Fact Checker

Fact Checker: How does Iowa's COVID-19 testing stack up?

Iowa Gov. Kim Reynolds waits during a Sept. 29 news conference on the state's response to the coronavirus in Johnston. (
Iowa Gov. Kim Reynolds waits during a Sept. 29 news conference on the state’s response to the coronavirus in Johnston. (AP Photo/Charlie Neibergall)

Iowa’s response to the spread of COVID-19 is once again in the spotlight as infections surge across the United States.

Gov. Kim Reynolds in a Nov. 10 news conference said of the state’s testing availability: “So Iowans, I think we’ve tested 1 in 3 — our numbers when we look at every type of test that we’re utilizing, we are way at the top compared to other states.”


Reynolds’s first statement in this two-part claim is correct, according to the state’s COVID-19 dashboard.

Graded a B

The number of Iowans tested as of last week when she made the claim was nearly 1.07 million. That number was about 1.15 million as of Friday.

Iowa’s population is estimated at 3.15 million, according to U.S. Census data, so this does mean 1 of 3 Iowans have been tested for COVID-19.

It should be noted this figure covers people tested over more than eight months since the disease was confirmed in Iowa, not just recently.

The governor’s next claim about how Iowa compares with other states on administering COVID-19 tests is not as simple to prove.


Pat Garrett, Reynolds’ communications director, said she was including PCRs and other antigen and rapid tests conducted in Iowa in both her claims.

According to the Food and Drug Administration, these tests are used to diagnose COVID-19 cases — the former being a molecular test that detects the virus’ genetic material, and the latter detecting specific proteins from the virus.

While the antigen tests, typically used in congregate settings like long-term care facilities, produce results faster, the agency says they are less accurate. Centers for Disease Control and Prevention guidance defines a confirmed case as one that was diagnosed with a molecular test, while cases diagnosed with antigen tests are presumptive positives.

There are limitations to the dashboards compiled by the public, journalists and public health experts showing how states stack up against one another on testing.

While some dashboards show how many total tests and tests per capita states have conducted, not all states include all available types of tests in their reported data. A Kaiser Health News analysis released in September showed that 22 states and Washington, D.C., either do not report antigen tests or count antigen positives as COVID-19 cases. States may also report antigen tests separately and not in their total of tests administered.

Publicly available data shows more of a grim picture of testing in Iowa. The Washington Post, using data from the COVID-19 Tracking Project, reports Iowa ranks among the bottom 10 of states in tests administered per capita.

The COVID-19 Tracking Project, a volunteer organization launched by The Atlantic, pulls data directly from state public health departments, so however those agencies report their data is what is used to calculate the totals. This initiative’s data is used by most major media outlets and academic sources, including the University of Washington’s Institute for Health Metrics and Evaluation and Johns Hopkins University’s Coronavirus Resource Center.

Based on this data, the Fact Checker has previously found that Iowa was below the “testing target” for each state from the Harvard Global Health Institute.


However, Paul Trombino, Reynolds’ chief operations officer, told KCRG-TV9 last month the number of tests conducted each week in Iowa is twice as high as what is logged on the website. Iowa reports only the number of individuals tested and does not make public its data on the total tests administered — the state’s way of filtering out multiple tests run on one person.

For instance, U.S. Health and Human Services data shows 1.88 million PCR tests were administered as of Nov. 17 in Iowa. The state publicly reported 1.02 million of these PCR tests, about 54 percent. Antigen tests would be in addition to those PCR tests.

The COVID-19 Tracking Project notes these discrepancies and, according to the initiative, Iowa and only eight other states report testing totals using unique people rather than test specimens or encounters, which are unique people tested on a given day. The total encounters over time may include people who have already been tested, unlike Iowa’s method of counting.

Atlantic journalist Alexis Madrigal, one of the initiative’s co-creators, told the Fact Checker that “states that report ‘people tested’ like Iowa show far lower per capita testing rates” than those that report in test specimens or encounters. This means Iowa’s method of reporting the unique individuals tested rather than test specimens or encounters can explain why Iowa ranks so low using publicly available data.

“It could be that Iowa is doing a great job testing, but we cannot know that through our methods,” Madrigal said.

The White House Coronavirus Task Force report issued Nov. 8, the week Reynolds made this claim, showed the 3,035 tests administered per 100,000 residents in Iowa significantly exceeded the national average of 2,243 tests administered per 100,000 residents. This does not include antigen tests.

Some researchers have criticized the federal government for not sharing much of the COVID-19 data it collects, making it unclear to them how the task force calculates this figure.

The report does not include a ranking of tests administered across the 50 states, but it does color code this metric for Iowa as dark green, meaning it is equal to or greater than 2,000 tests and is among the top in the nation.


While the White House does not make all reports public, the Center for Public Integrity attempts to compile them as they are sent to governors. Even in its most recent available report of all 50 states, from Sept. 20, Iowa is marked as dark green in this metric. Its tests administered per capita fell below only nine other states.


Reynolds’s claim that 1 of 3 Iowans have been tested for COVID-19 over time is correct, though it sheds little insight on the current state of testing in Iowa. And the White House, using privately maintained data, reports Iowa is among the top of the 50 states for its number of tests administered per 100,000 residents. But without a clear publicly available data set, there are major discrepancies that make it difficult to draw comparisons in how states handle the virus. Because it is plausible Iowa could be performing better than the publicly shared data suggests — but we cannot prove it — we give the governor a B.


The Fact Checker team checks statements made by an Iowa political candidate/officeholder or a national candidate/officeholder about Iowa, or in ads that appear in our market.

Claims must be independently verifiable.

We give statements grades from A to F based on accuracy and context.

If you spot a claim you think needs checking, email us at factchecker@thegazette.com.

This Fact Checker was researched and written by Marissa Payne of The Gazette.

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