Experts fear Iowa healthcare system’s ‘collapse’ as one-day cases surpass 5,000 for the first time

Jordan Sellergren/Little Village

Iowa had its worst day for new COVID-19 cases on Friday, with the Iowa Department of Public Health reporting 5,065 more confirmed cases of the virus during the 24-hour period ending at 10 a.m. The new cases included 141 residents of Johnson County and 356 residents of Linn County.

The previous one-day record for new cases was set on Wednesday, when IDPH reported 4,764 new cases.

The number of deaths from COVID-19 also remained high. At 10 a.m. on Friday, IDPH reported the state’s death total had increased to 1,947, as 19 more Iowans succumbed to the virus.

The surge in hospitalizations continued to reach new levels, as 1,227 COVID-19 patients were reported in Iowa hospitals on Friday morning. Two hundred and thirteen of those patients were admitted in the previous 24 hours. The 240 patients being treated in intensive care units eclipsed the previous record of 215 ICU patients set on Thursday.

The burden the uncontrolled spread of COVID-19 is placing on Iowa’s healthcare system was prominently featured stories published on Friday by two national media organizations, The Atlantic and ProPublica.

“The entire state of Iowa is now out of staffed beds, Eli Perencevich, an infectious-disease doctor at the University of Iowa, told me,” Ed Yong, a preeminent science journalist, wrote in The Atlantic. “Worse is coming.”

Iowa is accumulating more than 3,600 confirmed cases every day; relative to its population, that’s more than twice the rate Arizona experienced during its summer peak, “when their system was near collapse,” Perencevich said. With only lax policies in place, those cases will continue to rise. Hospitalizations lag behind cases by about two weeks; by Thanksgiving, today’s soaring cases will be overwhelming hospitals that already cannot cope. “The wave hasn’t even crashed down on us yet,” Perencevich said. “It keeps rising and rising, and we’re all running on fear. The health-care system in Iowa is going to collapse, no question.”

The story in ProPublica by Caroline Chen echoed Yong’s.

Dr. Gregory Schmidt, associate chief medical officer at the University of Iowa Hospitals and Clinics, said his colleagues are converting 16 hospital beds into new ICU beds in anticipation of an influx of COVID-19 patients. “People in leadership are starting to say things in meetings like, ‘I have a sense of impending doom.’”

Schmidt told Chen about the psychological toll dealing with the latest surge in COVID-19 cases is having.

“You watch patients who are young and who should have had good lives die without their families by them, and their families being distraught, and then you go out through your community and you see people partying and going to bars.”

Schmidt said he and others are exhausted, and hospitals are on the edge of being overwhelmed.

The same message was delivered by Dr. Jorge Salinas, an infectious disease specialist at UIHC, and Dr. Stephen Scheckel, chief medical officer of Mercy Iowa City, to a group of Johnson County elected leaders on Thursday evening.

The local governments in Johnson County hold Joint Entities meetings four times a year, but Thursday’s meeting was an emergency session focused on the state of COVID-19 in the county.

Scheckel offered a slightly — but only slightly — more optimistic assessment of hospital capacity than Perencevich did in his interview with Yong. Scheckel said that in the latest survey of hospitals he was aware of, there were still two hospitals in eastern Iowa that had staffed ICU beds available. But, he added, “It won’t take long for those to fill up.”

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In general all the hospitals in the region “are pretty much at their maximum capacity,” Scheckel said.

The upcoming holiday season and the looming winter weather pose an increased risk for virus activity, because COVID-19 spreads easily in the small indoor gatherings. That sort of community spread is what is driving much of the current surge in Iowa.

Iowa City Councilmember Janice Weiner said during the meeting that leaders should be encouraging community members “to take the long perspective.”

“With a vaccine on the horizon, we will not be in this situation a year from now. So please Zoom your Thanksgivings. Just stay with your small family group, do whatever you can to keep yourself safe at this point.”

The ability of local officials to take mitigation steps to slow the spread of the virus is extremely limited. The power to take the actions that would have the biggest impact — such as closing bars or limiting their serving hours and their customer capacity — rests entirely with the governor.

Gov. Reynolds has taken a minimalist approach to mitigating the spread of COVID-19, insisting that almost no government-imposed restrictions are necessary, because Iowans need to make their own individual decisions about the best way to live with the virus until a vaccine becomes widely available. The governor has even preempted the abilities of cities and counties to take more aggressive virus mitigation actions than the ones she has approved at the state level.

In the absence of more support from Reynolds, the local leaders who attended the Joint Entities meeting have focused on such things as limiting access to public facilities to reduce opportunities for large-scale virus transmission, and restructuring how their cities and the county provide services in an attempt to keep workers safe.

Both Iowa City and Johnson County have face mask mandates, although the governor insists such mandates are improper and unenforceable under state law.

At the meeting on Thursday, the local leaders agreed it is important to speak with a unified voice on COVID-19 and provide a consistent message to members of their communities: wear a mask, practice social distancing, limit your gatherings to members of your immediate household, avoid places where large numbers of people congregate and stay home whenever possible.

Near the end of the meeting, Mayor Terry Donohue of North Liberty said he had been working on how to convey the importance of taking basic precautions against the virus and thought he’d found a simple way to do it.

“Wear your mask,” he said. “Personal sacrifice now, especially going into the holidays, will save lives later.”