Reprinted with permission from the Summer 2020 issue of The Prairie Progressive, Iowa’s oldest progressive newsletter. The Prairie Progressive is funded entirely by reader subscription, available only in hard copy for $12/yr. Send check to PP, Box 1945, Iowa City 52244.
In 1981 I left Iowa City for a family medicine position in Massachusetts.
When I was a family medicine resident and for a short time working around Iowa City, Iowa had a robust public health system and state lab. When health issues occurred, they were closely tracked, and orders were quickly placed to control infection spread. Testing for such infections as strep and sexually transmitted infections were covered by the State Lab. Immunizations were mandatory to attend school.
Fast forward to 2020.
Massachusetts, led by Republican Governor Baker, now has the third highest number of documented cases of Covid-19 in the US. This is due to its population density and the initial unavailability of testing for the virus SARS-COV-19 that causes Covid-19. Due to its public health efforts of strong mitigation, cases of Covid-19 are now decreasing in Massachusetts, unlike in Iowa, where cases are continuing to increase. Now that SARS-COV-19 testing is more available, Massachusetts is instituting wide-spread testing, tracking, and isolation. This is important since many people with SARS-COV-19 have no symptoms.
Unfortunately, Iowa Republican Governor Reynolds has not instituted a robust public health effort to mitigate or to test, track, and isolate for SARS-COV-19. Cases are increasing, and the effort to control the outbreaks are inadequate.
Extended care facilities, prisons, and meat processing plants are hot spots for infection spread. Inadequate testing, tracking, and isolation are clearly present in these hot spots,
as is lack of appropriate social distancing and personal protective equipment. Large corporate meat packing plants were told by the Trump administration to stay open. They were also told that interventions to control the spread of SARSCOV-19 were recommendations, not enforceable public health mandates. The Iowa Governor seems to support this lack of enforcement. Local government and public health officials may not be able to intervene. Since many hospitals have closed across rural Iowa, the increase in Covid-19 cases risks overwhelming the capacity of local health care.
The federal response has been chaotic and irresponsible, with no national strategy to clamp down on this virus and resulting disease. Trump has made the pandemic states’ rights issue, allowing the government of Iowa to inadequately control hot spots.
Most workers in packing plants where there is no mandated enforcement are black, brown, or immigrants. Most eople in extended care facilities are at-risk older individuals. A disproportionate number of people in prison are black and brown.
It is understandable that the people in Iowa and across the country are under a great amount of financial and emotional stress due to loss of income and isolating as a result of the pandemic. But the toll of losing over 70,000 people across the country, in this short period of time, is heart-wrenching. In many of the Republican-controlled states, including Iowa, without adequate public health measures the re-opening of their economy’s deaths will continue to increase, mostly in high risk groups.
As Governor Cuomo of New York recently said (and could be said of Iowa): “HARD TRUTH. Project models have doubled the number of expected deaths because of reopening acceleration. HARD TRUTH. How much is a human life worth? HARD TRUTH. That is the real discussion that no one wants to admit.”
Where does Iowa’s Governor stand?
–Richard Rubin is semi-retired from the University of Massachusetts Amherst Health Service and is a fulltime fly fisherman