Hospitalizations continue to spike as Iowa has seen new record highs on most days in the past week.
As of Wednesday evening, the state's coronavirus website was reporting 605 people were hospitalized, with 113 admitted in the previous 24 hours. The hospitalized number represents a new high for Iowa during the pandemic. The newly-admitted number equals the record high set on Tuesday.
In the past month, the state has broken its record for daily hospitalizations 11 times. Five of those new records were set in the past week with hospitalizations jumping from 564 on Monday night to nearly 600 a day later.
Eli Perencevich, a professor of internal medicine and epidemiology at the University of Iowa, said health care workers are burning out.
"The biggest concern is we're going to see more and more deaths, as hospitals get overwhelmed," Perencevich said. "There's evidence that there is a tipping point where hospital staff get overwhelmed. Even if you have beds, you don't have enough staff, staff start getting sick too, as we just let the virus spread in the community, because staff live in the community."
Perencevich said hospitals are also facing significant financial strains from the pandemic.
COVID-19 patients are expensive to care for and hospitals have lost a lot of money from not being able to do elective procedures, he said. This has put an extra strain on hospitals and health care workers.
"Even when you're working this hard, a lot of staff nurses and doctors have been furloughed or forced to take pay cuts, because hospitals are losing so much money in the pandemic. So it's just like a, you know, double, triple whammy of personal safety, personal well being and then everyone, all the staff, that your colleagues are at risk," he said.
Before the pandemic, Iowa hospitals, especially in rural areas, were already facing shortages of health care workers.
As temperatures have cooled off, hospitalizations spiked across the U.S. with rates climbing 46 percent in the past month, according to the New York Times. In recent weeks, Midwestern states, including Iowa, have seen some of the biggest spikes in new cases.
Rossana Rosa, an infectious disease specialist in Des Moines, said the state's spike in hospitalizations was expected. Increases in hospitalizations follow increases in rates of new COVID-19 infections, she said.
"For most of October, we've seen more than 1,000 new cases per day on average, and so it takes some time from the moment when you start seeing a rise in new cases to the time that people get admitted to the hospital," she said. "So this is expected. Sadly, it's expected."
Rosa said the state is in a vulnerable position as it heads into winter, a season where other respiratory virus infections will increase, putting even more strain on health care workers.
"It's not only influenza, but other respiratory viruses that that can also make vulnerable patients sick," she said. "So it's just piling up and piling up things that we have to deal with."
As cases and hospitalizations have increased this month, Gov. Kim Reynolds has declined to issue additional restrictions, saying her team is in communication with the state's hospitals, which have reported being able to handle the increase in cases.
"After seven months of treating COVID-19 are doctors, nurses and other health care professionals are experienced in treating the virus and they now have access to new therapeutics and different treatment options to help patients recover sooner," she said at her last press conference on Oct. 7.
Reynolds' office did not respond to a request for comment on Wednesday.
In an email last week, Iowa Department of Public Health Spokesperson Amy McCoy said the state has "stronger communication and outreach to health care organizations and providers in affected areas" and will "ensure resource capacity and offer assistance."
McCoy's email was in response to the White House Coronavirus Task Force report dated Oct. 18, which found Iowa had more than double the nation rate of new infections the previous week.
This week's report, which is dated Sunday, said 97 percent of Iowa's counties have moderate to high levels of community spread and said the increase in community spread is increasing hospital admissions.
The report pointed to social gatherings as a source of increased community spread, saying cooler weather has driven more social gatherings indoors, significantly increasing transmission.
"We need to get our act together," Perencevich said. "As far as large groups, we can't have any large group gatherings anywhere, because that's where it's spreading.”
But Perencevich said while individuals need to do things like wear masks, avoid group gatherings and practice social distancing, state officials need to step up and issue restrictions like mask mandates and bar closures to slow the spread of the virus.
"This isn't up to individuals. It's not like a heart disease where you just have to individually eat healthy. This is a public health crisis," he said. "So we need, you know, county and state level ordinances and plans. And without leadership, we're not getting anywhere. This is all on the governor and IDPH and other state leaders.”
Note: This story was updated on Oct. 28 at 6:10 p.m. to reflect the most recent COVID-19 hospitalization figures for Iowa.