Black Hawk County Health Department

COVID-19 is a respiratory disease caused by a novel (new) coronavirus that was first detected in China and has now been detected internationally, including the United States, and Iowa

From person-to-person by respiratory droplets, similar to seasonal flu. Respiratory droplets are droplets produced when someone coughs or sneezes that can contain the virus. The virus spreads when droplets get into a person's mouth, nose, or eyes. People are considered the most contagious when they are experiencing symptoms.

It is important that if you are ill with fever or respiratory symptoms (cough or difficulty breathing) that you remain home and isolate from others in the home. You should remain isolated at home until:

• You have had no fever for at least 72 hours (that is three full days of no fever without the use of medicine that reduces fevers) AND
• other symptoms have improved (for example, when your cough or shortness of breath have improved) AND
• at least 10 days have passed since your symptoms first appeared.

These are recommendations that all ill Iowans should follow regardless of whether or not they have been tested for COVID-19.

Approximately 80% of Iowans infected with COVID-19, will experience only a mild to moderate illness. Most mildly ill Iowans do not need to go to their healthcare provider or be tested to confirm they have COVID-19. Contact your health care provider by phone for guidance about care for your symptoms.

Patients who have severe symptoms, such as difficulty breathing, should seek care immediately, and should call their health care provider before going in to be seen. Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their health care provider early, even for mild illnesses.

Iowans should stay at home and isolate themselves from other people and animals in the home in the following situations. Isolation should be in place for 14 days after the last exposure.

• Taken a cruise anywhere in the world.
• Traveled outside of the United States.
• Live with someone who has symptoms of COVID-19 (fever or respiratory symptoms) or has tested positive for COVID-19.

People in self isolation should:

• Stay home and do not go to school, public areas or attend gatherings.
• Do not use public transportation, ride sharing or taxis.
• Postpone all travel.
• Wash your hands often and practice good hygiene.
• Postpone all non-essential medical appointments until you have completed your 14 days of self- isolation. If you have an essential medical appointment during this time, please work with your healthcare provider and local public health professionals as needed to help coordinate the visit.
• Take your temperature twice a day. Watch for a fever, cough or difficulty breathing.

Family members or other persons who reside in your home may remain in your home, but you should stay in a specific room away from others in your home and use a separate bathroom (if available). As long as you remain healthy, the other persons in your home can go about their daily activities as normal (there is no restriction on their movement).

If you think you may need healthcare, call first. Your provider can assess whether you need to be seen in the office or if you can recover at home.

To more accurately reflect the data our team is monitoring, we will be publishing PCR and Serology (antibody testing) positive cases, along with the number of recovered cases and deaths. As testing becomes more widely available, we want to provide the public with more data since these numbers are widely circulated on social media. For a more extensive look at the data, click here.

• PCR test: A positive PCR test indicates an ongoing infection.
• Serology test: A serology test is sometimes called a "coronavirus antibody test." It’s used to identify past infections.

In an effort to publish the most up to date information on local numbers, the Black Hawk County Department of Health reports COVID-19 cases as it's available. The Black Hawk County Department of Health reported cases include positive PCR tests, positive serology tests, and symptomatic close contacts of cases. As a result, the county’s data may differ from the state’s reported cases.

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• PCR test: A positive PCR test indicates an ongoing infection.
• ‍Serology test: A serology test is used to identify recent or past infections.
• Symptomatic close contact: A person that is exhibiting symptoms of COVID-19 and is a close contact to a person that tested positive for COVID-19. Close contacts are identified by the health department through case investigations.

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The 3 C's:

Clean: Clean your hands with soap and water, or use a hand sanitizing gel when water is not available.

Cover: Cover your coughs and sneezes with your sleeve or elbow.

Contain: Contain germs by staying home with ill. Don't go to school, work, shopping, or other outside activities while you are sick.

Residents should prepare for the potential of COVID-19 in the same way they prepare for severe weather or other events that could disrupt their normal routine. This includes making a plan and discussing it with your family. Some questions to consider when planning are: What would you do if you could not go to work or school because of illness? What if your day care provider was ill? How would you get groceries if you were ill?

If you are sick: You should not leave you home, if you are even mildly ill, except to seek medical care, and should wear a facemask when you are around other people (e.g., sharing a room or vehicle) and before you enter a healthcare provider’s office.

If you are NOT sick: Recent studies have indicated that some people with coronavirus don’t have any symptoms, and that even those who later develop symptoms can pass the virus to others before showing symptoms. Because of this new evidence, wearing cloth face coverings in public places where social distancing measures are difficult (like grocery stores and pharmacies) can be done to help further slow the spread of COVID-19. Wearing a cloth face covering in public can help protect others, it does not protect the wearer from being exposed. Cloth face coverings can be quickly and inexpensively made from an old t-shirt, a bandana, hand towel or scarf, and rubber bands. You should avoid touching or adjusting your cloth face mask while in public, clean your hands immediately if you do have to touch it, and launder the mask after each use and when it is visibly soiled. Wearing a cloth face covering is not a substitution for following social distancing guidelines.

If you have traveled internationally you should self-isolate for 14 days after returning. If during those 14 days you develop symptoms (fever, cough, and difficulty breathing) you should contact your health care provider before going in to be seen, and tell them about your travel history. The CDC travel advisories provide to most current information on areas with ongoing spread, and precautions for travelers. https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

COVID-19 virus is circulating across the United States. While there is no longer a recommendation to self-isolate for 14 days after returning home from travel outside of Iowa and within the United States (as long as the traveler remains well and has not been identified as a close contact of an ill individual), travelers should continue to clean your hands often, avoid close contact with others, keep 6 feet of physical distance from others, wear a cloth face covering in public, and cover coughs and sneezes.

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Community Spread: Occurs where individuals have been infected with the virus in an area and cannot specifically identify the source of the infection, or do not know how or where they became infected (e.g. cannot tie the illness to a specific event, like a cruise).

Social distancing means avoiding  large gatherings or other congregate settings, and maintaining distance (6ft) from others when possible. Personal social distancing measures include avoiding large gatherings or limiting the number of attendees, or distance or remote work, or online learning.

Individuals 60 years old or older with underlying conditions should stay home and avoid gatherings or other situations of potential exposures, including travel to affected areas.

Reduce activities (group congregation, religious services, etc.), especially for organizations with individuals with underlying health conditions.

Encourage staff to telework when feasible, particularly individuals at increased risk of severe illness. Limit non-essential work travel and gatherings.

Governor Reynolds signed a new proclamation continuing the Public Health Disaster Emergency until June 25, 2020. The proclamation permits bars, wineries, breweries, distilleries, and social and fraternal clubs may reopen on May 28 with the same public health measures as restaurants in place. The proclamation also permits the reopening on June 1 of additional establishments, including outdoor performance venues, casinos, bowling alleys, amusement parks, skating rinks, skate parks, outdoor playgrounds.  The proclamation again permits social, community, recreational, leisure, and sporting gatherings and events of more than 10 people if public health measures are implemented, including limiting attendance to 50% of the venue capacity and maintaining six feet of distance between those attending. This also allows practices, games, and competitions for youth and adult baseball, softball, and individual sports such as running, biking, swimming, tennis, and golf to resume with appropriate public health measures in place.                    

The full proclamation is online in its entirety and substantive information can be found below:

PROTECTION OF VULNERABLE IOWANS

SECTION ONE.  I continue to strongly encourage all vulnerable Iowans, including those with preexisting medical conditions and those older than 65, in all counties of the state to continue to limit their activities outside of their home, including their visits to businesses and other establishments and their participation in gatherings of any size and any purpose. And I encourage all Iowans to limit their in-person interactions with vulnerable Iowans and to exercise particular care and caution when engaging in any necessary interactions.

REOPENING OF BUSINESSES AND ESTABLISHMENTS

SECTION TWO.  Pursuant to Iowa Code § 135.144 (3), and in conjunction with the Iowa Department of Public Health, unless otherwise modified by subsequent proclamation or order of the Iowa Department of Public Health, I hereby order that effective at 12:01 a.m. on May 28, 2020 and until 11:59 p.m. on June 17, 2020:

A.   Restaurants and bars: A restaurant or bar, including a wedding reception venue, winery, brewery, distillery, country club, or other social or fraternal club, may reopen or remain open to serve food and beverages on its premises, but only to the extent that it complies with the following requirements:

(1)  Capacity limited: The establishment must limit the number of customers present at indoor or outdoor spaces to 50% of its normal operating seating capacity to ensure adequate spacing of groups. An establishment that ordinarily has a larger operating capacity for patrons standing is not prohibited from adding additional tables and chairs, provided that doing so complies with all other provisions of this Proclamation and any other applicable law.

(2)  Groups limited: The establishment must limit party size seated together to no more than ten people.

(3)  Social distancing: The establishment must ensure at least six feet of physical distance between each group or individual dining or drinking alone. Seating at booths closer than six feet may satisfy this requirement if the booths are separated by a barrier of a sufficient height to fully separate seated customers. All patrons must have a seat at a table or bar, and an establishment must limit patrons from congregating together closer than six feet.

(4)  Self-service prohibited:  The establishment must not have any self-service of food, including buffets or salad bars.

(5)  Live performances: An establishment may have live music performances, provided that any performer remains at least six feet away from patrons and other performers, and the establishment does not permit patrons from congregating together closer than six feet.

(6)  Other social distancing, hygiene, and public health measures: The restaurant shall also implement reasonable measures under the circumstances of each restaurant to ensure social distancing of employees and customers, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Inspections and Appeals and the Iowa Department of Public Health.

B. Fitness centers: A fitness center, health club, health spa, or gym may reopen or remain open, but only to the extent that it complies with the following requirements:

(1)  Capacity limited: The establishment must limit the number of customers present to 50% of its maximum legal occupancy capacity.

(2)  Social distancing: The establishment must ensure that all equipment, such as treadmills, bikes, weight machines, benches, and power racks, are spaced at least six feet apart or take other appropriate measures to ensure that more closely spaced equipment is not used.

(3)  Group activities: Any group activities or classes must be limited to a number of people that permits maintaining a distance of six feet apart at all times.

(4)  Other social distancing, hygiene, and public health measures: The establishment shall also implement reasonable measures under the circumstances of each establishment to ensure social distancing of employees and customers, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.

C.   Malls: An enclosed mall may reopen or remain open, but only to the extent that it complies with the following requirements:

(1)  Capacity limited: The mall must limit the number of customers present to 50% of its maximum legal occupancy capacity.

(2)  Common seating areas: All common seating areas, such as food courts, shall remain closed. Restaurants in food courts may operate on a carry-out basis.

(3)  Play areas: Any play area or playground must remain closed.

(4)  Social distancing, hygiene, and public health measures: The mall shall also implement reasonable measures under the circumstances of each mall to ensure social distancing of employees and customers, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.

D.   Other retail establishments: A retail establishment that was previously ordered to be closed statewide and then only in certain counties under section 5, paragraph I, of the Proclamation of Disaster Emergency issued on April 27, 2020 , may reopen or remain open, but only to the extent that it limits the number of customers present to 50% of its maximum legal occupancy capacity and implements reasonable measures under the circumstances of each establishment to ensure social distancing of employees and customers, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.

E. Salons: A salon, including any establishment providing the services of cosmetology, electrology, esthetics, nail technology, manicuring, and pedicuring, all as defined in Iowa Code § 157.1, may reopen, but only to the extent that it complies with the following requirements:

(1)  Capacity limited: The salon must limit the number of customers present to 50% of its maximum legal occupancy capacity.

(2)  Appointment only: The salon must operate on an appointment basis to ensure that the public is not gathering in a waiting area.

(3)  Social distancing: The salon must ensure that all customers are at least six feet apart when performing cosmetology practices.

(4)  Other social distancing, hygiene, and public health measures: The salon shall also implement reasonable measures under the circumstances of each salon to ensure social distancing of employees and customers, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.

F. Barbershop: A barbershop, as defined in Iowa Code § 158.1, may reopen, but only to the extent that it complies with the following requirements:

(1)  Capacity limited: The barbershop must limit the number of customers present to 50% of its maximum legal occupancy capacity.

(2)  Appointment only: The barbershop must operate on an appointment basis to ensure that the public is not gathering in a waiting area.

(3)  Social distancing: The barbershop must ensure that all customers are at least six feet apart when performing barbering services.

(4)  Other social distancing, hygiene, and public health measures: The barbershop shall also implement reasonable measures under the circumstances of each barbershop to ensure social distancing of employees and customers, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.

G.   Medical spas: A medical spa, as defined in Iowa Admin Code § 653-13.8(1), may reopen or remain open to provide medical aesthetic services, but only if the medical spa complies with the requirements for performing outpatient procedures that utilize PPE in section 9, paragraph A, of this Proclamation.

H.   Tanning facilities: A tanning facility, as defined by Iowa Code § 136D.2(5), may reopen or remain open, but only to the extent that the facility takes reasonable measures under the circumstances of each facility to ensure social distancing of employees and patrons, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with Guidance issued by the Iowa Department of Public Health.

I. Massage therapy establishments: An establishment where an individual is practicing massage therapy as defined by Iowa Code § 152C.1(3) may reopen, but only to the extent that the establishment takes reasonable measures under the circumstances of each establishment to ensure social distancing of employees and patrons, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with Guidance issued by the Iowa Department of Public Health.

J. Tattoo establishments: A tattoo establishment, as regulated by Iowa Code § 135.37, may reopen, but only to the extent that the establishment takes reasonable measures under the circumstances of each establishment to ensure social distancing of employees and patrons, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with Guidance issued by the Iowa Department of Public Health.

K.   Campgrounds: Any public or private campground may reopen or remain open, provided that the campground implements reasonable measures under the circumstances of each campground to ensure social distancing, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.

L. Race tracks: A speedway or race track, including a track conducting horse or dog races, may reopen or continue its operations, provided that it does not permit any spectators to attend its events in person until June 1, 2020. Effective 12:01 a.m. on June 1, 2020, a speedway or race track may permit spectators to attend, provided that the establishment complies with the following requirements:

(1)  Capacity limited: The establishment must limit the number of patrons present in any grandstands or other permanent seating to 50% of its normal operating capacity to ensure adequate spacing of groups.

(2)  Social distancing: The establishment must ensure at least six feet of physical distance between each group or individual attending alone when seated.

(3)  Other social distancing, hygiene, and public health measures: The establishment shall also implement reasonable measures under the circumstances of each establishment to ensure social distancing of employees and customers, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health and, for any food or beverage service, the Iowa Department of Inspections and Appeals.

M.  Libraries: A library may reopen or remain open provided that it limits the number of patrons present to 50% of its maximum legal occupancy capacity and implements reasonable measures under the circumstances of each library to ensure social distancing of employees and patrons, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.

N.   Drive-in theaters: A drive-in movie theater may reopen or remain open, but only to the extent that the theater ensures that all cars are parked at least six feet apart and takes other reasonable measures under the circumstances of each theater to ensure social distancing of employees and patrons, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with Guidance issued by the Iowa Department of Public Health.

O.   Movie Theaters: Any theater at which motion pictures are shown may reopen or remain open, but only to the extent that the theater complies with the following requirements:

(1)  Capacity limited: The theater must limit the number of patrons present in any individual theater to 50% of its normal operating capacity to ensure adequate spacing of groups.

(2)  Social distancing: The theater must ensure at least six feet of physical distance between each group or individual attending alone when seated in the theater.

(3)  Self-service prohibited:  The theater must not have any self-service of food.

(4)  Other social distancing, hygiene, and public health measures: The theater shall also implement reasonable measures under the circumstances of each theater to ensure social distancing of employees and customers, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health and, for any food service, the Iowa Department of Inspections and Appeals.

P. Museums, aquariums, and zoos: A museums, aquarium, or zoo may reopen, but only to the extent that the establishment takes reasonable measures under the circumstances of each establishment to ensure social distancing of employees and patrons, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with Guidance issued by the Iowa Department of Public Health.

Q.   Swimming pools: A swimming pool, as defined in Iowa Code § 135I.1 may reopen for the limited purpose of lap swimming and conducting swimming lessons (including life guard training), but only to the extent that the establishment operating the pool takes reasonable measures under the circumstances of each establishment to ensure social distancing of employees and patrons, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with Guidance issued by the Iowa Department of Public Health. Except for these limited purposes, all swimming pools and spas, wading pools, water slides, wave pools, spray pads, and bath houses, as defined in Iowa Code § 135I.1, shall continue to be closed.

REOPENING OF BUSINESSES AND ESTABLISHMENTS

(June 1, 2020)

SECTION THREE.  Pursuant to Iowa Code § 135.144 (3), and in conjunction with the Iowa Department of Public Health, unless otherwise modified by subsequent proclamation or order of the Iowa Department of Public Health, I hereby order that effective at 12:01 a.m. on June 1, 2020 and until 11:59 p.m. on June 17, 2020:

A.   Outdoor Performance Venues: An outdoor theater or performance venue where live performances are held may open or reopen to patrons, but only to the extent that it complies with the following requirements:

(1)  Capacity limited: The establishment must limit the number of patrons present in any grandstands or other permanent seating to 50% of its normal operating capacity to ensure adequate spacing of groups.

(2)  Social distancing: The establishment must ensure at least six feet of physical distance between each group or individual attending alone when seated.

(3)  Other social distancing, hygiene, and public health measures: The establishment shall also implement reasonable measures under the circumstances of each establishment to ensure social distancing of employees and customers, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health and, for any food or beverage service, the Iowa Department of Inspections and Appeals.

Until June 1, 2020, all outdoor theaters and performance venues where live performances are held shall continue to be closed.

B. Casinos and gaming facilities: A casino or other facility conducting pari-mutuel wagering or gaming operations may reopen, but only to the extent that it complies with the following requirements:

(1)  Capacity limited: The establishment must limit the number of patrons present on the gaming floor and waging area to 50% of its gaming or wagering positions as determined by the Racing and Gaming Commission.

(2)  Social distancing: The establishment must ensure that all wagering and gaming positions are spaced at least six feet apart or take other appropriate measures to ensure that more closely spaced positions are not used. Positions closer than six feet may satisfy this requirement if the positions are separated by a barrier of a sufficient height to fully separate patrons at each position.

(3)  Food and Beverage Service: The establishment shall comply with all the requirements of bars and restaurants in this Proclamation for any food and beverage service and shall not have any self-service of food, including buffets or salad bars.

(4)  Other social distancing, hygiene, and public health measures: The establishment shall also implement reasonable measures under the circumstances of each establishment to ensure social distancing of employees and customers, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health and, for any food or beverage service, the Iowa Department of Inspections and Appeals.

Until June 1, 2020, all such facilities shall continue to be closed, except that a race track conducting pari-mutuel wagering may reopen provided that it does not permit any spectators to attend its events in person.

C.   Amusements: A bingo hall, bowling alley, pool hall, arcade, or amusement parks may reopen, but only to the extent that the establishment limits the number of customers present to 50% of its maximum legal occupancy capacity and takes reasonable measures under the circumstances of each establishment to ensure social distancing of employees and patrons, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with Guidance issued by the Iowa Department of Public Health. Until June 1, 2020, all bingo halls, bowling alleys, pool halls, arcades, and amusement parks shall continue to be closed.

D.   Skating rinks and skate parks: An indoor or outdoor roller or ice skating rink or skate parks may reopen, but only to the extent that the establishment limits the number of customers present to 50% of its maximum legal occupancy capacity and takes reasonable measures under the circumstances of each establishment to ensure social distancing of employees and patrons, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with Guidance issued by the Iowa Department of Public Health. Until June 1, 2020, all indoor or outdoor roller or ice skating rinks and skate parks shall continue to be closed.

E. Outdoor playgrounds: An outdoor playground may reopen. Until June 1, 2020, all outdoor playgrounds shall continue to be closed.

EXTENSIONS OF CLOSURES AND ORDERS

SECTION FOUR.  Pursuant to Iowa Code § 135.144 (3), and in conjunction with the Iowa Department of Public Health, unless otherwise modified by subsequent proclamation or order of the Iowa Department of Public Health, I hereby extend the following orders until 11:59 p.m. on June 17, 2020:

A.   Theaters: All indoor theaters and other indoor performance venues at which live performances are held shall continue to be closed.

B. Senior citizen centers and adult daycare facilities:  All facilities that conduct adult day services or other senior citizen centers shall continue to be closed.

C.   Indoor playgrounds: All indoor playgrounds or children’s play centers shall continue to be closed.  This order does not apply to playgrounds in private residences or childcare facilities.

MASS GATHERINGS

(Until May 31, 2020)

SECTION FIVE.  Pursuant to Iowa Code § 135.144 (3), and in conjunction with the Iowa Department of Public Health, unless otherwise modified by subsequent proclamation or order of the Iowa Department of Public Health, social, community, recreational, leisure, and sporting gatherings and events of more than 10 people shall continue to be prohibited at all locations and venues, including but not limited to parades, festivals, conventions, and fundraisers until 11:59 p.m. on May 31, 2020.

A.   Spiritual and religious gatherings are not prohibited by this section, but a church, synagogue, or other host of a spiritual or religious gathering shall implement reasonable measures under the circumstances of each gathering to ensure social distancing of employees, volunteers, and other participants, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.

B. A gathering of people inside parked cars, trucks, or other enclosed motor vehicles shall not constitute a gathering of more than 10 people if no more than 10 people are inside each vehicle, all people remain inside the vehicle at all times.

C. Planned large gatherings and events must be canceled or postponed until after termination of this disaster.

MASS GATHERINGS

(Effective June 1, 2020)

SECTION SIX.  Pursuant to Iowa Code § 135.144 (3), and in conjunction with the Iowa Department of Public Health, unless otherwise modified by subsequent proclamation or order of the Iowa Department of Public Health, effective 12:01 a.m. on June 1, 2020, and continuing until 11:59 p.m. on June 17, 2020:

A.   A social, community, recreational, leisure, or sporting gathering or event, including but not limited to a parade, festival, convention, or fundraiser, of more than ten people may be held, but only if the gathering complies with all other relevant provisions in this Proclamation and the following requirements:

(1) Capacity limited: The gathering organizer must limit the number of participants present in any indoor venue to 50% of its normal operating capacity to ensure adequate spacing of groups. The gathering organizer must limit the number of participants present in any outdoor venue with grandstands or other permanent seating to 50% of its normal operating capacity and the number of participants in other outdoor settings to a number that permits the social distancing required by paragraph 2.

(2) Social distancing: The gathering organizer must ensure at least six feet of physical distance between each group or individual attending alone.

(3) Other social distancing, hygiene, and public health measures: The gathering organizer shall also implement reasonable measures under the circumstances of each gathering to ensure social distancing of gathering participants, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health and, for any food service, the Iowa Department of Inspections and Appeals.

Any social, community, recreational, leisure, and sporting gatherings and events of more than 10 people that does not comply with these requirements shall continue to be prohibited at all locations and venues.

B. Non-school sporting and recreational events: Practices, games, and competitions for baseball, softball, and individual sports, such as running, biking, swimming, tennis, and golf, are not prohibited by this section even where athletes may have some contact within six feet, provided that the organizer of such activities and events implements reasonable measures under the circumstances of each gathering to ensure reasonable social distancing, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.

C.   Spiritual and religious gatherings: Spiritual and religious gatherings, including any funerals or weddings, are not prohibited by this section. But a church, synagogue, or other host of a spiritual or religious gathering shall implement reasonable measures under the circumstances of each gathering to ensure social distancing of employees, volunteers, and other participants, increased hygiene practices, and other public health measures to reduce the risk of transmission of COVID-19 consistent with guidance issued by the Iowa Department of Public Health.

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Symptoms may appear 2-14 days after exposure, with an average of 4-5 days:

• Fever
• Cough
• Shortness of breath

CALL YOUR DOCTOR: If you think you have been exposed to COVID-19 and develop a fever and symptoms, such as cough or difficulty breathing, call your healthcare provider for medical advice.

People who are a close contact to a confirmed case of COVID-19, or traveled to or live in an area of ongoing community spread of COVID-19, and develop symptoms of COVID-19 should call their health care provider to determine whether or not they should be tested. People who are hospitalized with fever and respiratory failure and no alternate cause, or people with a chronic medical condition who are hospitalized with fever and respiratory symptoms should also be tested.

• Mildly ill patients are encouraged to stay home and contact their health care provider by phone for guidance about care for their symptoms.
• Patients who have severe symptoms, such as difficulty breathing, should seek care immediately.
• Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their health care provider early, even for mild illnesses.

Health care providers, with guidance from CDC and public health, will determine who should be tested and prioritize patients for testing.

Federal resources are being announced daily to assist all Americans and the health care systems with testing.

You can find more information about federal resources as well as Medicare and Medicaid coverage here: https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/covid19/index.html

In Iowa, tests that are sent to SHL are provided at no cost and considered a test of public health significance. Private lab testing may incur a fee. Many health insurance companies are already waiving fees for the testing if a health care provider determines that a test is needed. Check your insurance provider’s webpage or hotline for your individual coverage.

If you are ill with COVID-19 you should stay home except to get medical care, prohibit any visitors, and separate yourself from family members and common areas as much as possible. If you need to be around other people you should wear a face mask, and you should avoid sharing household items. Monitor your symptoms, and if they start to get worse call your doctor before going in to be seen.

Sick people should not care for infants or other people at high risk for complications of COVID-19.

The sick person should stay in a room separate from family members and away from the common areas of the house. For example, a spare bedroom with its own bathroom, if possible. Keep the bedroom door closed.

If possible, sick persons should use a separate bathroom. This bathroom should be cleaned daily with regular household disinfectant.

Other household members, especially those at high risk for complications of COVID-19, should not come within six feet of the person who is ill.

Have the sick person wear a facemask, if available and tolerable, if they need to be in a common area of the house near other persons.

All persons in the household should clean their hands with soap and water or an alcohol-based hand rub frequently, including after every contact with the sick person or the person’s room or bathroom.

Use paper towels for drying hands after hand washing, or have separate cloth towels for each person in the household. For example, have different colored towels for each person.

Maintaining good ventilation in common areas of the house (e.g., keeping windows open in restrooms, kitchen, keep vent going in bathroom, etc.).