.

“We’re still learning what and to what extent the impact is, but at the moment it seems minimal,” said Sam Jarvis, community health manager for Johnson County Public Health. “However, there are concerns about reporting.

“We would like to continue to have the best visibility on local transmission as possible so that we can keep the community informed and make informed decisions.”

On Tuesday, the state public health department is shutting down its COVID-19 tracking site — coronavirus.iowa.gov — and instead providing those statistics on IDPH’s website, Garcia said earlier this month.

Going forward, the state also is no longer requiring reporting on negative test results — which means local public health agencies no longer will be able to report seven-day positivity rates for their counties.

Statewide infection counts have been harder to accurately measure in recent months with the wide availability of at-home testing options — meaning, Tucker Reinders said, new case data on the state’s dashboard is likely under reported.

In addition, Iowa no longer will require hospitals and nursing homes to report its case counts to the state. Instead, those metrics will be available on federal websites, as those entities still are required to report to federal entities, Garcia said.

Some Eastern Iowa public health agencies have said they will continue to track these metrics without the state’s assistance. Dwivedi said Linn County Public Health will continue to publicly share county hospitalization data available from local hospitals and from federal officials.

Johnson County Public Health will continue to ask long-term care facilities to report and coordinate outbreaks with the department, Jarvis said.

Linn County, however, will not be monitoring those outbreaks, as those health events now fall under the authority of the federal Centers for Medicare and Medicaid Services, Dwivedi noted.

Without the state-run COVID-19 website, Tucker Reinders said she is concerned individuals no longer will have easy access to data that can help them make informed choices in the near future. Any drop in vigilance in pandemic mitigation strategies could have consequences on vulnerable populations, or families with children under the age of five who aren’t able to get vaccinated yet.

“What is the impression the public is going to have if this one-stop shop is taken away?” she said. “Ending the proclamation hasn’t stopped the pandemic.”

The state also is pulling the plug on vaccinate.iowa.gov, an online tool that helps Iowans find available vaccine appointments in their area.

Local public health officials continue to urge residents to get vaccinated and boosted against the coronavirus and to practice other precautions, particularly as the virus transmission rate remains high. That includes staying home when experiencing symptoms and wearing a mask in public settings.

“While we hope to continue to see cases and hospitalizations decrease, should that change, we’ll continue to emphasize the mitigation measures we’ve had to practice the past almost two years so that we can continue to protect ourselves and others and support and maintain our local workforce and health care capacity,” Johnson County’s Jarvis said.

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