Author: Theresa Rose

DES MOINES – Gov. Kim Reynolds has ordered a partial activation of the State Emergency Operations Center (SEOC) in Johnston to ensure State of Iowa agencies are prepared in the event COVID-19 is detected in the state.

“While no positive tests of COVID-19 have been confirmed in Iowa at this time, we are proactively coordinating plans across state agencies to protect the health of Iowans and assess our operational needs so we are as prepared as possible,” said Gov. Reynolds. “We will continue to work with President Trump and his Coronavirus Task Force to make sure Iowa has the resources, information, and expertise to keep our communities safe.”

The partial activation began on March 4th and was followed by a state agency conference call led by Gov. Reynolds on March 6th to discuss preparedness strategies. The SEOC  provides a mechanism for face-to-face coordination and information sharing between State agencies and other partners. Beginning Monday, March 9th, twice-weekly agency coordination briefings will be held to provide the latest information on COVID-19 and to ensure necessary preparedness measures are in place. Should the situation change, the Iowa Department of Homeland Security and Emergency Management is prepared to transition the State Emergency Operations Center to an increased level of activation.

President Trump recently signed a $8.3 billion spending bill to combat the coronavirus through prevention, research, and other efforts. The governor’s office continues to receive regular updates from Vice President Mike Pence and President Trump’s Coronavirus Task Force.

Issued: 03/02/2020
Recommended strategies for use now:
Actively encourage sick employees to stay home:
• Employees who have symptoms of acute respiratory illness are recommended to stay home and not come to work until they are free of fever (100.4° F [37.8° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees should notify their supervisor and stay home if they are sick.
• Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.
• Talk with companies that provide your business with contract or temporary employees about the importance of sick employees staying home and encourage them to develop non-punitive leave policies.
• Do not require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.
• Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.
Separate sick employees:
• Employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath) upon arrival to work or become sick during the day should be separated from other employees and be sent home immediately.
Emphasize staying home when sick, respiratory etiquette and hand hygiene by all employees:
• Place posters that encourage staying home when sick, cough and sneeze etiquette, and hand hygiene at the entrance to your workplace and in other workplace areas where they are likely to be seen.
• Provide tissues and no-touch disposal receptacles for use by employees.
• Instruct employees to clean their hands often with an alcohol-based hand sanitizer that contains at least 60-95% alcohol, or wash their hands with soap and water for at least 20 seconds. Soap and water should be used preferentially if hands are visibly dirty.
• Provide soap and water and alcohol-based hand rubs in the workplace. Ensure that adequate supplies are maintained. Place hand rubs in multiple locations or in conference rooms to encourage hand hygiene.
• Visit the coughing and sneezing etiquette and clean hands webpage for more information.
Perform routine environmental cleaning:
• Routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
• No additional disinfection beyond routine cleaning is recommended at this time.
• Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.
Advise employees before traveling to take certain steps:
• Check the CDC’s Traveler’s Health Notices for the latest guidance and recommendations for each country to which they will travel.
• Understand that if employees travel to affected areas with community spread of COVID-19, there may be public health monitoring and movement restrictions issued to them upon their return.
• Advise employees to check themselves for symptoms of acute respiratory illness before starting travel and notify their supervisor and stay home if they are sick.
• Ensure employees who become sick while traveling or on temporary assignment understand that they should notify their supervisor and should promptly call a healthcare provider for advice if needed.
• If outside the United States, sick employees should follow your company’s policy for obtaining medical care or contact a healthcare provider or overseas medical assistance company to assist them with finding an appropriate healthcare provider in that country. A U.S. consular officer can help locate healthcare services. However, U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or give medicines, vaccines, or medical care to private U.S. citizens overseas.

Review your emergency plans
Businesses should be reviewing their emergency plans, and if businesses do not have emergency plans, they need to be developed. Businesses need to establish their planning priorities, examples could include: (a) reducing transmission among staff, (b) protecting people who are at higher risk for adverse health complications, (c) maintaining business operations, and (d) minimizing adverse effects on other entities in their supply chains.
Businesses need to keep the following planning considerations in mind:
• The severity of illness or how many people will fall ill from COVID-19 is unknown at this time, so plans need to flexible and scalable.
• Impact may be more severe for employees at higher risk for COVID-19 adverse health complications, such as older adults and those with chronic medical conditions.
• For the general American public, such as workers in non-healthcare settings and where it is unlikely that work tasks create an increased risk of exposures to COVID-19, the immediate health risk from COVID-19 is currently considered low.
Planning recommendations:
• Identify possible work-related exposure and health risks to your employees.
• Review human resources policies to make sure that policies and practices are consistent with public health recommendations and are consistent with existing state and federal workplace laws.
• Prepare for increased numbers of employee absences due to illness in employees and their family members, dismissals of early childhood programs and K-12 schools due to high levels of absenteeism or illness:
o Employers should plan to monitor and respond to absenteeism at the workplace. Implement plans to continue your essential business functions in case you experience higher than usual absenteeism.
o Cross-train personnel to perform essential functions so that the workplace is able to operate even if key staff members are absent.
• Explore whether you can establish policies and practices, such as flexible worksites (e.g., telecommuting) and flexible work hours (e.g., staggered shifts), to increase the physical distance among employees and between employees and others if state and local health authorities recommend the use of social distancing strategies.
o For employees who are able to telework, supervisors should encourage employees to telework instead of coming into the workplace until symptoms are completely resolved.
o Ensure that you have the information technology and infrastructure needed to support multiple employees who may be able to work from home.
• Assess your essential functions and the reliance that others and the community have on your services or products. Be prepared to change your business practices if needed to maintain critical operations (e.g., identify alternative suppliers, prioritize customers, or temporarily suspend some of your operations if needed).
• Identify essential business functions, essential jobs or roles, and critical elements within your supply chains (e.g., raw materials, suppliers, subcontractor services/products, and logistics) required to maintain business operations.
o Plan for how your business will operate if there is increasing absenteeism or these supply chains are interrupted.
• Set up authorities, triggers, and procedures for activating and terminating the company’s emergency plan, altering business operations (e.g., possibly changing or closing operations in affected areas), and transferring business knowledge to key employees.
• Plan to minimize exposure between employees and also between employees and the public, if public health officials call for social distancing.
• Establish a process to communicate information to employees and business partners on your emergency plans and latest COVID-19 information. Anticipate employee fear, anxiety, rumors, and misinformation, and plan communications accordingly.
• In some communities, early childhood programs and K-12 schools may be dismissed, particularly if COVID-19 worsens.
o Determine how you will operate if absenteeism spikes from increases in sick employees, those who stay home to care for sick family members, and those who must stay home to watch their children if dismissed from school.
o Businesses and other employers should prepare to institute flexible workplace and leave policies for these employees.
• Local conditions will influence the decisions that public health officials make regarding community-level strategies; employers should take the time now to learn about plans in place in each community where they have a business.
• If there is evidence of a COVID-19 outbreak in the US, consider canceling non-essential business travel to additional countries per travel guidance on the CDC website. Travel restrictions may be enacted by other countries which may limit the ability of employees to return home if they become sick while on travel status.
• Consider cancelling large work-related meetings or events.
Employers with more than one business location are encouraged to provide local managers with the authority to take appropriate actions outlined in their business emergency plans based on the condition in each locality.
Businesses are encouraged to communicate closely with their local public health departments to ensure they are receiving timely and accurate information regarding COVID-19 activity in their community. In addition, businesses should work with IDPH and/or their local public health to determine appropriate action and notifications if COVID-19 is identified in the workplace.

There is an expanding global outbreak of respiratory illness called COVID-19 caused by a novel (new) coronavirus. Community spread if being detected in a growing number of countries, including parts of the U.S.
There are currently no confirmed cases of COVID-19 in Iowa.
 IDPH provides updates on persons being monitored, tested and test results every Monday, Wednesday and Friday on the department’s COVID-19 webpage: https://idph.iowa.gov/Emerging-Health-Issues/Novel-Coronavirus.
o Remember there are seven different coronaviruses, and four of these are common. You may be diagnosed with a “coronavirus” if you have cold-like symptoms; this is not the novel coronavirus (COVID-19) that is in the headlines.
Public health efforts are focused on both containing the spread of the virus and mitigating its potential impact.
 We are working closely with the Iowa Department of Public Health and the CDC, as well as local public and private partners to prepare for the potential introduction and spread of COVID-19 in our county.
 Currently, individual risk of COVID-19 is dependent upon exposure.
o This includes travelers returning from affected international locations where community spread is occurring. These locations are updated by the CDC and may be found at https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html.
Everyone can do their part to help respond to this emerging public health threat.
 Every-day prevention methods are very important:
o Wash your hands frequently.
o Stay home if you are ill.
o Cover coughs and sneezes with a tissue.
 Perform routine cleaning.
o Routinely clean frequently touched surfaces (e.g., doorknobs, light switches, countertops) with the cleaners typically used. Use all cleaning products according to the directions on the label.
 Individuals and communities should prepare for COVID-19.
o We are working with schools and businesses to make plans for potential absences due to illness.
 We recommend consideration of flexible schedules and tele-working or learning options.
 We recommend flexible sick leave policies to care for individuals and their families.
 We do not recommend the requirement of a doctor’s note for sick leave.
o Individuals should make a plan with their families.
 This is similar to plans for other events, like severe storms, that could interrupt normal activities.
 Individuals should consider plans if schools or businesses needed to close to modify their schedules.

 The Iowa Dept. of Public Health has many targeted recommendations for schools, businesses, long-term care facilities and more at https://idph.iowa.gov/Emerging-Health-Issues/Novel-Coronavirus.
If you have recently been to an area with ongoing spread of COVID-19 or have been exposed to someone sick with COVID-19 in the last 14 days, you may face some limitations on your movement and activity. Please follow public health instructions during this time.
 The Iowa Department of Public Health (IDPH) has requested Iowans returning from a country where novel coronavirus (COVID-19) is spreading to voluntarily self-isolate for 14 days following their return. Areas in this travel notice currently include:
o Italy
o Japan
o South Korea
 Public health authorities, in accordance with the President’s Task Force on Coronavirus are mandatorily monitoring travelers from:
o Mainland China
o Iran
 Your cooperation is integral to the ongoing public health response to try to slow spread of this virus.
 If you develop COVID-19 symptoms, contact your healthcare provider, and tell them about your symptoms and your travel or exposure to a COVID-19 patient BEFORE you go to the clinic or office.
o Symptoms of COVID-19:
 Fever
 Cough
 Shortness of breath

While COVID-19 (Coronavirus) is not currently in Iowa, influenza is circulating at high level. Henry County Health Center has been working with Henry County Public Health to receive the latest information about influenza and COVID-19.

“HCHC receives regular updates from the Iowa Department of Public Health (IDPH) on COVID-19. We are implementing the screening recommendations from IDPH, and should COVID-19 present in this area we will follow our organization’s Emergency Preparedness Plan. This plan gives detailed processes for how the health center will effectively manage infectious disease for the care and safety of our patients and staff,” explained Cindy Cotton, HCHC’s Quality/Infection Control Director.

HCHC is emphasizing to the public that the prevention measures for influenza and COVID-19 are the same:

• Cover your coughs and sneezes with tissue or your upper arm/elbow.
• Clean your hands frequently with soap and water.
• Contain germs by staying home when ill.

Due to the high level of influenza activity, Henry County Health Center asks that individuals with respiratory and/or influenza symptoms, such as coughing, fever, aches, sore throat and runny nose, please refrain from visiting HCHC patients and Park Place Elder Living elders until symptoms are gone. This is a safety precaution to maintain a healthy hospital environment.

Also, due to the 2019 Novel Coronavirus (COVID-19), the Iowa Department of Public Health (IDPH) has issued screening recommendations for all healthcare facilities. Coronavirus is identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. The virus spreads person-to-person. There have been confirmed cases identified in the United States.

The IDPH Recommendation is that all Iowa healthcare facilities implement screening procedures before or at patient check-in. Patient screening questions asked at HCHC are:

1. Do you have a fever or respiratory symptoms (e.g., cough or difficulty breathing)?
2. Did you travel from China, Iran, Italy, Japan or South Korea within 14 days of symptom onset?
3. Did you have close contact with a laboratory-confirmed COVID-19 patient within 14 days of symptom onset?

If an individual has traveled to China and/or Iran and feel sick with fever, cough or difficulty breathing, they should seek medical care right away. Before going to a healthcare office, call ahead and tell them about your travel and your symptoms. Calling in advance will assure that proper infection control measures are taken so that other patients are not put at risk of potential infection of the virus.

HCHC appreciates the public’s assistance in our infection control efforts. Thank you for helping to keep our patients, elders and our community healthy.

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