If Shelter-in-place isn’t mandated in Iowa, what can we do?

Like many of you in Iowa, I sat with my family listening to Governor Reynold’s press conference this afternoon. First and foremost, I want to applaud the State of Iowa, Governor Reynolds personally, and her staff for doing what is a very hard thing —keeping composure in an exceptionally unknown and dynamic time. Whether or not I agree with everything, I recognize the weight of these days on Gov. Reynolds and her team. 

Yesterday I published some short thoughts on shelter-in-place and why I feel like it’s an eventual need to keep us all safe. The considerations are few and generally macro-level. The assumptions are essentially what will happen in Iowa if we do not make a change based on what we know in the rest of the world. One thing we do know? Italy has had over 4,000 deaths related to COVID-19, a number assumed to be low based on the fact that many other deaths took place before testing was ever administered.

What we know

We know the community spread of COVID-19 is now in Iowa and our data is behind the state of the virus in the public domain. We know we will run out of beds and our hospitals are already stressed. We already know we need to do something. The team at Covid Act Now has made this incredibly easy to digest.

One thing to note: A date of March 27 does not imply business as usual for the next week. It means business as usual will cripple our communities without potentially extreme proactive measures taken.

This image also really speaks to the same thing the Governor is stating when she says “bend the curve” from my perspective. The truth is that if we stop the spread by social distancing and isolation, we give health care systems and scientists time to catch up. We need to buy the scientific community time by changing our behavior. 

To Governor Reynolds credit, she’s assuming good intent. If people have the right information they will make the right decisions. When she says “we’re Iowans and we do the right thing,” I agree with her. It’s true far above the average and I was nodding my head when she said it. (Is everyone nodding their head? Is everyone watching?)

That said, right now we need to consider the risk of what happens when someone does the right thing and accept that not everyone who comes through the state is Iowan or has any care about the state. They might just be passing through. Someone else may not be listening to the governors daily advice. Let’s say 100,000 people watched the press conference today. I assume that’s high but let’s just run with it. There are 3.156 million people in Iowa. Even if 100,000 people watched that announcement and 100% of them complied with the the call to do the right thing it means there are 97% of Iowans we are assuming will learn this information through osmosis. That leaves more than 3 Million Iowans we simply assume will do the same thing when the reality is they may not even get this information. 

3% conversion is not a high enough penetration to change community behavior across the state.

Our interstates for example are still awash with activity. Be it for freight, family gatherings, or as much as I hate to admit it a bit of transparent before a long gravel travel and get together. Just this morning I sat by the front window in my house and witnessed a few dozen groups out and about.  It’s not clear to everyone how serious this is. 

My massively biased opinion is that by mandating shelter-in-place, we remove the lack of clarity that a recommendation implies. Some folks will still ignore it but a larger percentage of people will listen when it’s a mandate.  

In many ways, I recognize it’s time for me to acquiesce to this a bit and start thinking about each day that shelter-in-place is not mandated, what can we do? What can communities looking for guidance actually do?

Well here is what we think we know. We, in this sentence, is somewhat misleading. What is actually represents is a group of us that have self quarantined our families. We’re in week two or three of this and are trying to figure out how to help. 

• Health care providers don’t have enough N95 masks to confidently get them through. They have enough for today, but as you can see from the graph above today is less important than a week from now in terms of treatment.
• There is not a plan in place being communicated for COVID-19 testing. 
• It’s not clear at the state level how many people have been cured of COVID-19 in Iowa which says our data is behind, incomplete, or most concerning, the inverse of that is how many people in Iowa have died of COVID-19? What is our death rate? What will be our death rate?

Make no mistake. COVID-19 kills people which is why this is so important. Making changes and creating mitigation is not about self gratification. It’s about ensuring less people die.

So if we want to ensure less people can die and we can’t control shelter in place, what can we do?

Here’s my straw man:

1. Figure out how many tests are in Iowa. Figure out how many of those tests are allocated to find the path to testing 100% of Iowans and anyone who walks into a medical facility, Iowan or not. Testing is the first step to getting an accurate count.
   
2. Start taking inventory of which hospitals in the state have a shortage on beds, N95 masks, respirators, and anything else.
   
3. If the state won’t mandate shelter-in-place, start talking to your peers and advocating for it. Not all people are symptomatic and if the virus is already in your home you may not know it. You owe it to your community to stay the hell home until you can confirm, with a test, that you won’t spread COVID-19. You might be right, you might be strong enough to muscle through it. But the 10 year old next door with respiratory issues since he was young? Maybe not. The neighbor’s elderly parent who lives with them? Definitely not. This is not about you — it’s about sacrificing a bit of freedom and space for the next few weeks for the better of all.

Based on the blog I wrote recently, I’ve heard from state officials, CEOs, directors, and individuals who are all trying to figure out the same thing. How do we help?

It’s clear that there is a massive amount of capital out there that would go to work buying N95 masks, producing N95 masks, and mobilizing to donate facilities for beds. I’m proud of the Governor’s work creating a plan for critical workers and healthcare and can’t help but think private enterprise can help here. There are more questions for the Governor, too…

1. If you are providing childcare what is the plan to have all childcare providers tested?
2. What is the plan to test all children at all childcare providers as they attend, and extend that to all families whose children attend? Not just testing for a slight fever daily, testing for the virus. If there is a fever, it’s likely too late.
3. What is in this shipment that is coming Monday or Tuesday? Who is it going to and what communities will it help?

There are so many questions but it feels as though we can come together. In an effort to do something not knowing what I’m doing here are my asks for this community.

• If you can make N95 masks, send me an email.
• If you can use N95 masks, send me an email.
• If you want to finance the purchase of N95 masks, send me an email.
• If you can make tests like IDT, send me en email.
• If you have a need for tests like what IDT offers, send me an email.
• If you want to finance the purchase of tests like IDT offers, send me an email.
• If you can volunteer to help at either hospitals or at test facilities, send me an email.
• If you already have a list of what hospitals are in need of supplies, send me an email.

I have no idea how I’m going to mobilize this but we’re in the middle of a global pandemic and I think our state is doing the best job it can in a tough situation. As citizens and ally’s of the state, now isn’t the time to complain about what they are doing, now is the time to help them. This isn’t a tech community thing, it’s an everyone thing.

I don’t know if doing any of this will benefit anyone but I’m not going to sit around and do nothing, and Iowan or not I hope you’ll do the same.  Huge props to the work Eric & team are doing in the corridor to help hospitals get what they need.

E-mail or Twitter are the best ways to reach me.