The State Level Trumps
By 
The story of the coronavirus in this state is one of government inaction in the name of freedom and personal responsibility. Iowa Governor Kim Reynolds has followed President Donald Trump’s lead in downplaying the virus’s seriousness. She never imposed a full stay-at-home order for the state and allowed bars and restaurants to open much earlier than in other places. She imposed a mask mandate for the first time this month—one that health-care professionals consider comically ineffectual—and has questioned the science behind wearing masks at all. Through the month of November, Iowa vacillated between 1,700 and 5,500 cases every day. This week, the state’s test-positivity rate reached 50 percent. Iowa is what happens when a government does basically nothing to stop the spread of a deadly virus.
“In a lot of ways, Iowa is serving as the control group of what not to do,” Eli Perencevich, an infectious-disease doctor at the University of Iowa Hospitals and Clinics, told me. Although cases dropped in late November—a possible result of a warm spell in Iowa—Perencevich and other public-health experts predict that the state’s lax political leadership will result in a “super peak” over the holidays, and thousands of preventable deaths in the weeks to come. “We know the storm’s coming,” Perencevich said. “You can see it on the horizon.”
Leadership matters, especially given people’s plum ignorance about issues such as public health.
Iowa’s problem is not that residents don’t want to do the right thing, or that they have some kind of unique disregard for the health of their neighbors. Instead, they looked to elected leaders they trust to tell them how to navigate this crisis, and those leaders, including Trump and Reynolds, told them they didn’t need to do much at all. (Although some residents have certainly deliberately ignored the advice of public-health experts.) “When our strategies are not consistent with CDC evidence, when we are not adhering to even the advice of the White House task force, it raises questions in people’s minds on the seriousness of the pandemic and the validity of the mitigation strategies,” Lina Tucker Reinders, the executive director of the Iowa Public Health Association, told me. “People don’t necessarily know what the right thing to do is.”
Which means that not only are health-care professionals tasked with saving sick Iowans’ lives, but it’s also fallen on them to communicate the truth about the pandemic.
Before last spring, Brian Gehlbach told me he was decidedly not a “social-media person.” Now, though, the 51-year-old critical-care physician spends hours on the weekends carefully crafting long Facebook posts about COVID-19. He writes about masks’ effectiveness in preventing the virus’s spread, attaching illustrations and graphs as evidence; he offers warnings about the precarious state of Iowa’s intensive-care units; and he patiently unpacks the concept of the tragedy of the commons. (Occasionally he throws in a photo of his cat for levity.)
Gehlbach told me about his weekend routine while we sat outside the hospital on a cold park bench, as the straps of his mask pulled down on his ears, making him look like a gray-haired elf. In his posts, which are public and in many cases widely shared, Gehlbach never mentions Trump or Reynolds by name, and he doesn’t refer to Republicans or Democrats. Framing the pandemic around partisan politics makes Iowans tune out, he says, and right now, health-care workers desperately need them to listen. “I just feel compelled to try to reach as many people as I can so that we can save lives, so they won’t have regrets, so we have beds, so that my colleagues will suffer a little bit less,” Gehlbach told me.
Of course, what’s really sobering is that Iowa Republicans did better in 2020 than in 2018, Joni Ernst was reelected to the Senate, and Kim Reynolds took all this as a mandate on her leadership on the virus. And to be fair, that’s exactly the lesson she should take as a politician. Being a sociopathic murderer was….appealing to Iowans, both at the national and state level.