Lessons Learned: COVID-19 data has helped Siouxland District Health with pandemic response

WOODBURY COUNTY, Iowa — The first positive case of COVID-19 in the United States was confirmed on January 19th in Washington state. Almost two months later, On March 8th, Iowa announced its first 3 positive cases. It was just two weeks later that COVID-19 arrived in Woodbury County.
In the 6 months since that day, the Siouxland District Health Department (SDHD) has tested, tracked and traced the spread of COVID-19 in our community, while learning more about the novel coronavirus right along with the public.
In an exclusive sit-down with Siouxland News Reporters Vivian Rennie and Katie Copple, the SDHD discusses the data they've collected from the more than 5,000 positive cases in Woodbury County, the lessons they have learned along the way and what is next for the community.
THE DATAThe Siouxland District Health Department announced the first confirmed positive case of the novel coronavirus in a Woodbury County resident on March 20th and a lot has changed since that first report.
Once a positive test result is reported to the health department, the contact tracing process begins which is an important component of slowing the spread of the virus.
"We really feel like it's very important to make sure that if you are doing a COVID test, whether it's rapid or otherwise, that that actually gets reported because we have to be able to get those test results so that we can do contact tracing and some of the things that go along with that," said SDHD Deputy Director Tyler Brock.
In March and early April, the SDHD was only reporting a few positive cases a week. But that quickly changed. By mid-April, they were reporting triple-digit positive cases daily as outbreaks were reported in large local employers.
"The peak was the week ending May 3, and the number of cases we received notification in that week was 667. When we got about to the end of May, then we started seeing as it's kind of a little come down to 261 cases. And then over the course of the next few weeks, it declined gradually and over the course of the entire summer," Grieme said. "It just sort of hovered around that 70 to about 105 cases, and we just seem to begin, kind of a gradual increase over the last few weeks."
Throughout the summer, the SDHD was only reporting a handful of cases a day. Now that schools and businesses have reopened and Siouxlanders are spending more time in large groups and at large gatherings, cases are rising once again.
SDHD officials say that these latest cases are among the young adults and school-aged individuals.
I think it's been pretty obvious that a lot of young adult college-age type kids taught that that age range has been kind of at the center of this uptick.With more than 5,000 positive cases in Woodbury County, the SDHD has been tracking and analyzing the data, which they are now releasing publically.
This data breakdown includes which group of residents have been impacted most.



Woodbury County COVID-19 Distribution by Race (9/25/20)

"I think within Woodbury County, what we show is actually 70% of all those affected were Caucasian," SDHD officials said about the data. "Blacks are 10% Asian 10% and then we get down to just very small micro amounts is what it would be for that following that kind of that remaining 10%."



Woodbury County COVID-19 Distribution by Ethnicity (9/25/20)

In the 24 Woodbury County zip codes, almost half of all cases fall into two areas with half of the reported cases in the 51103 and 51104 zip codes.



Woodbury County COVID-19 Distribution by Zip Code (9/25/20)

The SDHD also breaks down the confirmed positive cases by gender with a close split between males and females.



Woodbury County COVID-19 Distribution by Gender (9/25/20)

When broken down by age, those in the 21-30 range, or young adults, make up more than 1,000 of the positive cases in the county. Following that group, the three groups that make up the bulk of the middle are spread out between ages 31-60.



Woodbury County COVID-19 Distribution by Age (9/25/20)

When looking at deaths, those above the age of 51 have been the hardest hit with nearly 75% of the reported deaths between ages 51-80.



Woodbury County COVID-19 Distribution by Age (Deaths) (9/25/20)

The Siouxland District Health Department releases the latest data every Friday on its website, keeping the public up to speed with how this virus is moving through the Woodbury County community.
LESSONS LEARNEDHealth officials aren't just fighting a global pandemic, but also the ever-changing information on how to treat and prevent the spread of COVID-19. The team at the SDHD has been working tirelessly to keep local residents informed while learning right along with them.
Right at the start, the county had a pandemic plan in place, which they used as a baseline for responding to the virus.
"I think that started some of the guidance with it," said Grieme. "8 months ago, we were kind of monitoring and at that point in time, we were waiting to see how it would affect the United States overall and more succinctly, when would we see the cases come up in the state of Iowa."
A lot has changed over the last 6 months, including the way the Siouxland District Health Department responds to COVID-19. One of their quickest implementations was a drive-thru testing site in downtown Sioux City.
We were one of the first counties to have a drive-thru community testing site.
While testing was important, so was contact tracing and health officials say that was one of their most challenging obstacles.
SDHD says if you've tested positive, it's extremely important that you answer your phone when health department officials call. They not only need to track each positive case, but also trace where exposures may have happened.
Staff would work for hours each day making calls to those who were sick and it took a toll on the staff's mental health.
"I think one of the biggest challenges we had with the staff was just keeping the mental ability," said Grieme. "Because in some cases those individuals would have a name on a list that they would interview and do the contact investigation and I think one of their mental health concerns is the fact that a number of days later, they would see that individuals name in the obituary section of the paper."
Now, 6 months in from when the first case was reported locally in March, they continue to learn more about this virus.
"It is not necessarily the age as people suspected," Grieme said. "They may be more adversely affected, but it is that 21-30 age that we are looking at creating the most of our cases."
The health department is also working closely with school districts to prevent outbreaks, evolving their methods the more they learn.
We do feel like the schools are the best equipped to identify the kids that are in school contacts."So if we do have someone that is COVID-positive and they have been at school during that infectious time period, we do feel that the schools are best positioned to know who did they sit by, what class were they in here, whats the lunch period look like, what's the bus situation look like," Brock said. "So we have worked with them very closely to identify those in-school contacts."
They've also changed the way they quarantine close contacts in schools to help prevent a teacher shortage. Now, if an educator has been exposed, they can still come to school if they are not showing symptoms while closely monitoring their health status. This is something that has also been implemented with healthcare professionals, first responders and emergency personnel.
Both Grieme and Brock say they are still learning about COVID-19 every day and are doing their best to keep the public informed.
I think it's important for the public to understand that we were learning as they were and we tried to do the best for the guidance that we could."We have done a lot of good things we have had a lot of struggles we have kind of run the gamut here at Siouxland District health and we have more ahead of us yet to learn and yet to accomplish," Brock concluded.

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