Part of a six-part series on the impact of the COVID-19 pandemic in Hamilton County

Iowans have been living with the COVID-19 pandemic for the past six months, with business and school closings, social distancing, hand sanitizer and face coverings.

Hamilton County has not experienced a large influx of cases that other parts of the state have seen. That may be partially due to the size of the county, according to one health official.

“We go a couple days with no positive cases, and then out of a week we’ll have one or two and then a day with nothing,”said Shelby Kroona, director of Hamilton County Public Health. “We’ve been able to keep our numbers low, but we’re also a small county.”

“We had a small spike in June and since then, we’ve been on a seesaw ever since,” she said. As of Tuesday, there have been 315 positive cases reported since March in Hamilton County with 3 deaths attributed to COVID-19.

She said the low numbers may also be due to businesses throughout the county having employees and customers wear masks. Having no in-person school in the spring may also be part of the equation as children and families were more isolated.

Kroona said she expects that there would be “pockets” of COVID illness throughout the fall and winter months. Those clusters of illness typically occur after large events, especially if people attend from different parts of the state or even other states.

“We’ll have the potential for a cluster of illnesses 7 or 8 days after a large event,” she said.

After six months of wearing masks and social distancing, many people are suffering from what Kroona calls “COVID fatigue.”

“Frankly, we’re all tired,” she said. People are ready to get out, to socialize, go to gatherings, restaurants or bars. Many hear stories of friends and neighbors who just had COVID-19, and it was just a mild case of the coronavirus. Kroona said people may try to rationalize that they, too, would not be greatly affected by the virus.

“But the problem with that thinking is, we don’t know who is going to get very ill. At first, it was just the elderly and those in longterm care,” she said.

“But as this has unfolded, you just have to turn on the news to hear, for example, a 20-year-old football player who passed away from a heart attack. Or someone else who suffered a stroke (as a result of COVID-19),” she added. “That’s the scary part – we don’t know who is going to get significantly ill.”

Fall and winter typically bring influenza and other seasonal bugs. Kroona said with those illnesses added into the mix, area residents should get a flu vaccine this fall and continue to follow the public health guidelines of staying home when they are sick, frequent hand washing, social distancing and wearing a face covering when away from home.

She related that Australia had a very mild flu season this year.

“They think that the flu shot may be a good match and everybody there is wearing masks,” she said. “So they are going to do some research, but they think the masks have prevented some flu deaths.

“If wearing a mask helps slow the spread of influenza and we can prevent some children and adults from dying from the flu, that would be great, too,” she said.

Kroona said her department has started preplanning for when the COVID-19 vaccine becomes available. Originally, she said the federal level had hoped to have it available by November. But realistically, Kroona said the planning processes are telling her it could be a six-month duration from about January through June.

She said the first to receive the vaccine will be essential workers like doctors and nurses, longterm caregivers and residents and public safety workers.

“After that, there will be a decision making tool from the federal government and we will have multiple kinds of clinics in Hamilton County. They could be at doctor’s offices, public health, the hospital and probably will include pharmacies, just like the flu shots,” she said. According to what she has learned, there should be no cost to those receiving the vaccine.

Likely, the first vaccine to market will be the two-dose variety. She said there are two different manufacturers — one has 21-day separation and the other is a 28-day separation between the shots.

“So people will be need to be very mindful of what brand of shot they received and where they received it so they can return for the second dose,” she said.

Kroona acknowledged that there is a large portion of the population who are nervous about receiving a new vaccine that has been in trials only a short time before coming to the market. Data indicates that right now, it appears the vaccine will be between 40 to 50 percent effective.

“They will have better data as more and more people receive the vaccine. We still don’t know the long-term immunity because the coronavirus is so new,” she said. “The hope would be that about 50 percent of the people would accept taking the vaccine.”

COVID-19 will likely be with us for some time, she said. The virus seems to be following the same kind of trajectory as the Spanish Flu more than 100 years ago.

“There were three cycles of the Spanish Flu before they finally felt that it was under control,” according to Kroona.

Hamilton County residents should to not be afraid to be tested for COVID-19. It’s better to know for sure whether they have the virus and there should be no stigma about finding out the truth, she said.

But Kroona also reiterated that between now and the time the virus is under control, Hamilton County residents still need to be vigilant with hand washing, social distancing, limiting contact with others and using face coverings.

“If we want to stay safe, those public health measures are the best proven methods until we have a vaccine,” she said.