2010 2012 2014 2016 2018 2020–5%051015%CUMULATIVE EMPLOYMENT GROWTHSOURCE: BUREAU OF LABOR STATISTICSIOWAU.S.was everywhere, hitting rural counties especially hard.
Despite growing cries from the public health community
to do more, Gov. Reynolds again just asked Iowans to be
responsible. As the curve climbed, the governor herself ap-
peared on stage with President Trump and without a mask
at an outdoor rally attended by thousands of his support-
ers in Des Moines.
In November, health facilities around the state began an-
nouncing that they were at or near capacity—they lacked ei-
ther the staff or beds to handle more COVID patients. The
governor responded with a set of complicated rules aimed
at controlling the spread: no more than two spectators per
child at an athletic event; face coverings should be worn at
indoor gatherings of 25 or more, or outdoor gatherings of
over 100. Finally, the week before Thanksgiving, Reynolds,
in a tone that begged forgiveness—“No one wants to do
this ... I don’t want to do this”—issued a statewide mask
mandate, albeit one with some exceptions.The mask rule couldn’t have come soon enough
for Marshalltown Mayor Joel Greer. A lawyer by day,
Greer had watched COVID stress his community since
early spring. Marshalltown, a city of 28,000 smack dab in
the middle of Iowa, is a meatpacking town, and like other
Iowa cities it had had an early outbreak at its pork pro-
cessing facility and largest employer, JBS. Dozens tested
positive for the virus in April, and one local employee died
a week before retirement in May.
It had just gone on from there. For Greer, it was a
source of frustration and heartbreak that his county had
at times been one of the most hard-hit in Iowa, while Iowa
was one of the most hard-hit states in the country.
Greer Zoomed periodically with a group of mayors
in central Iowa. Many wanted to issue mask mandates,
something they technically didn’t have power to do. Some
went ahead with it anyway. Unwilling to exceed his legalwe don’t have to? Our employees are still out in the com-
munity. They don’t have a choice.”
Western Home effectively guarded its sites against a
COVID-19 outbreak until late July, when it experienced
its first one in Madrid. The virus had slipped in during a
visit from one of the facility’s contracted therapists. Over
the course of a few days, six patients and three staff on the
home’s first floor tested positive for COVID. It was tough
on morale. “They were beating themselves up because
they felt like they had failed,” says Hansen, who, like other
health and long-term-care providers across the country,
has been contending with a serious shortage of workers.
The fall brought scary and unspeakable tragedy to some
of Western Home’s properties. The company had some
managed-care facilities where nearly 100% of residents
tested positive, and where workers, also positive, took
care of them. “It just scares the crap out of you,” he tells
me. “[My employees] have got families too.” The biggest
challenge has been controlling the virus in dementia units.
At one small facility in Cresco, Iowa, eight of 24 residents
were lost to COVID. “We see what the results of this are,”
he says of the state’s lax approach to the virus.
When I spoke with Hansen in mid-January, his staff
and residents were still awaiting vaccines. Says Hansen:
“It’s not rolling out nearly as fast as we had hoped.” He
didn’t blame the state but the federal government, which
is running the rollout in long-term-care facilities with
the private sector. “It’s just not well-coordinated enough.
We’ve got folks, quite honestly, that are going to die be-
cause of this, because of exposure that continues on.”
Hansen remains frustrated by the dynamics around
the virus in Iowa. He noted that the day before we talked
there had been an “Informed Choice Iowa” rally involving
hundreds of unmasked Iowans in the rotunda of the Iowa
state house (where state legislators are not required to
wear masks, and many don’t). The group was calling for
an end to COVID mandates. “I don’t know what happened
to common sense in the middle of this whole pandemic,”
says Hansen. “It’s just crap that this thing turned out to be
as political as it did.”
Naturally, I didn’t stop worrying about
COVID when the derecho hit. I worried more. As Iowans
will tell you, they come together in disasters. I imagined
the virus spreading with all the goodwill.
Cedar Rapids did see cases peak slightly after the
derecho and the immediate recovery, says St. Luke’s Hos-
pital’s Niermann, but the situation wasn’t as bad as she
feared it would be. “Masking went way down,” she told
me. “Honestly, people had to work on a different level of
hierarchy of needs.”
Far worse was yet to come. For much of the fall, Iowa
was one of the nation’s COVID chart-toppers. The virus
WHAT COMES NEXT : THE HEARTLAND