State Says Curve Is Starting To Flatten; Iowa Disease Experts Don't See Evidence Of That

Apr 9, 2020

A top state public health official said Thursday Iowa is starting to “flatten the curve,” but some infectious disease experts do not see the rate of COVID-19 infections slowing in the state.

The goal of social distancing is to flatten the curve, or avoid a spike in infections, so the health care system isn’t overwhelmed.

“When we’re looking at our epidemiological curve, it is starting to flatten, which means that Iowans are listening,” said Sarah Reisetter, deputy director of the Iowa Department of Public Health. “And that means also it’s time to continue to do those things so we don’t start moving in the wrong direction.”

State officials provided data this week showing the state has not overwhelmed its health care system at this point in time, and ventilators and intensive care beds are available.

Gov. Kim Reynolds has ordered schools and several kinds of businesses to close through April 30 and banned gatherings of more than 10 people. She is urging all Iowans to stay home as much as possible to prevent spreading the virus, and to convince their neighbors to do the same.

“If we do that, then these press conferences can be about how we can start to open things back up and get the state and this country back to normal,” Reynolds said Thursday.

Dr. Eli Perencevich, an internal medicine and epidemiology professor at the University of Iowa, said those measures have ensured Iowa is experiencing fewer cases than it could have, lessening the impact on the state’s health care system.

But he does not see evidence that the curve is flattening in a way that would allow for safely relaxing social distancing measures. He said that would require new daily cases to be near zero.

“We still don’t have evidence with the case counts that the curve is flattening,” Perencevich said. “And there is concern because the number of tests we’re sending has been increasing, but the percent of those that are positive has also been increasing…so there’s still a lot of COVID out there.”

Iowa saw its biggest single-day jump in COVID-19 cases Thursday, 125 additional cases for a total of 1,270 confirmed cases, and two more deaths for a total of 29.

And Perencevich points to an estimate that only about 10 percent of COVID-19 cases in the U.S. are being counted because testing is still limited. In Iowa, testing is still largely focused on health care workers, hospital patients and outbreaks in long-term care facilities.

“Until we can really ramp up our testing, it’s hard to get a sense of where we are,” Perencevich said. “But we’re certainly not catching all of the citizens of Iowa that have COVID.”

Much more aggressive testing was implemented in countries that have opened things back up after a COVID-19 outbreak.

Perencevich said cell phone data can also provide a look at how social distancing is working, and Iowans have room for improvement. According to Unacast, Iowa had a grade of C+ Thursday for its reduction in average distance traveled.

IPR asked IDPH what data support their statement that the curve is starting to flatten.

“More testing is being done and we are confirming about the same amount of positive cases per day,” IDPH spokesperson Amy McCoy said in an email. “This means the epidemic or ‘epi’ curve is beginning to look flat and not progress upward at a fast rate.”

But Dr. Megan Srinivas, an infectious disease doctor in Fort Dodge, also told IPR she does not see evidence that the curve is beginning to flatten.

“We’re looking at the rate of people testing positive,” she said. “It increased between yesterday and today. It’s becoming more vertical than horizontal, which is the exact opposite of flattening.”

Srinivas also raised concerns about the lack of widespread testing, and said the state’s numbers are likely far lower than the true number of cases.