The first Iowan dies from COVID-19; officials admit they don’t know how many ICU beds the state has

IDPH Deputy Director Sarah Reisetter speaks at Gov. Kim Reynolds’ press conference, March 24, 2020. — video still

At the beginning of her Tuesday afternoon press conference on the state’s response to COVID-19, Gov. Kim Reynolds talked about what a good job her administration has done keeping her constituents up to date on the latest developments with the disease.

“I made a commitment to do my part to keep Iowans informed,” she said before thanking various agencies, including the staff of the State Emergency Operations Center and the Iowa Department of Public Health (IDPH).

But one of the first questions from reporters revealed the limits of the information the Reynolds administration is providing the public.

After explaining that IDPH had said the number of available ICU beds in the state was “confidential as part of emergency protocols,” a reporter asked Reynolds, “Why is that information being kept from the public?”

Reynolds turned the question over the IDPH Deputy Director Sarah Reisetter. Based on Reisetter’s answer, it appears the number of ICU beds is not so much confidential as it unknown.

We are actively in the process of understanding what the bed availability is in the state. Part of that calculation is not only how many beds are available, but do we have staffing to support all of the beds. So, we’re continually working with our hospital systems, with our health care system within our health care coalitions to understand what the capacity is and what the surge capacity might be, and what the patient transfer protocols might look like in the event that we do have a particular hospital that doesn’t have the capacity to admit any additional patients.

So, we’re still very much working on that.

Earlier in the press conference, Reisetter explained the metrics IDPH uses to determine what actions should be taken by the governor, in what Reynolds called her administration’s “layered approach intended to slow the spread of the virus in our state.” But at least one of the key metrics is as vague as the number of ICU beds available.

Metrics that we look at when we make recommendations about mitigation measures include the percent of our population that is 65 or older. This tells us if a particular community might be vulnerable; the percent of identified cases requiring hospitalization, this tells us how severe our identified cases are; the rate of infection per 100,000 Iowans in the past 14 days, this tells us how many cases exist in a community within the most recent incubation period of the virus; the number of outbreaks in settings like long-term-care facilities, where our older populations and Iowans with underlying health conditions lives, this tells us about clusters of illness among in a vulnerable population in a shared community setting.

We look at these four factors, in addition to information about the experiences of other states, in making recommendations to Gov. Reynolds and to our local community partners about what mitigation strategies are appropriate now to control the spread of the virus in our communities.

However, given how little testing has been done for COVID-19 in Iowa, it’s unlikely public health officials can accurately determine the rate of infection per 100,000 residents.

Still, Reynolds expressed confidence that the recommendations she is receiving are based on the best data available, and that as that data changes, the recommendations will continue to reflect the best advice available.

Reisetter said the current rate and geographical distribution of the spread of COVID-19 in the state is what IDPH expected would follow the confirmation of community spread of the disease on March 14.

“We do anticipate we’re going to see out case numbers go up this week,” Reisetter said. “We think it’ll take some time for the impact of the social distancing measures that everyone is practicing right now to be able to be reflected in our case count.”

But both Reisetter and Reynolds said there’s no need for further mandatory restrictions to be placed on Iowans in the attempt to limit the spread, and Reynolds said she believes the voluntary compliance with requests to stay at home and limit non-essential activity should be enough.

The governor said she is aware Linn County and Cedar Rapids officials want her to issue a shelter-in-place order as governors in other states have. Reynolds said she takes their concerns “very seriously,” but contends current data doesn’t support issuing such an order.

“I don’t want Iowans to think that I’m making these decisions lightly,” Reynolds said. “But I have to be consistent in using the data that I’m using to make the decision that I’m making.”

On Tuesday morning, IDPH reported another 19 Iowans have tested positive for COVID-19, bringing the total number of confirmed cases in the state to 124.

• Black Hawk, 1 middle-aged adult (41-60 years)

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

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

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

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

• Johnson County, 1 middle-aged adult, 1 older adult

• Muscatine County, 2 older adults (61-80)

• Polk County, 3 adults, 1 middle-aged adult (41-60 years), 1 older adult (61-80 years)

• Poweshiek County 1 older adult (61-80 years)

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

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

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

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

Four hours after the press conference concluded, the governor’s office sent out a press release reporting the first COVID-19 death in Iowa.

“The individual was an older adult, 61-80 years of age, and a resident of Dubuque County,” according to the governor’s office.

During the press conference, Gov. Reynolds unveiled a new state website that compiles the state’s published statistics regarding COVID-19, advice regarding the disease and information for those who have lost the jobs during the current emergency.

Unemployment was the final topic raised at the press conference on Tuesday.

Reynolds was asked what help is available for those who were self-employed but now find themselves out of work. Self-employed individuals are not currently eligible for unemployment benefits in Iowa.

The governor said she believed benefits for the self-employed will be included in the relief bill currently under consideration in Congress.

“We’ll watch and see what happens with that, and then we’ll see what we need to do from a state perspective,” Reynolds said.

It was pointed out to the governor that people attempting to contact Iowa Workforce Development by phone regarding employment benefits are having problems getting their calls answered. The governor said she would look into the issue.

It’s not surprising the IWD phone system would be having difficulties. At the governor’s press conference on Friday, the agency’s director, Beth Townsend, said, “We are seeing an unprecedented number of claims.”

At the time, Townsend declined to estimate the number of unemployment claims IWD had received.

“We’re going to coordinate with the governor’s office and release those numbers next week,” she said.

That information has not yet been made public.

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