BOH

The members of the Wayne County Board of Health have found themselves busier than ever in recent months and have been faced with tough decisions while looking out for the best health interest of the county. The once a month meetings turned to once a week as they worked to stay on top of the Covid-19 pandemic.

The county remains with one single recorded case of Covid-19 as the State of Iowa positive numbers and deaths continue to rise. Wayne County being a rural area along with the conscious efforts from community members, the board of health and all healthcare workers have proven to be successful in keeping the local coronavirus numbers down.

As the board came together on May 20, several tough questions were on the agenda to be answered as local towns, organizations and businesses have reached out asking for guidance regarding their events. Dr. Joel A. Wells, DO noted the difficulty in making the tough decisions isn’t one to take lightly.

“As a board of health it’s time for us to start publicly commenting on this and we are a long ways from August and even July, and if we scrap the baseball and softball seasons now, these kids are going to be affected by these decisions,” stated Dr. Wells. “I think it’s time for us to act.”

Local youth ball organizations have pushed seasons out unsure how to move forward with a ball season while also following guidelines. Humeston and Clio have already made decisions to cancel their town celebrations, while surrounding towns within the county are still holding out to make a final decision.

“I don’t see the governor going from 10 in a gathering to hundreds, maybe 50, 100 at the max and that will be the biggest thing,” said Wayne County Public Health Administrator Shelley Bickel. “These organizations want our guidance though.”

“In most of these issues the age isn’t addressed of when you think kids can be responsible and there is a concept where things won’t work based on the ages,” said Dr. Wells. “This virus is an infectious disease and if you look at the states that were hit hard, it did overwhelm their medical systems. It did do that and that should add a little bit to our anxiety.”

Dr. Wells and Bickel along with fellow board of health members Clayton Merritt, Tom Swearingin, Penny Fetters and Susie Gibbs released the following statement on their views regarding upcoming summer events and how to make the decision whether to postpone, cancel or hold the event:

“The Wayne County Board of Health will address the concerns that arise while the residents of Wayne County continue their efforts to maintain social distancing in an environment where COVID-19 continues to be a significant health threat and likely will continue to be one for the near future.

We realize that our local community has been dealing with significant changes in their lifestyle since the State of Iowa declared a Public Health Disaster Emergency on March 16, 2020.  Since that time there has been changes in our ability to test for the virus - we are better equipped to test.  Our knowledge of the virus has improved and we have had more time to assess how our efforts and others efforts have worked at slowing the spread of the virus.  There is still no vaccine or curative treatment available.  We now have knowledge that people with mild or no symptoms can spread this disease.  Public health measures and prevention has proven to be effective at slowing the spread and reducing the expected number of infected individuals.  However, the state and nation still has a significant number of cases and if anyone fails to take appropriate precautions, then they risk contracting a potentially serious infection and spreading that infection to others and this is an everyday fact of life.

The situation has tested our society.  It has certainly affected the global and local economy.  It has tested our patience.  It has created anxieties where none existed on a scale that is overwhelming.  It has brought us together as well as created vast differences of opinion when it comes to how we deal with multiple and sometimes complicated decisions about our health risks.

The board is cognizant that a significant portion of society is ready to take the risk of contracting infection in lieu of continuing to isolate themselves to the degree that is becoming socially “painful”.  We also acknowledge that there is plenty of risk and it varies from individual to individual depending on other factors such as age, general health status, place of residence, etc.  Actions of any one individual may not only have adverse consequences for themselves but their neighbors and coworkers as well.  Governments are starting to contemplate as well as they work to actively lift restrictions on gathering and conducting business.  We understand the push to do this, but also feel that the role of the board of health is to provide advice that is carefully worded to guide local residents in such a way that it maximizes their physical, emotional and social health.

We will attempt to review activities within our county and begin to recommend whether we think these activities can be resumed in a safe manner or whether they need to continue to be postponed until a later time.  If we recommend that an activity can be resumed, we will attempt to research the issue so we can also provide advice on how the activity should be modified to minimize any adverse consequences.  We will monitor and adjust our advice to the current knowledge and health status of our community.

As we give advice for activities, we will ask the following questions:

What is the good or benefit that will result?

What are the dangers to the participants or society at large that will result?

Is there a way the activity can be modified to maintain the good and eliminate or reduce 

the risks?

Should the activity simply be postponed?

Are there any unintended consequences that will result?

Is there a state or national recommendation that applies to the activity and is it    

appropriate for Wayne County?

With that in mind, we reviewed the upcoming activities in Wayne County this summer including the county fair, baseball/softball, auctions, town celebrations, swimming, weddings and children’s theatre.  

The current state proclamation in place limits social gatherings to 10 people or less and this precludes having all of the events listed.  We anticipate that the state will start to loosen these restrictions but that does not make large gatherings safe or eliminate the need to socially distance and use appropriate hygiene.  We see that many communities have concluded that reducing a large celebration to a small social gathering effectively undermines the point of the activity altogether and therefore, most of these events would be better off postponed.  

Children’s events are very age dependent and it is logical to anticipate greater difficulty getting younger children to follow good hygiene and distance.  Some events are an aggregate of individual events and are complex to evaluate.  The county fair is a good example of this (rodeo, livestock show, concession stands, 4-H exhibits, etc.)  It would likely be best if each aspect be considered on its own merit.  

Swimming is a good example of an activity that is probably benign from the standpoint of letting kids swim in chlorinated water.  However there are dressing rooms, bathrooms and concession stands.  Drowning is a major cause of death in children and adolescents and there certainly may be unintended consequences if swimming goes on in unsupervised settings.  The board cannot provide any clear guidance at this time and will continue to research.

Sports are certainly a treasured activity for our youth.  The board acknowledges the value or good of these activities.  We believe that baseball/softball represents an ideal sport to “try out participation”.  The outdoor nature of the event, the ability to spread out and the non-contact play would make it an activity that lends itself to modification and we think it could be conducted rationally this summer.  The board will post recommendations on its Facebook page and also local news sources.  The recommendations are based on proposals from the USSSA league, Babe Ruth, Ohio and Nebraska youth leagues. Our advice on modifications will stand even if the state suggests unrestricted participation.

This board previously dealt with the issue of auctions and we stand by our previous recommendations to postpone or conduct only as directed by the Iowa Dept. of Agriculture and Land Stewardship.

We would like to point out that the Board of Health is open to all comments and concerns and always willing to listen to public comments.”

“Some may feel they are being cheated in a sense, but you have to weigh the benefits against the risk,” Fetters added. “We all need to do this.”

“Nobody wanted this to happen or intended for this to happen,” said Merritt.  

“My take on this as a physician is the principals for managing this as an infectious control process has not changed,” Dr. Wells added in closing. “If you don’t wash your hands, you aren’t doing what you should be doing. If you are less than six feet from someone, you aren’t doing what you should be doing. If you do bring people together and they cannot space themselves out adequately, that is bad and the more people we bring together the more risk there is. It is that simple.”

Following the adjournment of this meeting, Iowa Governor Kim Reynolds announced additional loosening of restrictions including the opening of high school baseball and softball seasons beginning June 1. Along with that announcement Reynolds added movie theaters, zoos, aquariums, museums, swimming pools for laps and lap-swimming only and reception venues will be allowed to reopen with appropriate health measures being following and social distancing beginning May 22.

Governor Reynolds also noted state parks will be allowed to open restrooms, showers and cabins beginning May 22 however playgrounds and shelters will remain closed along with casinos, amusement parks and playgrounds.

Bars will be allowed to reopen indoors and outdoors at 50 percent capacity beginning Thursday, May 28. 

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