As the novel coronavirus continues to spread through Iowa, Gov. Kim Reynolds faces one question more than any other: Why have you not yet ordered Iowans to stay in their homes?
As of Friday, Iowa was just one of five states without a statewide or partial shelter-at-home order, according to tracking from the New York Times. (The other four are North Dakota, South Dakota, Nebraska and Arkansas.)
Reynolds, who conducts daily briefings on the state’s response to the novel coronavirus, has said repeatedly that her public health department uses a range of data to determine whether and when to make such an order, and that the virus’s spread has not triggered the need to require all Iowans’ stay in their homes except for essential needs like groceries and health care.
She also has said many of the orders she has put in place — closing schools and many businesses — are elements similar to what are in many states’ shelter-at-home orders.
And yet as Iowans grow concerned as the virus spreads more, and when they see groups of people huddled together in public, the question keeps coming back.
On Sunday, Iowa saw its deadliest single day yet because of the virus, with another eight deaths reported for a total of 22. And another 83 people tested positive, for a total of 868.
Those numbers likely will continue to increase in the coming weeks as state public health experts expect the peak to come later this month.
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Which means that, unless she issues one, Reynolds will continue to face questions about a shelter-at-home decree.
The ongoing debate has many points and counterpoints.
The back-and-forth over a shelter-at-home order contains echoes of Iowa’s water quality oversight and the debate over voluntary vs. involuntary compliance.
Reynolds’ current orders do require school buildings and many businesses closed. But while she strongly encourages Iowans to remain in their homes as much as possible, her orders do not require it. That is the essential difference between what Reynolds currently has in place vs. a shelter-at-home order.
Reynolds’ public health advisers created a formula that uses health and demographic data to determine when a shelter-at-home order would be necessary. Reynolds says using that data and formula helps ensure her administration makes decisions based on evidence and not emotion.
But that data includes elements like outbreaks in long-term care facilities, hospitalization rates and the number of virus infections per capita. In other words, the model relies on things that have already happened.
Critics of the formula contended the state should instead be proactive in its approach — recognize that the virus will spread and issue a shelter-at-home order before those things happen, instead of waiting until after they do.
Reynolds says another reason she has not yet issued a shelter-at-home order is its potential to upset supply chains and workforce for the state’s health care facilities. The leaders of two Iowa hospitals agreed, saying they supported her decision to hold off because such an order would hamper their ability to provide care and further disrupt the economy.
But people calling for a shelter-at-home order say if the virus continues to spread exponentially throughout the state, the number of Iowans who become infected, sick or even die could similarly threaten hospitals’ ability to provide care and also the economy.
The outside pressure on Reynolds to issue a shelter-at-home order continues to mount.
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The state medicine board voted Friday to urge her to issue a shelter-at-home order. That board’s members are appointed by Iowa governors and oversee the licensure and regulation of the practice of medicine in the state.
National public health experts are weighing in, too. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and the most prominent figure in the Trump administration’s coronavirus response efforts, last week called for a national shelter-at-home order.
And top elected Democrats in Iowa — U.S. Reps. Abby Finkenauer and Cindy Axne, and Democratic Statehouse leaders Janet Petersen and Todd Prichard — all have formally asked the Republican governor to issue the order.
So the shelter-at-home debate in Iowa will continue either until Reynolds issues one, or the virus begins to dissipate.
Erin Murphy covers Iowa politics and government. His email address is firstname.lastname@example.org. Follow him on Twitter at @ErinDMurphy.
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