Lives and livelihoods are at stake. Unless the Dubuque County Board of Supervisors can offer a persuasive public health argument to support its decision, the elected officials pledged to care for the health, safety and welfare of the citizens of the county should reconsider and approve the face-covering resolution adopted by their Board of Health.
The resolution speaks for itself. The volunteer board with a wide
variety of backgrounds in health took great care to root their decision in science and experience. Their rule advances the simplest and lowest risk prevention and mitigation tool available to address this national, state and local public health disaster emergency.
The importance of stemming the transmission of the COVID-19 virus that has sickened tens of thousands of Iowans, killing more than 1,200 since March, cannot be overstated. On an almost daily basis, dozens of Dubuque County residents are reported to be infected. And because the Iowa Department of Public Health does not share accurate, specific testing or contact tracing data, we are left to guess where and how the virus is spreading.
The county Board of Health exercised its unique statutory responsibility: The board “shall” make and enforce reasonable rules and regulations necessary for the protection and improvement of the public health (Iowa Code Chapter 137). As county Public Health Director Patrice Lambert suggested: Prevention does not mean waiting for people to get sick before taking action to keep them healthy.
It is curious that the supervisors had a “work session” with other politicians but not health care professionals, or even their own Board of Health. The advice of the County’s medical liaison was not acknowledged, much less heeded. The Board of Supervisors is obstructing the Board of Health without providing evidence that a face-covering requirement is unreasonable or unnecessary.
Some have suggested that “home rule” means the county should defer to individual mayors. “Home rule” provisions were amendments to the Iowa Constitution passed by voters in 1968 and 1978, giving cities and counties the right to determine their own local affairs in manners not inconsistent with state law.
Recognizing delay at the county level, the city of Dubuque exercised home rule with its face-covering ordinance in August. The Board of Health regulation would apply to the city of Dubuque and would remain in effect if the City Council were to repeal its ordinance. The Board of Health covers the whole county, including municipalities. Cities can do more, not less. Home rule is a power to act, not a reason for failing to act.
Iowa eliminated city boards of health in 2010. County supervisors cannot “delegate” the authority of the Board of Health to cities. Home rule regulates the relationship between state government and local governments. A separation of powers based on “home rule” does not apply to the relationship between counties and cities.
As state lawmakers, our hands are not clean. From 2016 to 2020, public health funding in Iowa declined more than 7%. The general fund tax dollars we spend on “community capacity” declined 36%. We allocate only $1.8 million for infectious diseases. We certainly have work to do when the Legislature convenes in January.
To keep current, I have “sat in” on almost every Board of Supervisors and Board of Health meeting since the pandemic began. One thing is clear: We can’t have “business as usual” now if we want to get back to “life as we knew it” in the future.
After several months of being whipped around as if caught in a hurricane for which they were not prepared and from which they could not escape, members of the Board of Health were “getting their sea legs.”
By unanimously voting to require face coverings as a modest, common-sense coronavirus prevention and mitigation practice, the Board of Health is standing on solid ground. The supervisors have no good reason to pull the rug from under them.