Gov. Reynolds begins to lift COVID-19 restrictions in certain areas of Iowa

Governor Kim Reynolds has begun to relax emergency restrictions in Iowa even as cases of COVID-19 continue with near exponential growth across the state.

     As of Sunday, April 26, there have been 5,474 confirmed cases of COVID-19 in the state, nearly doubling the 2,902 cases from the week prior.

     A portion of the increased number of confirmed cases can be attributed to an increase in testing across the state, particularly with surveillance testing done at meat packing plants and long term care facilities. According to Reynolds, roughly 30% of Iowa's cases are related to manufacturing and another 15% are related to health care workers.

     "We will continue to see clusters of positive cases in these types of facilities because COVID-19 spreads quickly and easily among people in close proximity. Once the virus is introduced into this type of an environment it's very difficult to contain," said Reynolds on Monday, April 20. "But these also are essential businesses and an essential workforce and without them peoples lives and our food supply will be impacted."

     An additional 41 deaths last week were attributed to the virus, bringing the total death count to 118. Of the fatal cases, 51 have been elderly (age 80+), 48 have been older adults (60-80), 16 have been middle aged (40-60), and three have been young adults (20-40). A significant percentage of deaths in Iowa have been of residents in long term care facilities. So far, 16 long term care facilities have reported outbreaks, accounting for about 9% of the state's cases.

     Roughly one in 82 Iowans have been tested, with about 15% of those testing positive. In total, 274 elderly, 865 older adults, 2,120 middle aged adults, 2,144 young adults, and 72 children have tested positive for the disease.

     The increase in testing has had some impact on the state's regional assessments, bumping northeast Iowa's Region 6 down to 9 from a 10, though the enhanced restrictions made in those counties will remain in place.

     The severity of the spread of COVID-19 varies wildly depending on which area of the state you are in. Regions 1, 5, and 6, comprising of southeastern half of the state, all register at a 9 on the governor's 10-point assessment scale. Regions 2, 3, and 4, making up the bulk of the northwest half of the state, register 5-6.

     On Tuesday, April 21, Reynolds announced the launch of the Test Iowa Initiative, a state partnership with Nomi Health, a Utah-based medical billing start-up, and Domo Analytics, a marketing analytics company, to increase the state's capacity to conduct tests for COVID-19.

     "The more that we can get Iowans to go through the assessment process, it really will help us identify where the hotspots are, where we're starting to see a cluster, and where we are seeing nothing happening so we can start to talk about areas of the state that are ready to open up and how we phase that in."

     People that suspect they may have contracted the coronavirus can fill out an assessment questionnaire at TestIowa.com asking about their current health status, any pre-existing conditions they may have, and their risk of exposure to the virus. If a person meets the criteria, they will be scheduled a time and place to receive a COVID-19 test.

     "I want to encourage every Iowan to go to TestIowa.com and take the assessment," said Reynolds. "The more that we can get Iowans to go through the assessment process, it really will help us identify where the hotspots are, where we're starting to see a cluster, and where we are seeing nothing happening so we can start to talk about areas of the state that are ready to open up and how we phase that in."

     This partnership is expected to provide 540,000 tests, increasing the state's capacity to test by an additional 3,000 tests per day. Testing started in Des Moines on Saturday, with more testing locations expected to open up in the coming weeks.

     In the meantime, Governor Reynolds has started the process of relaxing restrictions and opening the state back up.

     On Friday, April 24, Reynolds announced that hospitals and other outpatient surgery providers may once again perform elective procedures. Hospitals were restricted from these procedures earlier in the month to help preserve the state's supply of Personal Protective Equipment (PPE) and make sure facilities were capable of handling a potential surge of COVID-19 patients.

     "Fortunately, Iowa has not experienced the health care surge that other states have had," said Reynolds. "The coordination and collaboration between providers, systems, and the state, gives us the confidence that we can effectively care for COVID-19 patients while also providing procedures to improve health and quality of life for others."

     Hospitals that wish to start scheduling elective procedures will have to abide by some conditions, such as being able to maintain a sufficient supply of PPE without relying on state stockpiles and must continue to accept and treat COVID-19 patients as needed, reserving 30% of their beds for COVID-19 patients.

     Reynolds also announced that outdoor farmers markets will be allowed to continue, though again with restrictions. Farmers markets can only permit vendors that sell food, entertainment activities are prohibited, seating areas are prohibited, and vendors must be spaced at least six feet away from each other.

     Other social distancing rules still apply, such as limiting the size of groups. Violation of these regulations is a simple misdemeanor by law, though Reynolds recommends that law enforcement expend all other warning options before issuing a ticket.

     "Ticketing would be a last resort," said Reynolds. "I believe in Iowans and their ability to be responsible. I don't anticipate any problems."

     On Monday, April 27, Reynolds announced further lifting of restrictions in certain areas of the state where the spread of the virus has shown signs of stabilization. While certain areas of the state are still hotspots for virus activity, other areas have seen considerably less. There are fifteen counties in the state that have yet to have a confirmed case of COVID-19.

     Starting on Friday, May 1 in 77 counties, restaurants, fitness centers, libraries, race tracks, and retailers may re-open their businesses to 50% of their normal operating capacity. Shopping centers may also re-open to 50% capacity, but play areas and common seating areas are still prohibited.

     For restaurants, groups of customers may not exceed six people and the restaurant must ensure at least six feet of distance between each party. Self-service, such as fountain drinks and salad bars, are prohibited.

     Bars will remain closed to the general public, however patrons can still arrange for carry-out or drive-through food and drink.

     Fitness centers that re-open must likewise maintain six feet of distance between equipment, limit group activities to ten or fewer people, and ensure that all participants maintain a distance of six feet at all times.

     Race tracks will be allowed to re-open provided that they do not permit in-person spectators.

     Other social gatherings such as community gatherings and sporting events are allowed so long as they are limited to ten or fewer people, with the exception of religious gatherings which are exempt from the ten person restriction but must otherwise adhere to social distancing guidelines.

     "The reality is that we can't stop this virus. It will remain in our communities until a vaccine is available," said Reynolds. "We must gradually shift from an aggressive mitigation strategy to focus on containing and managing virus activity for the long term in a way that safely and responsibly balances the health of our people and our economy.

     While restaurants, fitness centers, and retail stores will be allowed to re-open on May 1, the closure of other businesses in the state has been extended to May 15. As testing capacity in the state increases, the governor will consider making more targeted re-openings in areas where risk of the virus spreading is low. With increased testing, the governor hopes to be able to impose or lift restrictions on a county-by-county basis, or even on a community-by-community basis.

     "This is our first step of many of reopening Iowa and getting life and business back to normal as soon as possible," said Reynolds.