Video still of Gov. Kim Reynolds at her Nov. 10, 2020 news conference.

On Tuesday, the Iowa Department of Public Health reported 4,441 people statewide tested positive for COVID-19 during the 24-hour period ending at 10 a.m. The department has reported more than 4,000 new cases on five of the last six days. The new cases on Tuesday included 219 residents of Johnson County and 424 residents of Linn County.

IDPH reported another 27 deaths from the virus between 10 a.m. on Monday and 10 a.m. on Tuesday, increasing the stateโ€™s COVID-19 death toll to 1,872.

According to the department, 102 of the stateโ€™s 434 nursing homes had ongoing COVID-19 outbreaks on Tuesday. That is the highest number of such outbreaks yet reported.

Hospitals also set new records, with IDPH reporting 1,135 patients with confirmed cases of the virus, 196 of whom were being treated in intensive care units; 166 of those patients had been admitted during the previous 24 hours. All three of those numbers represent new highs.

Last Thursday, the University of Iowa Hospitals and Clinics activated its surge plan to deal with the sharp increase of COVID-19 patients. On Monday, UnityPoint Health announced that all four of its Des Moines hospitals were at or near capacity.

โ€œThe overall increased patient volume is stressing our healthcare system and it is putting capacity at risk,โ€ Gov. Kim Reynolds said at a news conference on Tuesday.

Since the pandemic reached Iowa, the governor has focused on keeping the healthcare system from being overwhelmed rather than stopping the spread of the virus in communities. Reynolds has repeatedly said that people just need to behave responsibly and learn to live with the virus, until a vaccine becomes widely available.

But now, the governor said, the uncontrolled spread of COVID-19 in Iowa has reached unacceptable levels and is causing staffing at hospitals to become โ€œincreasingly challenging.โ€

โ€œItโ€™s critical that all Iowans do everything within their power to stop the spread of the virus now,โ€ Reynolds said.

The governor, who has resisted introducing any further mitigation measures for weeks, finally decided to use some of her emergency powers and imposed some new COVID-19 restrictions.

The added restrictions in the new emergency health proclamation Reynolds issued on Tuesday, however, are very limited.

โ€œEffective at midnight, any social, community, recreational, leisure or sporting gatherings with more than 25 people indoors or 100 people outdoors will be prohibited unless all people over the age of two wear masks,โ€ the governor said.

โ€œGroups of individuals who attend these events together are limited to eight people, unless the group is from the same household. And all groups must still maintain social distancing from other groups at the event.โ€

The governor is also requiring masks to be worn by both customers and workers โ€œat salons, barbershops, massage therapy establishments, tattoo establishments, tanning facilities, and other establishments providing personal services.โ€

Since March, Reynolds has consistently rejected face mask mandates, claiming they are impossible to enforce. During the news conference, a reporter asked Reynolds why she considers the mandate in her new proclamation to be any different.

The governor said, โ€œWeโ€™ve asked our police department [sic], our officials, to help us enforce that. But that includes educating, informing and as a last result, issuing a misdemeanor [sic].โ€

Asked why she doesnโ€™t extend the mandate to all public activities, Reynolds said she believed that targeting certain activities โ€œis the right action to take at this time.โ€

This answer seemed contrary to the governorโ€™s statement during her prepared remarks that virus spread in the state was now so extensive, โ€œwe can no longer pinpoint any one age group or type of activity that’s driving it.โ€

Youth sports and high school athletics were also the focus of one of the governorโ€™s new targeted mitigation effort. There will be a limit of two spectators per athlete at indoor sporting events.

The limitation on groups not from the same household to eight or fewer members will also be in effect in bars and restaurants as well. Groups must be separated by six feet, and individuals must be seated to eat or drink.

โ€œBowling alleys, pool halls, bingo halls, arcades, indoor playgrounds, and childrenโ€™s play centers are now required to ensure that groups and individuals remain six feet apart at the establishment,โ€ according to the summary of the new proclamation published by the governorโ€™s office. โ€œAnd groups at those establishments must also be limited to 8 people unless the entire group is from the same household.โ€

The proclamation also โ€œorders all employers to evaluate whether any more of their employees can feasibly work remotely.โ€

The provisions of the new proclamation will remain in effect through Nov. 30.

UIHC infectious disease expert Dr. Jorge Salinas told Iowa Public Radio the governorโ€™s new mitigation steps were โ€œprobably what was needed when we had very little transmission in the community.โ€

Stronger actions are necessary when the rate of virus spread has reached the stage it is at in Iowa, according to Salinas.

“Now we are reporting more than 4,000 cases a day every day, that will translate into a tremendous increase in hospitalizations in the next two weeks,โ€ he said.

Iowa Senate Minority Leader Janet Petersen offered a blunter assessment.

โ€œGov. Reynoldsโ€™ latest steps to fight COVID are like buying a smoke detector after your house is blazing out of control,โ€ the Des Moines Democrat said.

Reynolds said repeatedly during the news conference that she is still primarily relying on Iowans voluntarily taking the precautions needed to limit the spread of COVID-19. As she did last week, the governor suggested that โ€œpandemic fatigueโ€ had caused people to ignore basic COVID conduct, leading to the current surge in virus activity.

In her new proclamation, Reynolds called on โ€œall Iowans to consider how their choice to adhere to public health mitigation strategies impacts the spread of COVID-19 in their family and community.โ€ The governor also said, as she did last week, she believes that the ad campaign her administration is launching this week will help people overcome pandemic fatigue and behave more responsibly.

During her prepared remarks on Tuesday, Reynolds urged Iowans to consider how fortunate they are to have so few COVID-19 restrictions.

โ€œI know that getting life back to normal is what Iowans want, and weโ€™ve managed to get things back to normal already, even if they look and feel a little different yet,โ€ she said. โ€œYou can still eat in a restaurant, you can still go to a movie and work out a gym. And in many states, you canโ€™t do that.โ€

โ€œIowa is open for business and we intend to keep it that way.โ€