Allamakee County reported as having two confirmed cases of COVID-19

Schools across Iowa closed for four weeks, many events canceled or postponed; Health officials offer guidance

The Iowa Department of Public Health (IDPH) and Allamakee County Public Health have reported Allamakee County’s first cases of COVID-19.

“This investigation has identified two cases of COVID-19 with known international travel exposure,” the joint health departments shared in a jointly-released statement. “One individual is a middle-aged adult between 41-60 years; the other is a child, age 0-18 years. This is not indicative of community circulation of the virus here in Allamakee County. It remains critical that all residents continue to take preventive measures.”

Those preventive measures to help slow the spread of the COVID-19 infection include:

• Staying home when ill.
• Covering coughs and sneezes with a tissue or elbow/upper arm.
• Washing hands frequently with soap and water for at least 20 seconds (humming the “Happy Birthday” tune twice in succession).

The public health departments state that it is believed coronaviruses are primarily spread through respiratory droplets, which means to become infected, people generally have to be within six feet of someone who is contagious and have the droplets land on them.

“This may be a novel virus, but it is not a novel investigation,” the statement furthered. “Public health staff participates in disease investigations all the time and are well trained to handle these outbreaks. We will continue to work with our partners to provide support and guidance on community actions in Allamakee County.”

COVID-19 IN IOWA
It has been just over a week since the first positive tests for novel coronavirus (COVID-19) were reported in the state of Iowa, beginning in Johnson County within a small group of Iowa City residents who traveled on a cruise to Egypt. Since that Sunday, March 8 announcement the number of positive cases in the state of Iowa has grown to 23 as of this week’s print deadline, including the first three cases not related to travel from an infected area and determined to be “community spread” from an unknown origin, the first community spread case being identified and first reported Saturday evening, March 14.

According to State of Iowa public health officials, community spread occurs when an individual has been infected with a virus where public health officials cannot specifically identify the source of the infection, or they cannot determine how or where the person became infected.

The emergence of the first “community spread” case means State of Iowa officials recommend for the first time that Iowans not hold or attend large gatherings of more than 250 people, an effort aimed at slowing or preventing further spread of the disease. A number of events and activities ranging from small community gatherings, to church services, to youth, high school, college and professional sporting events and seasons have all been called off within the state, nation and throughout the world in an effort to help control the spread of the COVID-19 disease caused by the coronavirus.

The Centers for Disease Control and Prevention (CDC) more recently announced - as of Sunday evening, March 15 - that people throughout the United States should avoid events involving 50 people or more for the next eight weeks. That announcement comes as some major cities have already put in place bans on large events and ordered bars and restaurants to close.

“This recommendation is made in an attempt to reduce introduction of the virus into new communities and to slow the spread of infection in communities already affected by the virus,” the CDC said.

The expansion of community spread to three cases this past weekend prompted Iowa Governor Kim Reynolds to hold a Sunday evening, March 15 press conference at which she announced in conjunction with the Iowa Department of Public Health and the Iowa Department of Education the recommendation to close all Iowa schools, joining a similar action taken in the surrounding Midwestern states of Illinois, Minnesota and Wisconsin. Administrators in the Allamakee Community School District and the Eastern Allamakee Community School District reacted quickly to the Governor’s recommendation, announcing school closures in those districts effective immediately Monday, March 16 and continuing through at least April 13, depending upon further developments.

WORLD RENOWN KNOWLEDGE WITH LOCAL TIES
Waukon native Dr. Michael Osterholm is the director of the Center for Infectious Disease Research and Policy (CIDRAP), a world-renown authority in addressing public health preparedness and emerging infectious disease response. He has been quoted and interviewed through a variety of global media venues regarding COVID-19 that has been deemed a worldwide pandemic. Osterholm’s greatest initial concern with the response in the United States to the outbreak is the fact that he sees the initial response being handled as if the COVID-19 outbreak were only a “coronavirus blizzard”, meaning just having an impact of several days to a week, when, in fact, he warns that it will likely be more like a “coronavirus winter, and we’re just in the first week,” meaning it will be more like an entire season with early indications of this outbreak lasting anywhere from three to six months once it reaches a location.

Upon the early analysis of this COVID-19 infection, Dr. Osterholm and his CIDRAP colleagues have stated that, although this coronavirus is very similar to the more common influenza viruses, the sentiment is that its impact will likely be “20 to 30 times greater” than any seasonal influenza outbreak in terms of number of illnesses, hospitalizations and even fatalities.

Dr. Osterholm has been noted as saying that one of the most troubling aspects of this new outbreak is the early evidence that seems to point toward people being contagious even before they may show any symptoms, making the spread of the virus more difficult to track or predict. Osterholm has also suggested that the most important thing is to protect those who would be most adversely affected by the virus, which he says would be the older generation and those with underlying health conditions.

SIMILARITIES AND DIFFERENCES WITH INFLUENZA
Health officials, including Dr. Osterholm, note that there are some distinct similarities between the coronavirus and influenza, including the most tale-telling symptoms of fever, cough, body aches and fatigue, with those symptoms for each virus being anywhere from mild to severe and even fatal in the most extensive cases. Health officials say the coronavirus seems to have the added tell-tale symptom of resulting in shortness of breath that should prompt immediate medical treatment.

Treatments are also very similar for both in that treatment of those symptoms is primarily the only means to help a person ride out the virus as it runs its course. There are no antibiotic treatments that will aid in the recovery of such viral infections.

The similarities further extend to transmission of the virus between individuals, with respiratory transmission being the primary vehicle through coughing, sneezing, talking or breathing. The greatest difference, however, is that the coronavirus has shown an early tendency to remain in the air through tiny droplets that can cause the disease well after an infected person is no longer in the area, thus making this virus much easier to transmit and more difficult to contain.

For both influenza and COVID-19, the most effective similar forms of prevention continue to be frequent hand washing, coughing or sneezing into a discardable tissue or at least into the crook of one’s elbow, refraining from touching one’s face, staying home when one is sick, and limiting contact with people who may be showing symptoms. If unable to wash hands with soap and water for at least 20 seconds (humming the “Happy Birthday” tune twice in succession), then a hand sanitizing gel with at least a 60% ethyl or isopropyl alcohol consistency is recommended. See additional hand washing specifics on Page 1B of this same issue of The Standard.

Local officials have reported that some residents have noted availability of alcohol-based hand sanitizers is limited in some places. “This should not be a reason for undue concern,” said Lisa Moose, Allamakee County Public Health Director. “Hand sanitizers are convenient and effective, but we want everyone to remember that good ol’ soap and water is still the best way to prevent illness.”

Influenza has had vaccinations formulated to help provide some immunity to the disease, but there is currently no vaccination for coronavirus and likely not to be one for many months, according to health officials. Those same officials say that it is the fact that there is no built-up immunity to this COVID-19 infection caused by the coronavirus that has fueled the quick and wide pandemic spread of the disease.

HOW TO SEEK TREATMENT
Locally, the influenza virus has prominently emerged once again in recent weeks, forcing area healthcare facilities to limit visitors to hospital patients and long-term care residents. Those restrictions have been in place since last week and will remain until further notice now that the coronavirus has also emerged within the state of Iowa.

When experiencing any of the symptoms listed above, it is highly recommended that individuals call ahead to their doctor or healthcare facility to determine a course of treatment in order to limit or prevent additional exposure (see shaded box on Page 1A regarding testing). Local healthcare officials advise that calling and describing symptoms and exposure history will help determine if an individual needs to be evaluated in person and further determine the specifics of any possible testing for influenza or coronavirus. Calling ahead will help medical facilities make the appropriate entrance and treatment accommodations for an individual while limiting exposure to other patients and/or staff.

Veterans Memorial Hospital in Waukon advises that those experiencing the symptoms described above should call the hospital at 563-568-3411 before traveling to the hospital, including its urgent care or emergency room service offerings. The hospital also advises that additional information about COVID-19 can be found through the Iowa Department of Public Health (IDPH) and the Centers for Disease Control and Prevention.

A status report of monitoring and testing of COVID19 in Iowa provided by IDPH can be found at https://idph.iowa.gov/Emerging-Health-Issues/Novel-Coronavirus. Additional information can also be found by following IDPH on social media, such as on Facebook at @IowaDepartmentOfPublicHealth and on Twitter at @IAPublicHealth. In addition, a public hotline has been established for Iowans with questions about COVID-19. The hotline is available 24 hours a day, seven days a week by calling 2-1-1.