UI epidemiologist: Iowa is reopening too soon and risking COVID-19 spread

By: - May 1, 2020 2:12 pm
Nurses' station in a busy hospital.

Iowa has reached a new high this year for hospitalizations of people with COVID-19. (Photo by FS Productions/Getty Images)

Iowans in 77 counties now have freedom from significant COVID-19 restrictions, allowing them to dine out at their favorite restaurants or pick up new jeans.

But a University of Iowa epidemiologist said the reopenings are happening too soon. Eli Perencevich, professor of internal medicine and epidemiology at the UI Carver College of Medicine, said that could accelerate the spread of COVID-19 and a second wave of infections in the state.

“We’re so close,” Perencevich said. “We’ve done just an amazing job of sheltering in most areas of the state. A couple more weeks (and) we might have been in a safer place.”

Eli Perencevich is a professor of internal medicine and epidemiology at the University of Iowa Carver College of Medicine. (Photo submitted by University of Iowa)

Perencevich lists three main factors in deciding whether to reopen the state: The rate of COVID-19 cases, testing numbers and mass contact tracing.

The state is currently working on increasing its tests and contact tracing, but Perencevich said it’s clear Iowa has not yet reached its peak number of positive COVID-19 cases, which makes reopening more dangerous than if case rates were decreasing, he said.

Reaching the peak is significant because it’s when the state experiences its highest rate of positive COVID-19 cases. After the peak, case numbers gradually go down, lessening the spread of the virus.

To determine if Iowa is on the other side of the peak, the number of positive COVID-19 cases need to be going down, despite testing numbers going up. 

On Friday, the state reported nearly 740 positive COVID-19 cases and Reynolds said high numbers are also expected over the weekend, due to results from TestIowa.

Sarah Reisetter, deputy director of the Iowa Department of Public Health said she expected Iowa to hit its peak of COVID-19 cases by early to mid-May during a press conference on April 22. Prior to that, she said the department expected Iowa to reach its peak mid-to-late April.

On Friday, Reisetter changed the state’s peak expectations again. She said the Iowa Department of Public Health had been anticipating the peak to happen toward the end of April or early May, but she would not speculate any more if or when it will happen because of increased testing efforts in the state.

More testing and tracing will be needed to properly assess the rate of infection in the state, Perencevich said.

“We’re not going down at all,” Perencevich said. “You want to see a situation that you’re testing a bunch of people and the percent is going down each day.”

Perencevich is not alone in his fears. COVID-19 projection models from the University of Iowa urged state officials to continue its mitigation strategies for at least two more weeks, suggesting more infections might be prevented, according to data provided by the governor’s office on Tuesday. Perencevich did not base his projections on that model.

On Wednesday, Reynolds said she appreciates the work that went into the report but “it’s not sustainable for us to continue to lock the state down.”

She said that because of her efforts over the past six weeks and the way Iowans have responded, “we were able to flatten the curve and we were able to mitigate the impact on our health care resources” and the UI model represents only a “snapshot” in time.

Rural Iowa ‘just as much at risk’ despite few cases reported

Reynolds said she has confidence in opening up counties that have little to no virus activity and encouraged Iowans to continue social distancing and mitigation efforts in those areas.  She announced Monday that retail businesses and restaurants could open at 50% capacity in 77 of Iowa’s 99 counties starting Friday, as long as they follow social-distancing guidelines.  Farmers markets and church services are now allowed to open statewide, also under social-distancing requirements.

Reynolds said the mitigation strategies she put in place last month are not sustainable for the long term and have “unintended consequences for Iowa families.”

But Perencevich said he fears testing is lacking in rural Iowa, particularly as processing plants across the state report outbreaks in their facilities.

Even if rural communities have less density, people leaving their homes and going out expose them to the risk of catching and spreading COVID-19.

Churches, which have also opened statewide, may bring one of the biggest risks to older Iowans, Perencevich said.

Younger churchgoers who carry the virus may unknowingly spread it to older congregants, who may become sick and require hospitalization. Church activities, such as singing, may also spread droplets of the virus, Perencevich said.

“The rural areas are just as much at risk as the urban areas,” Perencevich said.

His biggest concern is that by reopening, more Iowans will get sick and overwhelm hospitals, which are currently at manageable levels, according to the state’s data. The state reported Friday there were over 3,900 inpatient hospital beds available statewide, more than 540 open beds in intensive care units and more than 650 ventilators available.

“I don’t want our ICUs to be overwhelmed,” Perencevich said. “I don’t want my colleagues to be overwhelmed and I don’t want my neighbors to become sick.”

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