Cottage Grove Place in Cedar Rapids has been added to the Iowa Department of Public Health list of long-term care facilities with COVID-19 outbreaks. According to IDPH, six people at Cottage Grove have tested positive for the virus, one of whom is considered recovered. IDPH does not distinguish between residents and staff when reporting the number of positive cases at a long-term care facility.
There are two other Linn County long-term facilities on IDPH’s list, Willow Gardens Care Center and Winslow House Care Center, both of which are located in Marion. In Johnson County, one long-term care facility — the Solon Nursing Care Center — is experiencing an outbreak, according to the department.
IDPH defines a COVID-19 outbreak in long-term care as three or more residents testing positive. The department will only report a long-term care facility has cases of the virus — either among residents or staff — after it meets that definition of an outbreak.
This is the second outbreak at Cottage Grove. The facility had its first confirmed cases in late April, and was declared recovered in early June. A total of six residents tested positive during that outbreak. Four of those residents recovered, two died.
IDPH is reporting outbreaks at 26 long-term care facilities as of 10 a.m. on Friday — an increase of four since Monday, when it reported 22 outbreaks.
Cottage Grove is located near Washington High School, but its outbreak is unlikely to have any impact on whether that school, or any other Cedar Rapids Community School District school, would receive permission from the Iowa Department of Education (DOE) to switch to all online classes, if the school district requested a waiver.
According to Gov. Kim Reynolds and DOE, schools are required to provide in-person instruction for at least 50 percent of the instructional time during a two-week period. DOE standards released last week say that districts would not be eligible for a waiver for these requirements until there is a 14-day average of 15 percent positive results in a county’s COVID-19 tests and schools have a 10 percent absentee rate.
Most public heath experts, including the director of the CDC, recommends schools switch to all online classes if their communities have average positivity rates above 5 percent.
According to the 14-day positivity rate averages published by IDPH, the current 14-day average for Johnson County is 8 percent and for Linn County it is 9 percent. Despite having an average positivity rate above what most public health experts recommend, on Thursday DOE rejects a request from the Iowa City Community School District to use all online instruction for two weeks when its schools reopen on Sept. 8.
Only seven of Iowa’s 99 counties currently have 14-day positivity rate averages of 15 percent or higher, according to IDPH. Webster County has the highest average, with a 23 percent rate over the previous 14 days. But at the governor’s press conference on Thursday, Reynolds and IDPH Medical Director Dr. Caitlin Pedati explained that Webster’s high average might not qualify its schools for a waiver to provide all online instruction.
According to the governor and the medical director, “community context” can outweigh a high positivity rate. Webster County’s recent high positivity rate reflects, among other things, the ongoing outbreak at the Fort Dodge state prison located in the county.
Pedati said it was important to be “flexible” when using an average positivity rate when assessing virus activity in a county, but she only gave examples where that flexibility could be used to discount a high positivity average. Pedati said that cases in “congregate settings” probably should not be used to decide if a school district qualifies for a waiver.
IDPH used the term “congregate setting” to describe locations where people live together in large numbers — long-term care facilities, dormitories and prisons for example — as well as workplaces where workers are in close contact, including factories and meat processing plants.
Of course, even though prison inmates and long-term care facility residents may not circulate in the wider community, and therefore may not contribute to community spread of COVID-19, workers at prisons and nursing homes do, and can spread the virus even if they are asymptomatic.
On Thursday, a new study of asymptomatic COVID-19 patients published in JAMA Internal Medicine provided “more definitive proof that people without symptoms carry just as much virus in their nose, throat and lungs as those with symptoms, and for almost as long,” according to the New York Times.
The study is the work of South Korean researchers who “analyzed samples taken between March 6 and March 26 from 193 symptomatic and 110 asymptomatic people isolated at a community treatment center.”
This is the second study in two weeks to find that a group carries higher-than-expected levels of the virus. A study published in JAMA Pediatrics on July 39 found that young children may host as much or more of the virus in their upper respiratory tracts as adults do.
On Friday, IDPH reported another 588 Iowans were confirmed as having COVID-19 during the 24-hour period ending at 10 a.m. The newly reported cases bring the state’s total number of cases to 47,729.
The department also reported an additional six deaths. As of 10 a.m. on Friday, the state’s COVID-19 death toll stood at 912.
According to IDPH, 15 new cases of COVID-19 were reported in Johnson County on Thursday, and in Linn County, there were 64 new cases. Johnson County has a daily positivity rate of 5.1 percent on Thursday and Linn County has a daily positivity rate of 11.7 percent, the department reported.