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When will the COVID-19 public health emergency end?


More than a year has passed since Governor Kim Reynolds declared COVID-19 a public health emergency in Iowa and followed up that announcement by shutting down restaurants and bars.

Shortly after, the Governor closed all “non-essential” businesses, meaning any business not a convenience store, grocery store, liquor store, or gas station for 30 days in April 2020. There were additional  restrictions followed by the state offering financial help for any businesses which were seriously impacted by her Executive Orders. As it turns out, almost all businesses and non-profit organizations, including scores of churches, were impacted. And we are still seeing those effects today with a number of businesses closing permanently and a significant number of Iowans losing their jobs.

As it stands this week, COVID-19 cases are on the downswing across Iowa and Crawford County. The positivity rate for coronavirus testing in the state is less than 5%, and about 2% in Crawford County. In fact, in all of Crawford County, there are currently less than 10 active cases of COVID-19.

One of the reasons there are so few positive cases of COVID-19 has to do with the vaccination rate.

For the state of Iowa, over 2.2 million doses of the coronavirus vaccine (Moderna, Pfizer, and Johnson & Johnson) have been administered in the state. Approximately 33% of all Iowa residents are now vaccinated.

In Crawford County, the numbers are slightly better – 5800 people, or just shy of 34% of the total county population, has been vaccinated. For those over the age of 18, the percentage is 45.26! More than 11,000 doses of the vaccine have been administered in Crawford County and more doses are available every week.

According to public health experts, at least 70% of all residents must be fully vaccinated to reach herd immunity. In Crawford County, that means another 3,500 residents must opt to receive the vaccine.

One question that is asked repeatedly – when will the COVID-19 public health emergency end?

The pandemic’s two endpoints, a transition toward normalcy and herd immunity, may look different in different places. Many of the first steps toward ending the public health emergency in Iowa have already been taken: a return to fully in-classroom education; fewer restrictions on the operations of bars and restaurants; more gatherings with larger groups of people; and, the reopening of offices.

Nonetheless, herd immunity will represent a more definitive end to the pandemic. Isolated cases may still occur—indeed, the virus may continue to circulate for one or more quarters after herd immunity is reached. But with herd immunity, population-wide public-health measures can be phased out. As populations get closer to this state, it may be helpful to introduce some nuance to what we mean by the term.

  • Nationwide herd immunity. The full population is well protected so that the country experiences, at most, occasional small flare-ups of disease.
  • Regional herd immunity. Some regions, states, or cities are well protected, while others experience ongoing outbreaks of COVID-19. For instance, the Iowa COVID-19 positivity rate may be low, but the Michigan rate is sky high.
  • Temporary herd immunity. A population or region achieves herd immunity for some period, but as variants are introduced, against which prior immunity is less effective, a new wave of cases is launched.
  • Endemicity. A region fails to achieve herd immunity. Endemicity is most likely in places where vaccine access is limited, where few people choose to be vaccinated, if the duration of immunity is short, or variants that reduce vaccine efficacy are common and widespread. Endemicity might include cyclic, seasonal waves of disease, broadly similar to the flu, or a multiyear cycle of resurgence.

The next few years are likely to see a combination of some or all of these options around the world.

Remember, herd immunity is not the same as eradication. SARS-CoV-2 will continue to exist. Even when a county, state, or even the entire country reaches herd immunity, ongoing surveillance, booster vaccines, and potentially other measures may be needed.

The best and quickest way to a normal life, comes from the vast majority of the population being fully vaccinated. If you are already fully vaccinated, thank you! If you have not yet received your COVID-19 vaccination but would like to do so, please call CCMH Medical Clinic at 712-265-2700 to schedule your appointment.