Modeling Pushes Iowa’s Curve Back

UPDATE: On April 21, the model moved Iowa’s peak forward one day to May 7, and estimates that peak to be 11 deaths per day.

Despite early projections, Iowa’s expected peak for coronavirus deaths per day has now moved back into May.

The University of Washington’s Institute for Health Metrics and Evaluation (IHME) has been widely used in the country, including by the White House, to project the impact of COVID-19 on every state. It predicts when a state will reach its peak daily deaths and hospital use.

The model is based on a state’s deaths and infection fatality ratios. It also takes into account state-issued social distancing measures like business closures, stay-at-home orders and travel restrictions.

On April 1, Iowa’s peak was projected for April 30. On April 17 — the most recent update — the model moved the peak back to May 8. At the peak, the model estimates 17 deaths a day.

“After June 29, 2020, relaxing social distancing may be possible with containment strategies that include testing, contact tracing, isolation, and limiting gathering size,” the page says.

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So far, April 14 has been the deadliest day with 8 deaths.

Gov. Kim Reynolds has implemented three of the six social distancing measures outlined by the IHME: restrictions on mass gatherings, school closures, and initial business closures.

In mid-March, she issued her first Public Health Disaster Emergency. In it, fitness centers, gaming facilities like casinos, theaters and senior citizen centers were closed. Mass gathers were ordered canceled or postponed and restaurants and bars were required to close or move to carry-out, drive-through or delivery only.

However, Iowa remains one of just a handful of states in the country that has not issued a statewide stay-at-home order. Though the Northeast Iowa region recently reached a 10 on the state’s metrics system, which then calls for a shelter-in-place directive at that time, Reynolds only issued a few additional social-distancing measures and did not call it a “shelter-in-place” move.

Since the earlier modeling, Iowa has developed some of the biggest outbreak hotspots in the country at meat packing plants. Those cases, and the number of plants and long-term care facilities, themselves have continued to increase. A few plants, like Tyson in Columbus Junction and National Beef in Tama, suspended operations, but are now reopening. Others, like a facility in Waterloo, have rejected calls from local leaders to halt business while the spread can be contained.

Ten long-term care facilities in the state have reported double-digit numbers of cases among both staff and residents. Last week, the majority of deaths in the state came from those cases at long-term care facilities.

The total number of cases have risen dramatically, too. On March 17, Iowa had 27 cases and by yesterday the state reported 3,159.

Three of the social distancing strategies that haven’t been taken, according to the model, involve the governor issuing a stay-at-home order, severely limiting travel and closing non-essential services. The last one is measured by whether there are enforceable penalties for non-compliance from the non-essential services.

The projection is an estimate, based on data and statistics, but still not definite. It’s most useful for hospitals and governments to plan for changes and brace for increases. Reynolds and state leaders were critical of the model’s projections for Iowa early on, but they only recently started the process for creating their own Iowa model.

by Nikoel Hytrek
Posted 4/21/20

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