There is no denying anyone working in the healthcare field currently is putting themselves at risk during the Covid-19 pandemic. The front line workers, feverishly putting forth time and effort to help those that are ill as well as keeping those that are healthy to remain that way.
With a virus attacking not only one county, one state, one country, but instead being a global concern, those in the healthcare industry must use their knowledge in this field to do any and everything possible to keep those they serve healthy.
Much like the mission statement for the U.S. Department of Health and Human Services, the Wayne County Board of Health along with Wayne County Public Health Administrator believe it their mission to protect the health and safety of the citizens of Wayne County.
“That is my job, that is the Board of Health’s job,” stated Wayne County Public Health Administrator Shelley Bickel during the board of health’s weekly public meeting held Wednesday morning. “Bottom line that is my job to protect the health within our county. People don’t have to agree with this and we don’t have to agree with them.”
Board of health members have fielded several phone calls from concerned citizens in the recent week pleading with them to take action regarding an upcoming large Amish horse auction scheduled to take place on Thursday, April 2. The auction originally scheduled for March 18 was postponed due to newly released recommendations from the President of the United States on March 15, which was followed by State of Iowa Governor Kim Reynolds.
The recommendation, which mandated guidelines on the heels of Centers for Disease Control and Prevention, requested citizens to cancel or postpone any gatherings of 50 people or more. Later in the day the number drastically dropped from 50 to 10.
Acting on behalf of concerned citizens, Bickel reached out to State Medical Director and Epidemiologist Dr. Caitlin Pedati, Assistant to the State Medical Director Ann Garve and the State of Iowa Attorney General’s Office for guidance on handling the situation. Bickel was informed the sale needed to be shut down pursuant to Iowa Code section 135.144(3).
The concern with citizens and the board of health regarding this particular sale was present due to the large number of out-of-state buyers that were expected to attend. With buyers expected from across several states, the board of health worried an infected person in presence within the county could potentially create widespread travel of the virus.
Following the postponement of the sale however, The Iowa Department of Agriculture and Land Stewardship along with the Iowa Department of Public Health released new guidance for livestock auction markets during Covid-19 on March 23. Under the new guidance livestock markets were strongly recommended to institute immediate changes to prevent the spread of Covid-19 among staff, sellers and buyers.
“Under the current state regulations that apply to livestock auctions during the coronavirus pandemic at this time are vague and almost worthless,” stated Dr. Joel A. Wells, DO.
In the Wednesday morning meeting, Dr. Wells, proceeded to read the following statement supported by himself, the Wayne County Board of Health and Wayne County Public Health Administrator:
“Several members of the Board of Health (BOH), Dr. Joel A. Wells, Tom Swearingin and Penny Fetters as well as Shelley Bickel, Wayne County Sheriff Keith Davis and Wayne County Attorney Alan Wilson, visited with the owner of the upcoming horse auction that is scheduled to be held on April 2, 2020 south of Seymour. The visit occurred on March 30 and involved the above individuals and Mr. Ura Gingerich, the owner. This auction company has operated legally in the past and maintains a current legal status in the state to operate as a livestock auction. Mr. Wilson and Mr. Gingerich were quick to point this out at the onset of our visit.
The State of Iowa declared a State Health Disaster Emergency that is to be in effect from March 18 through April 16. Mass gatherings of 10 people or more for social gatherings as well as gatherings at some businesses such as restaurants, casinos, etc. was prohibited. However, there is no mention of livestock auctions in the original proclamation.
On March 23, the Iowa Department of Public Health (IDPH) posted guidelines on its website that addressed livestock auction markets. This document is also sponsored by the Iowa Department of Agriculture and Land Stewardship (IDALS). This document has been reviewed prior to the meeting south of Seymour described above.
Several calls had been received by the BOH and prompted our visit. The purpose of the visit was to obtain information to determine if the scheduled auction was capable of following the guidelines and to determine if there was any threat to the public health status of residents of Wayne County. This specifically relates to the current coronavirus pandemic and whether or not this auction would promote the spread of this virus into or throughout the county.
Our visit consisted of a tour of the facility while asking Mr. Gingerich questions about how the upcoming sale was to be conducted. As noted earlier, on our arrival Mr. Gingerich informed us that he was a bonded auction company and Mr. Wilson insisted he was operating a legal business. There was to be about 65 horses on the sale bill. The auction was to start around 9:30 a.m. and finish around 3:00 p.m. estimated. There was a small amount of personal farm equipment to be sold also. The stables were viewed and would be tended by six to eight workers that would move the horses to the west side of the sale barn and the auction would be conducted outdoors if weather permitted. The sale barn itself has bleacher seating on either side and direct access to the stables also.
Mr. Gingerich estimated he would have approximately 100 buyers, but no absolute way to be sure. He promotes the sale by calling regular buyers and they would in turn call buyers they knew. He admitted the buyers would likely be coming from other states but very little specifics of which states were discussed. The sale date is also announced on the phone recording of the owner. He does not have access to internet or other means of hosting a virtual sale. The purpose of the sale was to clear his inventory of horses so he could move to Ohio. He stated this would be his last auction. He commented that he has sold the property and sale barn and needed “to get out so they could move in.”
There is a café that is integral to the facility and it was clearly marked as being closed. There was the equivalent of a mess hall attached and he understood that operating a café would be against guidelines for sale barns and for mass gatherings.
When the tour had ended, we asked if he could postpone the sale or use another facility to sell his livestock. He pointed out he was a legal entity and he did not think he could postpone. With that in mind, we proceeded to discuss ways that the sale could be held and we could minimize the impact and possibility of spread of coronavirus. He was willing to let the Public Health Department monitor the sale for compliance. Attendees would be screened with a health questionnaire and anyone with suspected illness would not be allowed to enter. They would agree to keep a list of all attendees with their name, address and phone contact. The restrooms would be disinfected at frequent intervals and they had adequate cleaning supplies and disinfectants. There would be no spectators; however there would be non-buyers that are drivers. We agreed they would stay away from the sale area and maintain social distancing.
The next day after being able to contemplate the situation, there are a few things that are clear to me as a physician on the BOH. The current state regulations that apply to livestock auctions during the coronavirus pandemic at this time are vague and almost worthless. They are guidelines and by their very nature end up being suggestions and entirely unenforceable. There is no mention of a maximum number of people that could gather. Only a reference to maintain six feet of spacing and “limit” the number of buyers. The only reference in the guidelines that indicate what a business is to do if their sale does not need to be held is “please” postpone and “if an auction can be”. Absolutely no guidance on how to determine whether an auction needs to be held.
I had a personal visit with Mr. Gingerich on the 31st because I do feel that the gathering of this many people from various other areas threatens the health of our county. There is nothing we know about coronavirus at this time that could lead to any other conclusion. This auction will increase the risk that an infected person will enter our community (based on the travel history) and that it will be propagated at this event (based on the number of people and likely proximity of the attendees). I explained my thoughts to Mr. Gingerich and asked, as well as begged him not to proceed with the sale. I do feel he is within his legal rights to have the sale, but I also explained that he would be putting many people at risk. He declined to postpone the sale, but agreed to all of the stipulations of the previous day.
I visited again with Mr. Wilson after my meeting with Mr. Gingerich and invited him to the 8:30 a.m. BOH meeting. Mr. Wilson insists that Ura Gingerich is within his legal rights to conduct this sale. I cannot dispute that. I can dispute the effectiveness of the current guidance document put out by the IDPH and IDALS. It is vague, lacks any true guidance and fails to address public safety adequately. It is my recommendation as the physician on the Wayne County Board of Health that we recommend the auction be postponed. I would like to propose that the board members make the same recommendation. I would also propose that the IDPH, IDALS and the governor’s office look at the current proclamation and give us a better document that can be enforced when the safety of the public is threatened.”
Following the reading of this statement, the BOH unanimously agreed and voted on supporting this statement.
“When I talked with Mr. Gingerich, he was tore up, he was visibly distraught on the verge of a panic,” added Dr. Wells. “The decision was not easy for him.”
“We don’t want panic and don’t need panic, but we are doing everything in our power to minimize the risks as much as possible,” said Board of Health member Fetters.
“Thousands of people could be affected by one sale,” said Dr. Wells.
“Maybe we will get super lucky and nothing will happen, the best-case scenario, no one will be affected,” said Fetters. “I think we are covering ourselves by making a statement that we are not in agreement with this. We understand legally he is okay to do this. I question how we are going to monitor this?”
Much discussion took place between the board members, Bickel and Environmental Health Director David Rhodes on the best way to mitigate the situation to protect the citizens within Wayne County. Questions ranging from health checkpoints on the entrances leading to the property along with lunch availability to those in attendance of the auction required much conversation.
The board agreed setting up checkpoints on the north and south entrances on the rock road leading to the property would be best. Using two healthcare workers along with the help of a sheriff’s deputy on each end would be used.
“We should be doing active screening at these checkpoints,” said Dr. Wells. “That means fully protected healthcare personnel asking the screening questions. If one person in a car is sick, then no one is allowed entrance to the site.”
The discussion of how lunch would be provided was another issue that left the board searching for the right answer. In an attempt to keep the large numbers away from the City of Seymour businesses, it was decided they would suggest offering sack lunches to those in attendance. The lunches could not be paid for as that goes against the governor’s recommendation, however they could accept tips. They would also recommend dispersing, rather than gathering together for the lunch meal.
“For clarification, this is not an Amish event, this is a horse auction,” Dr. Wells stated. “It isn’t a Christian event. It isn’t an Islamic event. It isn’t about religion, race or anything like that. As a board of health, this is simply for the safety of everyone around and our citizens.”
“It’s (the auction) going to happen unless a miracle happens in the next 24 hours,” said Bickel.
“My personal opinion is, I think this (auction) will happen as well and it will be a tipping point where we look at how many people show up and we use this as an example of how inadequate of Iowa’s doing is,” said Dr. Wells. “This should be a turning point for how we approach infectious disease in this state because in my opinion, I think as a board of health we send a message back to the state.”
Editor’s note: As of noon on Wednesday, the horse auction is still on as scheduled. Per the Wayne County Board of Health, Wayne County has zero positive Covid-19 cases, 13 negative tests returned with one test pending results.