As the COVID-19 pandemic continues to wreak havoc on the United States, different states have taken various measures to prevent a surge of cases that would overwhelm their healthcare systems. Most states have issued shelter-in-place orders or have implemented partial restrictions on travel, business operations, and social activities. These measures are based on epidemiological data and projections that indicate when their healthcare systems will face a shortage of hospital beds, intensive care units, and ventilators without significant restrictions. However, Iowa is one of the states that has not issued a shelter-in-place order. Instead, the Governor of Iowa has implemented half-measures to protect healthcare workers and citizens and prevent healthcare system shortages.
While the Governor of Iowa has referred to “metrics” and “data” in press briefings, the public has not had access to this information until recently. The “Guidelines for Implementing Public Health Mitigation Measures” were obtained by the Iowa City Press-Citizen, shedding light on the scoring system used to determine whether a shelter-in-place order is justified under the IDPH guidelines. This scoring system consists of scores of 1 to 3 on each of four measures, and it is applied to each of six regions in the state. Only when the score reaches 10 is a shelter-in-place order justified under the IDPH guidelines.
The southeast region, which includes Johnson, Washington, and Scott counties, along with 12 others, scores only a 7. Getting three more points will require either an outbreak at two nursing homes plus another 100 cases, or an outbreak at three nursing homes. That’s the only way the score will get to the magic number of 10 because the region can’t get any more points out of the other two measures. This matrix seems to make it challenging to justify a shelter-in-place order, even when the incidence of COVID-19 is high in a region.
The article criticizes the arbitrary and rigid nature of this matrix. It is not clear who developed the matrix, what science is behind the measures and scores, whether any other state or country has used anything like it, or whether it was vetted by any qualified epidemiologists at Iowa universities or hospitals. The matrix cannot be found anywhere on the IDPH website, and the underlying data have not been released despite repeated requests by members of the media and others.
Transparency and accountability are critical in the decision-making process of state governments in response to the COVID-19 pandemic. It is crucial for the public to have access to the data and models used by state governments to make decisions that affect their health and safety. The article suggests that the Governor of Iowa should consider more aggressive measures to prevent a surge of COVID-19 cases and protect the healthcare system in the state. The article argues that the IDPH matrix is not flexible enough to respond to changing circumstances, such as new outbreaks or changes in the availability of hospital beds, intensive care units, and ventilators.
In conclusion, the public needs more information and transparency to hold their leaders accountable and ensure that their health and safety are protected during the COVID-19 pandemic. States need to implement measures that are based on sound science, transparent data, and expert advice from qualified epidemiologists. The COVID-19 pandemic is an unprecedented challenge, and it requires a coordinated and evidence-based response from all levels of government, the private sector, and civil society. The United States must learn from this experience and prepare for future pandemics by investing in public health infrastructure, research, and innovation.
