With a sobering year for health care in 2020, local agencies saw a revolution in care as they executed new plans and ideas to get Webster County back on its feet. With a vaccine rollout in 2021, things are already looking up.

“The governor’s proclamation on March 17 changed the world of public health,” said Kari Prescott, director of Webster County Public Health (WCPH), in September. “We completely shifted all our efforts into preparing for and responding to anticipate situations that could happen in our county.”

Incident command immediately focused on enforcing the governor’s proclamations, isolation and quarantine policies, and communicating with health care providers as Public Health activated plans they’d hoped they would never have to use.

Hospital visits and many non-urgent outpatient procedures were suspended to prepare in March. A respiratory health clinic temporarily opened, closing by the end of the summer when it was no longer necessary for patient care.

After knowledge and practice developed, some equipment turned out to be needed less than originally thought.

For example: many needing respiratory assistance fared appropriately with the less invasive high-flow nasal canulas, which do not require sedation and regular back-to-stomach rotation by a team of nurses, said Leah Glasgo, CEO of UnityPoint Health — Trinity Regional Medical Center. The new knowledge eased early fears that Iowa would run out of ventilators.

As cases poured into the county over the summer, many from a prison outbreak at Fort Dodge Correctional Facility, Glasgo said that the hospital experienced surges in patients during the months of June, July and August — the biggest of which was in August. The hospital did not need to tap into the surge area prepared on its second floor after May. In the months following the early days of the pandemic, a different approach was adopted to caring for COVID-19 patients, meaning the hospital didn’t have to utilize as much space.

Glasgo said the hospital was not close to overwhelming its total capacity, which serves those in Webster County and many surrounding regions of Iowa, at any point over the first six months.

Over the course of 2020, public health interventions became politicized and chastised, said Prescott.

“I have been in public health for 20 years,” she said. “I have never witnessed a situation so polarized and so politicized where it significantly affected the work we do in the public health arena.”

Over the last year, Webster County Public Health went to work by helping neighboring counties in distress with case increases, employing targeted testing to help various employers and nursing homes keep outbreaks under control and working through difficult holiday weekends with waves at the end of the year to conduct contract tracing.

Targeted testing has been a critical tool in the fight to protect residents of nursing homes, who are acutely vulnerable to severe complications from COVID-19 and rely on employees that come in from the outside each day.

But the tool was also useful for other public health priorities whose populations might not be vulnerable, but have to report to work every day, like essential factories, agricultural processing facilities or meat packing plants where it’s difficult to socially distance.

Webster County was one of only 34 counties in Iowa that conducted its own contact tracing. The rest turned it over to the state. By doing its own contact tracing, the agency was able to have a unique, human touch in what can be a scary or confusing process for COVID-19 patients to navigate.

In 2020, Community Health Center of Fort Dodge administered 25,872 COVID-19 tests.

In November, TRMC began to offer a new treatment for COVID-19: Bamlanivimab. The medicine designed to prevent high-risk patients from developing severe complications, commonly referred to as monoclonal antibodies, contains synthetic antibodies that mimic the body’s natural ones and is administered through an IV infusion.

The hospital was excited to be able to offer cutting edge treatment as it experienced a high number of COVID-19 hospitalizations later in the year, which prompted the hospital to postpone overnight stay procedures in November.

With a vaccine in its very first stage making its way now to those who have worked on the frontlines of healthcare, Public Health continues to work to rollout a new beacon as quickly and effectively as possible.

The first shipment was allocated to the Fort Dodge hospital, where it was given to health care workers who have been fighting on the frontlines since March. Distribution is controlled through the Infectious Disease Advisory Council (IDAC) on Immunization Practices, which has prioritized health care personnel and long-term care residents in the current Phase 1A.

WCPH has been preparing efforts for mass vaccination clinics since mid-2020. The agency said it hopes to be able to offer the vaccine by mid-2021.