Moving Iowa quickly to shelter in place

For the first time I had a meeting cancel due to a COVID-19 death. The depth of sadness I feel for those impacted right now is something I can feel, but I can’t describe. This was definitely a wake up call for me.

I’m not a doctor and I can’t provide care to others but I do feel like I have an oddly weird view of the world right now. I’m watching the most intelligent people I follow and read react in a new way. They are self isolating because we now have enough data to know what to do. 2 weeks ago that same group was doing everything as-normal. That has completely flipped. They are now using their time distributing information the rest of us don’t have yet or don’t have a good view of yet.

I’m over the hurdle of believing that Shelter-in-place is something the midwest needs to move to immediately to stop the spread of this thing. The best view of this that I’ve seen that makes this spread easier to understand it’s impact on you, and on us in Iowa, is on Covid Act Now.

It’s easy to see why it feels like things are mostly normal. We’re still in an acceptable range of hospitalizations but the behavior we demonstrate now will either help or massively hurt our communities and loved ones in the coming weeks.

What this graph doesn’t consider is where the actual beds are or what percentage of them have respiratory support. We now have data and professional insights that tell us that the difference between some deaths and unthinkably large numbers of deaths is our behavior over the next week/days.

As if that’s not bad enough, rural Iowa and midwest support systems are even more poorly suited to handle this. What if 1000 people need a bed in a town of 2500? What if 500 of them can’t get respirators and what if the median age of that town weighs largely on the older side? The picture could get incredibly dim in a matter of weeks. Bad planning could result in a town being decimated.

It’s hard not to see the benefit of moving to shelter in place and following others even if it’s simply as a protection measure.

I’m a pretty healthy person in my 30s. My family is also healthy and while the optimist in me says we will all be fine I think we need to start assuming that’s not true. While progress won’t stop, markets won’t stop, and yes we will get through this… You can see plenty of people out and about like it’s no big deal. We’ve hit a point where we need the state to step in and announce shelter in place. I’m so hopeful this happens imminently so we never have to learn what the cost was of delaying the change.

🙏🏻to Zack and the team for putting together Covid Act Now.

4 thoughts on “Moving Iowa quickly to shelter in place”

  1. The model is as unrealistic as can be. The assumptions have so many extreme issues it defies logic to put any faith in the graphs as presented. Former pandemic adviser said 10 days ago we’ll see hospitals getting creamed in 10 days. 10 days ago. And one must ask why it’s not rampant in areas close to and even inside China.. Japan, Taiwan, Hong Kong, Shenzhen / Guangdong. Basic measures taken but certainly not shelter in place, shut everything down. Also environmental conditions such as a society that practices more social distancing than say Italy, as well as warmer and more temperatures developing in northern hemisphere that normally causes virus’ to deplete in strength. Lastly, the basic measures of hygiene, sanitation, and social distancing is much more effective cost/benefit than draconian society-wide measures. And no, don’t say, if it saves one life— think flu, abortion, car accidents, where all society has cost-benefit measures.

    1. Hey Matt, Thanks for the note. The project was built with the help of Nirav Shah( MD, MPH, Senior Scholar, Stanford University Clinical Excellence Research Center; Former Commissioner, New York State Department of Health & Vincent Mor (Florence Pirce Grant University Professor, Professor of Health Services, Policy and Practice, Brown University), Ben Goldman-Israelow (Infectious Disease Fellow, Yale School of Medicine). Is there any part of the model that you find to be un-realistic? Certainly would be helpful to understand in more detail where you feel this is unrealistic.

      The model is located here-

  2. Thanks for your post, Ben. A quick thought I had in regards to the situation…

    We need a call to act and to create supplies as a community:
    -Test kits
    -Hospital gowns
    -Any other community need that has been disrupted (food insecurity, grocery supply chain, etc)

    I’ve heard Debi Durham is starting to work with manufacturers. What if we (Iowa) created one spot where all this is listed online, and people/businesses/manufacturers can raise their hand where they can help?

    1. Debi is a champion for this state and everyone in it. Certainly anything we can be doing to support her work I’d want to be doing. Do you know where the largest shortages of supplies are? Is there anywhere for us to find out?

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