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At 10 a.m. on Friday, the Iowa Department of Public Health was reporting another 387 Iowans had tested positive for COVID-19 during the previous 24 hours, bringing the state’s total number of confirmed cases to 21,093. The department also reported another 11 people have died from the virus. The state’s COVID-19 death toll was at 589 on Friday morning.

According to IDPH, the number of people hospitalized in the state due to COVID-19 dropped to 299 on Friday. It’s the first time since late April that number has been below 300.

There was other news about the impact of COVID-19 on Iowa hospitals this week. The Iowa Hospital Association released a report saying hospitals in the state have seen a severe decline in income due to the pandemic.

The report found that during March and April, 90 percent of the state’s hospitals were operating at a loss.

“We’ve had a 52 percent decline in ambulatory surgeries, 37 percent decline in inpatient surgery surgeries, 21 percent decline in inpatient discharges, 29 percent required outpatient visits, which means that you have ongoing expenses and overhead of managing the facilities,” Kirk Norris, CEO of the Iowa Hospital Association, said at a press conference on Wednesday when the report was published.

Some of that decline is attributable to a ban on elective medical procedures Gov. Kim Reynolds imposed on March 27 in order to preserve the then-dwindling supply of personal protective equipment at medical facilities around the state. That ban was not lifted until April 27.

Although hospitals have received millions of dollars in financial support from the federal government during the pandemic through the CARES Act and the Paycheck Protection Program, Norris said those funds will not be enough to cover all the losses.

Much of the focus on Wednesday was on the impact of the temporary ban on elective procedures, but there have been other declines in people seeking medical treatment at hospitals that may also be related to COVID-19.

“Hospitals across the country … are reporting fewer visits for heart attacks, acute strokes, and other medical emergencies,” Yale Medicine reported in April. “Although the phenomenon is not clearly understood and studies are underway, some medical experts believe patients are either choosing not to seek — or delaying — emergency department (ED) care because of the fear of contracting COVID-19.”

A study published in April of patients in nine major hospitals across the county found a 38 percent decline in a major type of heart attack.

The report presented on Thursday just focused on the financial toll COVID-19 was having on Iowa hospitals.

Hospitals around the state have cut salaries and laid off workers as revenue declined.

“When your revenues have dropped off this steeply, your services dropped off as steeply as they have, you don’t have very many places to go,” Norris said. “And then pretty quickly, it’s people on the front lines who are at risk for losing employment.”

Norris was unable to provide any figures on how many people have been laid off from hospitals due to revenue losing during the pandemic. He said the Iowa Hospital Association does not collect that sort of information.