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. Community spread has been confirmed throughout Black Hawk County.

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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 from 2 days before symptom onset until 10 days after. Spread is more likely when people are in prolonged close contact with one another (within about 6 feet for at least 15 minutes).

If someone in your immediate household is ill with COVID-19 symptoms, you should stay home and isolate away from the person who is ill.  When you are home you should isolate away from your ill household member, wear a face covering if you need to be around them, regularly clean particularly high touch or shared services, and use separate bathrooms is possible.  You should remain home until your household member has received a negative test result or has been told they do not have COVID-19 by a health care provider.  If your household member tests positive you should quarantine at home for 14 days after the last time you were in close contact with your ill household members.  If you are able to isolate away from each other in the home, then the last time you were in close contact would be the day you started isolating away from the person who is ill.  If you are not able to isolate at home then the last time you are in close contact is not until the day the ill person no longer needs to isolate (10 days after onset of symptoms or day of positive test, and 24 hours fever free, and symptoms improving).

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 24 hours (without the use of fever reducing medication) 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. Iowans who do not qualify for a test from their provider may be able to receive a free test through a Test Iowa site (https://www.testiowa.com/en).

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. Quarantine should be in place for 14 days after the last exposure.

• Were within 6 feet of someone who has COVID-19 for 15 consecutive minutes or more
• Provided care at home to someone who is sick with COVID-19
• Had direct physical contact with someone who has COVID-19 (hugged or kissed them)
• Shared eating or drinking utensils with someone who has COVID-19
• A person with COVID-19 sneezed, coughed, or somehow got respiratory droplets on you
• 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.
• Critical infrastructure     employees will need to quarantine at home but may be permitted to work. Click the link to see guidance on critical infrastructure.

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: 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 evidence, wearing cloth face coverings in public places where social distancing measures are difficult (like grocery stores and pharmacies) should 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 to a country at a Level 3 travel risk you should self-isolate for 14 days after returning. The CDC updates travel guidance and risk levels regularly, so check here for the most up-to-date information. 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.

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. Travelers should be aware that some states may require quarantine upon entry.

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.

Effective Tuesday, Nov. 17 at 12:01 a.m. until Thursday, Dec. 10 at 11:59 p.m.

Mask Use: Indoor spaces open to the public & State executive branch buildings

     Masks required when individuals are within 6 feet of one another for 15 minutes or longer with certain      exceptions

Gathering Restrictions: Social, community, business, or leisure gatherings

     No more than 15 people indoors and 30 people outdoors

     These restrictions apply to wedding receptions, family gatherings, conventions, and other nonessential      gatherings but do not apply to gatherings that occur during the ordinary course of business or government

Sporting and Recreational Events: Youth and adult group sporting and recreational gathering are prohibited except for high school, college, and professional sports

High School Sports & Extracurriculars: Sporting, recreational, and extracurricular events

     Only two spectators permitted for each high school athlete, performer or competitor, and must wear a      mask and maintain 6 feet distance from other spectators

     Students can be closer than six feet and are not required to wear masks

Restaurants and Bars : Restaurant or bar, including a wedding reception venue, winery, brewery, distillery,

country club, or other social or fraternal club

     Closed to in-person services at 10:00pm

     No bar seating

     Masks required when not seated (while playing games, dancing, etc.)

     Six feet distancing between groups

     Groups limited to 8 people unless larger group is all same household

     Seated when eating or drinking and limit congregating

Fitness Centers: Fitness centers, health clubs, health spas, gyms

     Group fitness activities are prohibited

Casinos & Gaming Facilities: Masks required except when seated to eat or drink

Closer/Prolonged Contact Establishments: Bowling alleys, pool halls, bingo halls, arcades, indoor playgrounds, children’s play centers

     Closed to in-person services at 10:00pm

     Mask required when not seated to eat or drink

     Ensure that groups and individuals are six feet apart at establishment

     Groups limited to eight people unless larger group is all same household

Nonessential/elective surgeries: A hospital must reduce its in-patient, nonessential surgeries to a level that uses at least 50% fewer beds than it did on average during September 2020

According to the CDC, symptoms may appear 2-14 days after exposure, with an average of 4-5 days. People with these symptoms or a combination of symptoms my have COVID-19:

• Cough
• Shortness of breath
• Fever
• Chills
• Repeated shaking with chills
• Muscle pain
• Headache
• Sore throat
• New loss of taste or smell

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 confirmedcase 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. 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.

To see if you qualify for a free viral test for COVID-19 through Test Iowa click here.

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.).