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Iowa Officials Describe Point System For Guiding COVID-19 Mitigation Strategies

Iowa Department of Public Health
Iowa officials released this six-region map on Monday.

Editor's Note: This post has been updated to reflect the updated map released by state health officials on Monday, April 6.

Gov. Kim Reynolds and public health officials this week described their six-region point system to guide their decisions about COVID-19 mitigation strategies.

After Reynolds repeatedly declined to give specific information about the data she said she is using to support her decision to not issue a formal shelter-in-place order, the Iowa City Press-Citizen obtained a document showing the state’s point system. 

The document takes into account the percentage of the population over 65 years of age, the percentage of identified cases requiring hospitalization, the infection rate per 100,000 population in the past 14 days, and the number of outbreaks at long-term care facilities.

Each metric is assigned a value, and then those numbers are added up. A sum of 10 or greater on the 12-point scale would trigger a formal shelter-in-place order, according to the document.

State officials then released a map of Iowa divided into six regions. As of Thursday, each region had a rating between five and seven.

Reynolds has indicated she may consider certain measures such as shelter-in-place orders that would only apply to certain regions rather than the entire state.

“It allows us to have some flexibility to continue to not only address the supply chain, but to make sure that those essential workers that are on the line know that they are appreciated and feel comfortable continuing to come to work,” Reynolds said.

Dr. Rossana Rosa, an infectious disease specialist with UnityPoint Health, said the metrics themselves sound reasonable.

“I do think, though, that one has to acknowledge that some of the ways we go about collecting the data that goes into those metrics remains in flux, and also remains with limitations,” Rosa said.

She said a lot of the information depends on the amount of testing that’s happening, which has improved, but is still limited.

“So what would worry me is what goes into feeding those metrics,” Rosa said. “How do we ensure that those metrics remain accurate?”

Rosa said she is happy to hear Reynolds and state health officials say they are constantly analyzing the data and their metrics, and that they are open to hearing input from the medical community.

She added that staying home, truly only going out for essentials, and physically distancing from others is the only way Iowa can get through this.

Reynolds has resisted calls to issue a formal shelter-in-place order from the Iowa Board of Medicine, the Iowa Medical Society and some of Iowa’s top Democratic elected officials. She said the measures she has put in place, such as ordering schools and certain businesses to close and banning gatherings of more than ten people, are about the same as a formal shelter-in-place order.

Reynolds and state health officials provided additional information Friday about the development of the point system.

Reynolds said State Medical Director Dr. Caitlin Pedati developed the metrics, and said Pedati is “in daily consultation with her team of epidemiologists…and other experts in Iowa and across the country.”

Iowa Department of Public Health Deputy Director Sarah Reisetter said the six-region map mirrors one developed by IDPH in 2016 to strengthen regional disaster response.

“The regional medical coordination center map is data-driven and based on information that tells the story of where patients in different parts of our state go to receive care when they are experiencing a health emergency,” Reisetter said.

Natalie Krebs is IPR's Health Reporter
Katarina Sostaric is IPR's State Government Reporter