It is said that when the people of ancient Phrygia were without a ruler, an oracle exclaimed that the next person who rode into the city in an ox cart would be king. The next person who arrived in such a manner was the farmer Gordius. To demonstrate gratitude, his son Midas — yes, that Midas — tied the ox cart to a post with a knot that was impossible to untie. This Gordian knot remained for many years and it was foreseen that whoever could untie it, would go on to conquer Asia. Legend holds that Alexander the Great, perhaps by slicing it with his sword, was able to free the knot and achieve his dream of conquering Asia.
Iowa finds itself with its own Gordian knot: a dramatic increase in COVID-19 cases over the past month, with our state now leading the nation in new cases per capita. In contrast to the mythological knot, Iowa’s has been tied by many hands. The first is the chronic underfunding of our public health system, leading to delays and errors in our COVID-19 response. As just one example, IDPH’s backdating snafu hid many of August’s cases in April or May, which obscured the true extent of the pandemic from the public at a critical time.
The second is the return of thousands of students to schools, including public universities and private colleges across the state, before our community transmission rates were low enough to allow schools to safely reopen to in-person learning.
Finally, the third and most important, is the lack of an aggressive and coordinated response by our federal and state leaders. Gov. Reynolds’s failure to ramp up testing and contact tracing to the degree necessary, her continued hesitancy to institute a statewide mask mandate and her inability to push for the economic sacrifices necessary, such as closing bars and limiting indoor restaurant dining, have tied the hands of Iowa’s cities and counties as they tried in vain to control the spread of COVID-19. The absence of an intact social safety net to protect those bearing the brunt of the economic consequences of the pandemic is also a failure at the highest levels of state and federal government.
Unlike the Gordian knot, there is no Alexander the Great with an easy solution to Iowa’s current COVID-19 outbreak. Many large and small personal sacrifices will need to be made. Without trustworthy county-level data and without statewide leadership, each of us needs to act. We need to wear face masks when we leave our homes. We need to avoid bars, gyms and indoor restaurants. We need to avoid indoor gatherings larger than 10 people. We need to redouble our efforts to protect the most vulnerable among us, including those in long term care facilities, prisons, and those essential workers toiling to provide for our daily needs. And most importantly, we need to start voting for politicians who put the common good ahead of individualism. As we are learning painfully now, we need each other to end this pandemic.
Eli Perencevich, Michael Edmond and Daniel Diekema are infectious diseases physicians in Iowa City.