Iowa eases quarantine guidelines for schools and businesses, contrary to CDC recommendations
State officials will no longer recommend that people go into a 14-day quarantine after having close contact with a person infected with the coronavirus if both people were wearing masks during the encounter, Iowa Gov. Kim Reynolds announced Tuesday.
The eased guidelines, which apply to places such as businesses and schools, break with the Centers for Disease Control and Prevention's quarantine recommendations. The federal agency says anyone who has close contact with someone who has tested positive should stay home for 14 days, regardless of whether those involved wore facial coverings.
Reynolds suggested at a Tuesday news conference that such a strict rule might not be necessary for Iowa school districts.
"In some situations, they're having to quarantine a disproportionately high number of students when just a few positive cases have been identified," she said.
Reynolds said the state's adjustment comes after discussions with school superintendents and is an incentive for school districts to encourage mask-wearing. The state does not mandate masks in schools, and the policy change announced Tuesday does not include a mandate.
The decision quickly faced criticism from some public health officials and educators, who said the move breaks with scientific evidence. The Iowa Public Health Association issued a statement Tuesday afternoon calling on the governor to provide evidence supporting the new guidance. Masks, contact tracing and quarantine for exposed people are tools that work in concert to protect communities, and none supersedes the others, the association stated.
Dr. Rossana Rosa, an infectious disease physician with UnityPoint Health, likewise asked to see evidence that this could be an effective strategy. Rosa said there are many variables, including the infected person's viral load, the quality and fit of masks, and whether masks are being worn appropriately.
"You have to wonder about the intensity of each one of those contacts," Rosa said in an interview, referring to contacts by an infected person. "Indeed, I think you are actually saying this is a policy perhaps designed to reduce the number of children or people in quarantine, but doesn't seem to be necessarily aimed at reducing the number of cases in our state."
Iowa State Education Association president Mike Beranek in a separate statement said the governor's recommendation was "not consistent with what the scientific community continues to tell us about protecting ourselves, our students and our communities from COVID-19."
He said at the very least, the new guidance should have come with a statewide requirement for wearing facial coverings — a step Reynolds has refused to take, despite recommendations from health officials and the White House Coronavirus Task Force.
State epidemiologist: Iowa in step with Nebraska, Wyoming
Dr. Caitlin Pedati, the state epidemiologist, acknowledged Iowa's new policy breaks with CDC recommendations. She said Iowa made its decision after looking at similar policy changes in Wyoming and Nebraska, as well as data comparing virus activity in Iowa districts using face coverings with those that have not.
Wyoming and Nebraska are also Republican-led and largely rural states. According to the New York Times COVID-19 tracker, Iowa is No. 5 among the states and U.S. territories in fastest spread of coronavirus per 100,000 residents over the past seven days. Nebraska is No. 12 in the country, and Wyoming is No. 16.
The state compared four school districts in Sioux County, which leads Iowa in the percent of tests that are positive. Three of the districts did not require masks, while one did; the district with the mask requirement experienced less spread of the virus. The governor's office is not releasing the names of the schools that participated in the comparison.
Pedati also pointed to a study highlighted by the CDC that described how two hair stylists at a Springfield, Missouri, hair salon who had confirmed symptomatic COVID-19 cases did not appear to spread the virus to any of the 139 clients they were exposed to, likely because all parties involved wore face masks.
The change in policy will be for non-health care and nonresidential settings, Pedati said. Even though the people in question will not need to quarantine at home, they will still be asked to self-monitor for coronavirus symptoms.
Iowa hospitalizations, nursing home outbreaks rising
Reynolds' news conference came days after her proclamation extending bar closures in Johnson and Story counties, and against a backdrop of rising hospitalizations from the coronavirus.
According to the Iowa Department of Public Health, hospitalizations in the prior 24 hours have surpassed what they were during the first peak of cases in the spring.
In early May, the state reported a then-high of 559 COVID-19 hospital admissions over a 14-day period. As of Monday, there were 669 admissions over a 14-day period.
Total hospitalizations, and the number of COVID-19 patients in intensive care units across the state, are not at their spring levels, however. The state reports 38% of inpatient hospital beds, or more than 3,000, are available.
Nursing home outbreaks, defined as three or more residents testing positive, have risen to 50. That's more than triple the level from mid-July. Reynolds said she believed the spike was due in part to mandatory surveillance testing of nursing home staff that has begun as part of a federal requirement. Although the number of nursing home outbreaks is at a recent high point, Reynolds said the facilities are doing better at containing the virus and preventing its spread among residents.
Brent Willett, president and CEO of the Iowa Health Care Association, said Iowa nursing homes have performed about 32,000 tests per week over the past three weeks under the new federal rule, versus about 4,000 per week before the rule was in place.
The mitigation efforts include regular testing of staff members, as well as widespread testing of nursing home residents when surveillance testing uncovers a positive case. Although the 50 nursing home outbreaks reported Tuesday is a large number, he said he believes nursing homes have begun catching more cases where the infected person is showing no symptoms, thanks to more widespread testing.
"When we have a single positive test, whether we believe it's a false positive or not, we automatically move into outbreak mode," he said. "Meaning, we test the entire building of residents, as well."
More:Iowa reports another 7 COVID-19 deaths, 667 confirmed coronavirus cases
As of 10 a.m. Tuesday, 87,507 Iowans have tested positive for the coronavirus. Of those, 67,412 are listed as recovered, and 1,324 Iowans have died from COVID-19.
More:Iowa fines Premium Beef Plant in Tama $957 after huge coronavirus outbreak
Reynolds said Tuesday that state and local officials are watching hospitalizations and have surge plans in place, but she didn't express particular concern at the systems being overwhelmed.
“They have indicated that they still are able to handle what they're seeing,” Reynolds said.
Rosa, the infectious disease doctor, said Iowa's response to the pandemic has generally deviated from CDC, White House and World Health Organization guidelines.
"Honestly, we don't seem to be in a better-off place taking that strategy," Rosa said. "The virus has never really been under control in our state. We have been going through a series of surges and plateaus, and each surge has left us with a higher plateau than the previous one. I guess we'll see where the latest strategy will lead us to."
Nick Coltrain is a politics and data reporter for the Register. Reach him at ncoltrain@registermedia.com or at 515-284-8361.
Ian Richardson covers the Iowa Statehouse for the Des Moines Register. Reach him at irichardson@registermedia.com, at 515-284-8254, or on Twitter at @DMRIanR.
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