Iowa’s COVID-19 ‘peak’ expected soon

Gov. Reynolds delivers her Sunday, March 29 COVID-19 address. — video still

“We’re thinking that we might see a peak [in the number of COVID-19 cases in Iowa] — a first peak — in the next two to three weeks,” Iowa Department of Public Health Deputy Director Sarah Reisetter said on Sunday. “That’s the best information that we have right now.”

Reisetter stressed that that projection is based on the data the department currently has, but said, “things are changing on a daily basis.”

It was the first time IDPH has publicly stated an estimate of when COVID-19 cases may peak, shared at Gov. Reynolds’ Sunday afternoon press conference on the state’s response to COVID-19.

The remarks also came on the same day the first death of a Linn County resident from the disease was reported. According to IDPH, the deceased was between 60 and 81 years old and died Saturday night. No other information regarding the case was released.

The death of the Linn County resident brings the total number of COVID-19 deaths in Iowa to four.

Another 38 Iowans have tested positive for the virus, IDPH reported on Sunday, including four Johnson County residents and six Linn.

• Cedar County, 1 older adult (61-80 years)

• Cerro Gordo County, 1 adult (18-40 years), 1 middle-aged adult (41-60 years)

• Dallas County, 1 adult (18-40 years), 1 older adult (61-80 years)

• Dubuque County, 1 child (0-17 years), 2 middle-aged adults (41-60 years), 1 older adult (61-80 years)

• Henry County, 1 older adult (61-80 years)

• Iowa County, 1 middle-aged adult (41-60 years)

• Jasper County, 1 older adult (61-80 years)

• Johnson County, 2 adults (18-40), 2 middle-aged adults (41-60 years)

• Linn County, 1 adult (18-40 years), 3 middle-aged adults (41-60 years), 2 older adults (61-80 years)

• Marshall County, 1 middle-aged adult (41-60 years)

• Polk County, 2 adults (18-40 years), 2 middle-aged adults (41-60 years) 5 older adults (61-80 years),1 elderly adult (81+)

• Tama County, 1 adult (18-40 years)

• Washington County, 1 middle-aged adult (41-60 years), 1 elderly adult (81+)

• Winneshiek County 1 middle-aged adult (41-60 years)

• Woodbury County, 1 adult (18-40 years)

The new cases bring the number of people diagnosed with COVID-19 in Iowa to 336. So far, 65 people in Johnson County and 42 in Linn County have tested positive for the virus.

Reisetter provided the estimate for the first peak as part of her answer to a question about whether residents in western Iowa counties, where no positive cases have been reported, should be concerned about the virus spreading there.

“It should be every Iowan’s assumption that the virus is currently circulating in their community,” she explained.

At the press conference, Gov. Reynolds also faced questions about her claim that her most recent emergency proclamation bans surgical abortions in Iowa.

The proclamation issued on Thursday doesn’t mention abortion, but instead suspends “nonessential or elective surgeries and procedures that utilize personal protective equipment.” But in response to questions from the Des Moines Register, the governor’s spokesperson offered a one-sentence reply: “Proclamation suspends all nonessential or elective surgeries and procedures until April 16th, that includes surgical abortion procedures.”

But according to a joint statement issued on March 18 by the American College of Obstetricians and Gynecologists, the American Board of Obstetrics & Gynecology and six other professional organization of health care providers for women, “Abortion is an essential component of comprehensive health care. It is also a time-sensitive service for which a delay of several weeks, or in some cases days, may increase the risks or potentially make it completely inaccessible.”

The eight groups said they “do not support COVID-19 responses that cancel or delay abortion procedures. Community-based and hospital-based clinicians should consider collaboration to ensure abortion access is not compromised during this time.”

Gov. Reynolds was asked if she acted based on her own “personal ideology” when she asserted the ban on nonessential and elective procedures covered surgical abortions (the text of the proclamation states doctors should consider “all appropriate factors” when deciding what is essential), or if she had consulted medical professionals.

The governor didn’t say who she had consulted, but insisted her decision had nothing to do with ideology.

The proclamation suspends all nonessential and essential [sic] surgery procedures, until April 16, and we believe that that does include surgical abortion procedures. The decisions I have made have been made in the vein of really helping us strategically use our PPE stockpile that we have. That has been an issue from the very beginning of this.

I believe that at every press conference I have stated that the two things we really are worried about is [sic] making sure that we have the personal protective equipment to take care of those Iowans who are on the frontline serving Iowans and those in need, as well as our first responders and then just the workforce to make sure that we have our health care providers and our first responders healthy, so they can take care of Iowans.

The governor said the process she’d used to decide surgical abortions are nonessential was the “same thing I applied to everything.”

“For instance, I didn’t close bars and restaurants to go after the hospitality sector,” she said.

Of course, Gov. Reynolds has not made opposition to the hospitality industry one of the central principles of her political career, while she has consistently discussed her goal of ending legal abortions in Iowa, and is currently pushing for an anti-abortion amendment to be added to the Iowa Constitution.

Asked what she would say to those who believe a surgical abortion should be considered an essential medical procedure, Reynolds replied, “With every one of the directives we’ve made or every one of the orders that we’ve put in place, there are questions.”

“So, I guess if they have questions, the Board of Medicine would be the enforcement or the oversight for this. As people have questions, that’s where they can go and maybe get the answers that they’re looking for.”

The governor also said that the ban would help the state cope with a potential shortage of ventilators for COVID-19 patients, because it might free up anesthesia machines.

“Anesthesia machines can be tweaked so that they can be — converted — so that they can be used for ventilators,” she explained. “And ordering that order, that will free up a significant amount of ventilators or anesthesia machines that will be able to convert to ventilators.”

In a March 23 letter to customers, GE Healthcare, the largest manufacturer of anesthesia machines in the country, cautioned, “while an anesthesia device has a ventilator within it, the overall device is not the same as an ICU ventilator.” The company said it “does not in any way promote or recommend the use of anesthesia devices as ICU ventilators in any normal circumstances,” but recognizing the current emergency said the devices can converted if proper precautions are taken.

In response the nationwide shortage of ventilators, which has been exacerbated by Trump administration policies, last week the FDA approved the secondary use of converted anesthesia machines as ventilators.

The topic of possible shortages of critical supplies came up again, when the governor was asked about how the state would handle a situation in which there was a sudden surge of cases in one part of Iowa.

Reynolds said there have been planning meetings regarding this possibility.

“Last week I sat down with the CEOs of the big hospitals, and then working with our local public health providers and our healthcare coalitions, we have asked them to take a look at what it looks like if we hit a potential surge in one area of the state,” she explained. “How do they address that from a regional perspective? What happens if we’re at maximum capacity at one of our hospitals? What’s the alternative plan?”

According to the governor, “They are to come back next Thursday with that plan.”

Reisetter added that IDPH is currently working on a “crisis standards of care plan” to provide guidance for the medical community on how to make decisions regarding patient care in circumstances where the health care system is overwhelmed and needed supplies run short.

The governor tried to end her prepared remarks at the press conference on a positive note, by “tak[ing] this opportunity to thank the many people and businesses who are making a difference, whether it’s through individual acts of kindness or offering solutions that will impact many.”

The governor cited the example of MidAmerican and Alliant Energy, who she said have donated “thousands of masks for health care providers.”

Reynolds also pointed to the Iowa Department of Corrections and Iowa Prison Industries, who are using prison labor to produce hand sanitizer and personal protective equipment for health care workers.

“Iowans are always willing to lend their hearts and their hands during these times of need, and I just want to say thanks for your generosity, you certainly make us proud,” the governor said.

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