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A federal report released last week recommends that in Dubuque County, based on its COVID-19 activity, bars and gyms should be closed, restaurants should restrict indoor dining and promote outdoor dining, and face masks should be required in all businesses.

The latest White House report provides those recommendations for Dubuque County and other “red zone” counties. The designation is for areas in which more than 100 new cases per 100,000 population were reported in the past week and in which the positivity rate topped 10% during that time.

The state collectively also is deemed a “red zone” in the report. That prompted recommendations such as continuing to promote social distancing and the wearing of masks; testing all staff of long-term-care facilities for COVID-19 weekly; and requiring that meatpacking plants and “other crowded workplaces ... ensure social distancing, the wearing of face masks and regular testing.”

The report, dated July 26, was distributed to states by the Trump administration’s coronavirus task force and published July 28 by The New York Times.

Dubuque County is one of eight “red zone” counties in the state.

And Dubuque, Polk and Scott counties had the three highest totals of new cases in the state over the past three weeks. The three counties accounted for nearly 37% of all new cases in Iowa during that time.

The White House report also listed the cities of Dubuque, Marshalltown and Ottumwa as “red-zone” communities for heightened virus activity.

“I think that there has been a misconception or a belief that even though cases have gone up significantly, death rates have been low, and that created a false sense of confidence we can carry about business as usual,” said Dubuque oncologist and Dubuque County Board of Health Member Dr. Bobby Koneru, who has served as Dubuque County’s medical liaison during the pandemic.

“What we are seeing is although death rates have dropped significantly from the peak we have seen in March, we’re starting to see hospitalization rates go up. And death rates lag positive cases by several weeks. I think we’re going to see death rates rise.”

Twenty-four people with COVID-19 were hospitalized in Dubuque County as of July 29, according to the most-recent state data. That compared to 13 people two weeks earlier and five people four weeks earlier on July 1.

Two more COVID-19-related deaths in Dubuque County were reported in the 24-hour span that ended at 5 p.m. July 30, pushing the county’s toll to 28. The county has had five such deaths since July 21 after having just one in the prior five weeks.

Koneru fears county residents have “become numb” to the rise in new confirmed cases.

“People need to take this seriously,” he said. “It can be a deadly virus … and we’re seeing it can cause very severe symptoms in a certain percentage of the population” lasting for weeks and leaving lingering, unanswered health concerns.

“I worry all of the sudden we’re going to get hit with this huge surge of hospitalizations and it’s going to be too late to turn that back,” Koneru said.

City of Dubuque Public Health Specialist Mary Rose Corrigan echoed the sentiment.

“It’s a wake-up call,” Corrigan said. “It means we definitely have room for improvement and we need to do more as individuals and a community. It’s not just wearing a mask. It’s not just testing. It’s not just social distancing and handwashing. It’s not just staying at home. It’s all of these things that are going to make a difference.”

Ramped-up enforcement

The White House coronavirus task force recommends Iowa close bars and gyms in “red zone” counties, including Dubuque County.

Currently, bars, gyms and restaurants are allowed to operate at full capacity. However, bars and restaurants must ensure 6 feet of physical distance between each group or individual dining or drinking.

Starting last week, Iowa’s Alcoholic Beverages Division and Department of Inspection and Appeals began working together to ensure bars, restaurants and other food establishments follow social-distancing requirements and public health guidelines set forth by Gov. Kim Reynolds’ emergency proclamation.

“COVID-19 is still with us, and we need bars and restaurants to help mitigate the spread of the virus,” said Iowa Alcoholic Beverages Division Administrator Stephen Larson in a press release. “For those businesses that choose not to, they need to understand that there are consequences.”

For businesses with an alcoholic beverage permit or license, the state will issue a $1,000 fine for a first offense. For businesses with only a food license, the state will issue a warning, per the release.

A second infraction for any business will trigger a seven-day suspension of their food or alcohol permit or license. A third infraction will result in the loss of a permit or license.

Call for local mask mandate

The White House report also recommends recruiting more contract tracers to ensure all positive households are individually tested within 24 hours and increasing access to community testing.

Corrigan said county public health officials are looking at adding testing for those exposed to a known positive COVID-19 individual and who have been identified through contact tracing.

White House officials also recommend ensuring all retailers and “personal services” require masks of staff and customers.

Reynolds has encouraged Iowans to wear masks but has not required their use in public like a majority of states, including Illinois and Wisconsin. The governor has rebuffed calls from Iowa doctors to do so, arguing Thursday that such mandates are ineffective and often not enforced.

“All along we’ve said, ‘If you can’t social distance, wear a mask,’” Reynolds said during a press conference. “We know those are two things that help slow the spread and have an impact on COVID-19 in our state. And I believe Iowans are doing the right thing.”

Reynolds added “everything is on the table” of possible future mitigation measures based on positivity rates in localized “hot spots” of the state.

“But, right now, ... we’re going to ramp up the enforcement (on bars and restaurants) and take a look at that and see if that has an impact,” she said.