Nodaway County Health Department (

The Nodaway County Health Department is shown earlier this year. The health board denied the city of Maryville's request for the institution of a countywide mask mandate.

MARYVILLE, Mo. — The Nodaway County Health Department board on Wednesday decided against taking any action on a request from the city of Maryville to enact a countywide face covering ordinance.

After the meeting, Maryville City Manager Greg McDanel told The Forum that after meetings with county health officials, including from Mosaic Medical Center – Maryville and the health department, the city decided to ask for the countywide mask mandate.

“Extending the mask requirement beyond the city limits we believe is critical for the continued reduction of the spread of COVID-19,” McDanel told The Forum over the phone.

The board did not take a vote on the matter, but most members of the board and health department Administrator Tom Patterson said that the health department lacked the enforcement infrastructure to effectively manage such a mandate.

“As far as a countywide mask mandate … for most of us rural areas … it’s difficult to manage something like that, that’s why you don’t see countywide mandates,” Patterson said. “Although we may believe that that would be the thing to do, in reality, it’s hard to manage.”

In an email requesting that the health department adopt the countywide mandate, McDanel said that the city would “be happy to” assist by arranging coordination and cooperation with local law enforcement agencies, and by offering up the use of 6-12 employees to assist with contact tracing or other services as needed by the health department. He also acknowledged that enforcement would be an issue, but pointed out that just the adoption of an ordinance seems to have helped increase mask-wearing in Maryville without the ordinance ever having been enforced.

“I understand enforcement is always the key, but … I would say the majority of people try to do the right thing and follow the existing laws in place,” McDanel told The Forum. “And without one in place, there’s certainly more of a lax environment for the spread of COVID-19.”

Health department board members did express concern over the lack of masks in many places, but several voiced a preference for more stringently enforcing the existing citywide mandate before taking any additional steps.

“How hard is it (to wear a mask)?” said Jackie Ross, one of the board members who said the city’s enforcement needs to be stepped up. “It’s not a hard thing to do. (Not wearing a mask is) not caring about other people, that’s all it is.”

In the email to the health department, McDanel said the city does plan to take some steps to help increase compliance with the existing mandate.

“The City Council is revisiting this and will at a minimum increase visibility of officers at key locations to assist with compliance and steadily get tougher on enforcement as numbers/compliance dictates,” McDanel said in the email.

It’s likely the City Council will discuss what that increased focus on the ordinance may look like at Monday’s City Council meeting.

Patterson said that the ordinance in Maryville will have the greatest effect because the city is Nodaway County’s largest population center. But most exposures to COVID-19 so far, he said, have come from private settings or “team settings,” not in places where a mask mandate is likely to be enforced — though he said cases that likely came from incidental contact in public settings are on the rise in the county.

“We get people to buy in where we’re at already and get that shored up before we do more,” Patterson said.

Still, the board and Patterson stressed their support for wearing masks, which they reiterated is the easiest and best mitigation measure to stop the spread of COVID-19, just not something that they felt the health department was ready to mandate countywide.

“We support the mask wearer, we advocate for the mask wearer, but we have to be realistic in what we can do,” Patterson said.

Patterson added that he will speak with the county commissioners about their opinion on whether they would support a countywide mandate, something they have not expressed support for in the past. The county does not require masks in county government buildings, even those within Maryville city limits.

“It wasn’t as bad then,” Ross said about the commission’s prior lack of support for a countywide mandate. “This (now), is terrible.”

Vaccine preparedness

Earlier in Wednesday’s health department board meeting, Patterson said his agency is readying plans to store and distribute vaccines.

He said he expects “some COVID-19 availability” by the middle or end of December, but thinks the initial doses are likely to go to urban areas. If the vaccine follows past patterns, Patterson said there are likely to be priority groups who have will have access to the vaccine first, like health care workers, first responders and possibly the elderly and high-risk.

Patterson said he is looking at freezer options for storing the vaccines. Two of the leading candidates to soon be approved by the FDA, made by Pfizer and Moderna, need to be stored at cold temperatures. Moderna’s vaccine needs to be stored at a more regular freezer temperature — about -20 degrees Celsius — while Pfizer’s needs to be stored at -70 degrees Celsius, which is an exceptionally cold temperature that would require additional materials like dry ice.

He said that based on current estimates, the state would need to reach about a 50-60 percent vaccination rate to effectively mitigate the spread of COVID-19. For comparison, he said Missouri’s flu vaccination rate is about 40 percent.

To help contact trace at the local health department, Patterson said they have added eight contract workers to assist since the pandemic began, and have paid out about $20,000 more in payroll so far this year than last year to help pay for overtime and new workers.

“All the health departments … are really in a bind, are really struggling,” Patterson said. “No one’s built for this kind of thing, no one saw this thing coming.”

Other health department notes

  • Walk-in flu shots have been slow compared to prior years, but outreach clinic attendance has been high. Patterson said he expects a long, steady season of flu vaccinations.
  • Board member Ross announced her intention to resign from the board effective after the December meeting, and recommended Bridget Kenny, a nurse at Mosaic Medical Center – Maryville, to replace her. Kenny’s name will be submitted to the county commission for approval to serve on the board until April’s election. Two board positions will be up for election in April.

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