‘This is just the way it is’
By ANDREW MCGINN
See if this rings a bell:
Even with a lethal virus circulating, it was decided that a parade would go on as planned. City leaders were raring to strut their patriotism, and there was a belief that news of an epidemic was being overblown.
The date was Sept. 28, 1918. The place was Philadelphia. And the event — the now-infamous Fourth Liberty Loan Parade — drew 200,000 onlookers.
All of that brotherly love resulted in such a massive spike of influenza that municipal workers in Philly were eventually asked to volunteer as gravediggers.
Greene County Public Health Director Becky Wolf literally finished reading John M. Barry’s book on the 1918 flu epidemic — “The Great Influenza: The Story of the Deadliest Pandemic in History” — just as the novel coronavirus made landfall in the U.S. earlier this year.
“Please,” she remembers thinking, “let’s not make the same mistakes.”
How the response to COVID-19 will fare in the annals of history is, frankly, still up to us.
Just know that — as depressing as this sounds — we’re still only living in the first chapter.
“This has gone on a long time,” Wolf confessed. “We’re not finished with the first wave yet.”
As the county’s point person on infectious diseases, Wolf is urging people locally to keep their guards up as cases of COVID-19 surge nationally. But as a lifelong county resident — a grandma frustrated with not being able to host sleepovers with her grandkids — she understands coronavirus fatigue.
“People are tired of it,” Wolf explained. “They’re tired of hearing about it. They just want normalcy. I get that. I do too.”
While much has changed in the century since the so-called Spanish flu claimed 675,000 American lives — “They didn’t understand what viruses were like. They misunderstood what we know now,” Wolf said — one thing that hasn’t changed at all since 1918 is human nature.
“Everybody has their own opinion, and everyone has their own choice,” Wolf said. “All we can do is offer guidance.
“And maybe some prayers.”
That Greene County has the lowest COVID-19 infection rate of its six neighboring counties likely has less to do with divine intervention, however, and more to do with epidemiology.
“We’re more spread out. It’s rural vs. metro. More people, more chances to get infected,” Wolf said.
For instance, the longer COVID-19 persists, the more she worries about her two daughters — both critical care nurses at Mercy in Des Moines — developing post-traumatic stress.
These numbers are undoubtedly already obsolete, but as of Tuesday, Greene County has had 31 confirmed cases of COVID-19 since the April 6 announcement of the first local case.
Some residents have been mildly ill, while some others “have been very, very sick,” said Wolf, calling it “frightening” and far worse than just the flu.
Case numbers in neighboring counties fall according to population: Dallas County (1,427 cases); Webster County (432 cases); Boone County (174 cases); Carroll County (117 cases); Guthrie County (82 cases); Calhoun County (66 cases).
Every county — except Greene County — has had a death.
As of Tuesday, COVID-19 had claimed the lives of more than 750 Iowans. Nationally, the body count is nearing 135,000.
Admittedly, Public Health is waiting for an uptick in cases from the Independence Day weekend.
But if the numbers hold, it wouldn’t be the first time Greene County escaped the worst of a global pandemic. An estimated 16 Jefferson residents were lost to Spanish flu in 1918, a number touted as a success. The local press credited the Jefferson city council’s 12-week quarantine with saving lives.
“I’d like to take credit for it,” Wolf said of the county’s current numbers. “We could have double or triple. Our low numbers spoke volumes: People were trying to do the best thing. All I can do is keep plugging away with the message.”
That message is fairly simple: If inside, Wolf said, wear a mask.
The Centers for Disease Control and Prevention continues to urge the use of cloth face coverings in public settings to help slow the spread of COVID-19, as a mask may keep the wearer from spreading a virus they don’t even know they have.
“I know people get tired of masks. I do too,” she said. “We don’t handshake anymore. We don’t hug anymore. We’ve lost that personal connection. I’m a hugger.”
“This is just the way it is,” she added.
Shoppers visiting More Time on the north side of the Square are required to wear masks — with signs in English and Spanish spelling out that requirement.
Owner Jen Badger believes her policy is probably more strict than elsewhere around the Square.
“I don’t think people have been as bold as we have,” she said.
But to date, she said, only one person has called to voice their displeasure with the mask policy.
“I have the right to say, ‘No shirt, no shoes, no service.’ This kind of fits in the same category,” Badger said.
If anything, she thinks that more people are shopping in her store now because they know it will be a safe environment.
It’s the same reason she chose to shop at Menards over a different home improvement store on a recent trip out of town.
“I went to Menards,” Badger explained, “because I knew everybody had a mask on.”
At Public Health, Wolf and her staff have settled into what can only be described as a new normal.
They’re no longer working six and seven days a week like in the beginning of the pandemic. Guidance from state and national health officials no longer changes from morning to afternoon.
“It was very, very stressful,” she said. “It was overwhelming, for sure.”
Wolf and her two public health nurses still take turns answering the department’s local COVID-19 hotline, which can be called seven days a week between the hours of 8 a.m. and 8 p.m. at 515-386-0564.
The hotline averages between four and five calls a day, Wolf said.
“We have a lot of people who are seeking testing,” she said.
Unfortunately, local doctors can still only test people with symptoms of COVID-19.
But despite being able to develop something of a routine, it’s far too early to declare victory.
Wolf advises against summer travel to places that are hotspots.
“That’s the problem with a novel pandemic. You don’t know what it’s going to do,” Wolf explained. “It’s a highly infectious virus, we know that.”
On July 6, for example, a letter signed by 239 scientists in the journal Clinical Infectious Diseases called airborne transmission of COVID-19 a “real risk.”
If accurate — Wolf wants more evidence — it would mean, as the authors noted, that hand washing and social distancing are appropriate, but ultimately insufficient as protection.
Greater ventilation in public buildings and even germicidal ultraviolet lights are needed, they wrote.
It’s so far been the prevailing belief that COVID-19 spreads from one person to another through respiratory droplets when an infected person coughs, sneezes, talks, sings or shouts.
Airborne transmission would mean that virus-carrying respiratory microdroplets are released into the air — then remain aloft for an unspecified length of time. The virus that causes measles, Wolf said, can hang in the air for two hours.
Airborne transmission or not, school administrators already have a daunting task awaiting them this summer: deciding what to do about the 2020-21 school year.
Wolf said she’s been in conversation with the local districts as they formulate their plans.
Her first thought on kids returning to school was, “My God, we can’t just turn them loose.”
Wolf said she has since read information on the topic from the American Academy of Pediatrics. Kids, she said, are stressed.
“Kids need to have some normalcy,” she said. “The data so far is that younger kids are not getting this. Typically we call school kids ‘spreaders and shedders.’”
However, what to do to protect teachers and staff is admittedly a “question mark” at this point.
In reopening guidance released June 25, the Iowa Department of Education punted the mask issue to local school districts. State officials said they don’t recommend requiring masks, but individual districts are free to set their own policies.
“At some point, we’ve got to do it,” Wolf said of reopening schools.
Public Health is set to begin back-to-school immunizations on July 22. As it stands, the department has already seen a decrease during the pandemic in immunization visits, Wolf said.
That, she said, is concerning in itself.
“We could have a whooping cough outbreak,” Wolf said.
Regular influenza season is also coming up quickly, she said.
In other words, it’s not too late to take COVID-19 seriously.
“We’re not going to make judgments,” Wolf said. “We’re not going to say, ‘We told you so.’”