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Dubuque County supervisors on Nov. 12 unanimously approved a countywide mandate for face coverings to be worn in public, as local COVID-19 cases continue to surge.

The vote by the supervisors followed a unanimous recommendation from the nine-member county Board of Health on Monday night that a mask mandate be implemented as a way of reducing the spread of the coronavirus. The mandate will go into effect on Wednesday, Nov. 18, when the ordinance can be published in the three official county newspapers: the Telegraph Herald and its sister publications the Dyersville Commercial and Cascade Pioneer.

The Board of Health previously recommended such a move, but the supervisors voted, 2-1, in early September against instituting one. At that time, Jay Wickham was the only supervisor to vote in favor, with Dave Baker and Ann McDonough voting against it.

The since-revised mandate requires people older than 3 to wear face coverings in interior public spaces and businesses; on public transportation or when using a private car service; and when outside if they are unable to maintain 6 feet of distance from others. Exceptions are included for those with breathing difficulty or under oxygen treatment, or those legally or medically required not to wear masks.

Business owners will have to post signage indicating the mandatory wearing of face coverings inside and also have masks available at the entrance for people without one. The county Board of Health plans to provide masks to businesses.

The mandate runs through March 1, though it can be amended, extended or rescinded at any time.

When voting against the mandate proposed in September, McDonough and Baker cited the opposition of the mayors of the county’s smaller communities. The City of Dubuque already had instituted its mask mandate at that time.

But on Monday, McDonough voiced her support for the second mandate resolution during the Board of Health’s meeting, citing her feeling of a consensus among most of the county’s mayors that the mandate was now appropriate.

“That is not unanimous,” she said Thursday, in reference to the mayors’ stances, before voting in favor. “And, to be clear, no one abruptly changed their position or sold anyone out. It’s a pandemic. But leaders are intended to be responsive to the needs of their community toward minimizing harm.”

Wickham had held fast to his original support for the countywide mandate. On Thursday, he thanked the members of the Board of Health.

“They have passed two separate, very similar resolutions,” he said. “Those were both passed unanimously by those volunteers and health professionals. I greatly appreciate their effort and involvement.”

Baker, for his part, based his different vote this time around on just how drastically different the pandemic situation is now.

“The difference between now and when we voted on this a couple of months ago is significant,” he said. “I don’t want to hear from our hospitals that they don’t have room for people.”

When the supervisors voted down the mandate on Sept. 8, there were about 2,200 confirmed cases of COVID-19 in the county, along with 36 related deaths. The county’s 14-day positivity rate stood at 12.8%, and 11 Dubuque County residents with COVID-19 were hospitalized.

As of Nov. 12, there were more than 7,300 cases and 76 related deaths. The 14-day positivity rate had climbed to nearly 24%, and the number of county residents with the coronavirus had quadrupled, with local hospital leaders calling for the public’s help as their facilities face a deluge of cases from Dubuque County and beyond.

Baker did say he did not think the mandate would be a “magic wand.”

“I think there are other things to be considered,” he said. “I still have concerns about people complying with this, but doing nothing is not the right thing to do.”

Baker’s re-election effort was thwarted last week when he was bested by Harley Pothoff in the general election. On election night, Baker told the Telegraph Herald that he believed his opposition to the mask mandate hurt his chances at the polls.

McDonough agreed with Baker’s “magic wand” sentiment, turning to the Board of Health.

“This is one piece,” she said. “We should follow that up with some rapid-response items to assist the communities in being individually responsive as well.”

Sheriff Joe Kennedy had questions about enforcement of the mandate, which have been at the heart of some debate.

“Generally, when the county issues an order, it is enforced by the sheriff’s department in the unincorporated areas and the local departments in the small towns,” he said, asking if that would be true of the mandate.

Supervisors pointed to the fact that there was not a specific law enforcement piece to the resolution. Kennedy said his department would enforce the rule as its capacity allowed and that deputies would have masks with them to distribute to individuals without them.

County Attorney C.J. May III said it is a simple misdemeanor to violate a county health order, according to Iowa Code.

During the supervisors’ meeting, which was shown online live, opponents to the mandate — and the practice of wearing masks in general during the pandemic — filled the chat box with written comments of outrage.

But only one opponent spoke aloud during the public input portion of the meeting

With the move, Dubuque County becomes the fifth Iowa county to institute a mandate — after Harrison, Johnson, Story and Wright counties. Numerous cities have as well, including Guttenberg, Waterloo and Des Moines.

Gov. Kim Reynolds continues to insist that cities and counties do not have the authority to issue such an order. The municipalities with mandates argue that they have the legal standing to do so.