Iowa Governor Kim Reynolds updates the state response March 24, 2020 to coronavirus during a news conference at the State Emergency Operations Center in Johnston. The state counted its first COVID-19 death that day, a resident of Dubuque County. (AP Photo / Charlie Neibergall, Pool)
Iowa Governor Kim Reynolds will hold a press conference on COVID-19 at the State Emergency Operations Center in Johnston, IA, on Friday, April 3, 2020.
Pramod Dwivedi, director of public health at Linn County Public Health is photographed in Dr. The Percy and Lileah Harris Public Health Building in Cedar Rapids Wednesday, June 16, 2021. (Rebecca F. Miller / The Gazette)
CEDAR RAPIDS – The gap in timely communication from state officials to county public health agencies and other local entities created challenges in these communities’ ability to respond to coronavirus, according to a review of pandemic response commissioned by Linn County officials.
On Wednesday, the Linn County Board of Health released the county’s COVID-19 After Action report, a detailed analysis conducted by a third-party agency to identify successes and weaknesses in the county’s response to the coronavirus pandemic between March 2020 and June 2021.
The public health agency paid Arizona-based Coll Consulting $ 43,651 to conduct the review using federal and state funding. The review took place between September 2021 and February 2022.
Among its findings, the report identified the communication gap between the state and Linn County Public Health as a significant weakness in local COVID-19 response.
“There was a lack of strong real-time decisions from the state as well as timely communication of decisions made,” the report said.
In particular, the report found that information sharing from the state to local officials took place primarily during Governor Kim Reynolds’ public news conferences, meaning the county’s public health departments learned about new coronavirus response policies at the same time as the rest of the public.
This “created challenges in planning and implementing initiatives,” the report said.
One example was the state decision in March 2021 to extend the eligibility for COVID-19 vaccines to those with underlying medical conditions without prior notice to local public health departments administering vaccine administration. As a result, Linn County Public Health officials – as well as other state-wide officials – had to work through the weekend to prepare for the influx of demand for shots.
Linn County Public Health Director Pramod Dwivedi said it also put the local health department in an awkward position when they would receive questions from the public about the latest guidelines and they did not have an answer to them.
“In a very fast-moving and changing disease outbreak situation, communication is so critical,” Dwivedi said. “As a local health agency, you are right there in the field and responding to any outbreak, but when it comes to communication and resources, you are at the back of the queue. That needs to change.”
Public officials say there was clear communication
The governor’s office said the Iowa Department of Public Health routinely met with local and county public health officials to share relevant information about Iowa’s COVID-19 response and provided “a clear and direct line of communication.”
“In the ever-evolving pandemic, controlling information was crucial to reducing the spread of false information from trusted sources,” Alex Murphy, spokesman for the governor’s office, said in a statement to The Gazette.
Communication challenges are often identified in reports following post-emergency action, Iowa Department of Public Health spokeswoman Sarah Ekstrand said in response to the report’s findings.
“IDPH looks forward to hearing more from Linn County about their (after action report) and to reviewing strategies with our partners to improve communication strategies across all levels,” Ekstrand said Wednesday.
Local public health departments nationwide addressed a lack of consistency in guidance between states and federal health agencies, with states often taking a patchwork approach to mask claims, company closures, and other mitigating efforts.
Early in the pandemic, Dwivedi said the county’s public health department chose to follow the CDC guidelines – which often deviated from recommendations from the Iowa Department of Public Health.
Going forward, Dwivedi said he hopes state and local health authorities can create a coherent communication strategy in case of other emergencies.
“It would save lives,” he said. “We understand that there may be hiccups and problems in a rapidly evolving situation, but we need to have accountability and accountability to our neighbors.”
State officials have not publicly said whether the state will carry out its own post-COVID-19 response report, but the governor’s spokesman said the state is working to identify areas for improvement.
“The state continues to analyze our processes to determine whether there is a need for efficiencies and other areas for improvement, including communications, following the global pandemic, which had absolutely no playbook to follow,” Murphy said in an email to The Gazette .
Other improvement needs and successes identified
Overall, the report identified Linn County Public Health’s partnerships with other community stakeholders – such as hospitals, county and city governments, school districts and emergency services, among others – as a major strength of the local coronavirus response.
“This teamwork was important for such a large scale and duration,” the report said. “Linn County, local cities, the medical system, and community partners all worked together in a collaborative environment to save lives and mitigate the spread of the COVID-19 virus.”
Dwivedi said this partnership with stakeholders outside the public health agency was “crucial to our success.”
“It’s a team sport,” he said.
However, the report identified the need to better prepare staff to fill roles in the county’s incident command and emergency centers. Early in the pandemic response, it was clear that not all employees had adequate training or experience in this type of disaster preparedness, Dwivedi said.
“I think it was a shortcoming we need to address going forward so we are well prepared for the future,” he said.
Dwivedi said Linn County Public Health will work to address the necessary improvements in the future. In addition, local officials will seek to build on its strengths identified in the COVID-19 After Action report.
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