UI Health Care, Mercy leaders urge against shelter-in-place order for now

As some elected officials call for the governor to make an order for residents to stay at home, medical leaders in Iowa City emphasized that the order was not necessary on Wednesday, citing an impacted supply chain.


Katina Zentz

Brooks Jackson, MD, MBA, University of Iowa vice president for medical affairs and dean of the UI Carver College of Medicine, speaks to attendees during “State of the Enterprise: Strengths, Challenges, and the Path Forward” at the Medical Education and Research Facility on Wednesday, Nov. 28, 2018. Jackson provided an overview of UI health care research.

Sarah Watson, Managing Editor

Iowa City hospitals are encouraging not calling for a shelter-in-place order, Mercy Iowa City and University of Iowa Health Care officials said at a press conference Wednesday.

Iowa Gov. Kim Reynolds has maintained that Iowa doesn’t need an order from the state for residents to stay at home yet, but said Monday that local governments have the authority to declare their own shelter-in-place order. Johnson County officials were hesitant to diverge from the governor, and maintained on Wednesday that they wouldn’t recommend a mandatory halt to nonessential travel.

University of Iowa Vice President for Medical Affairs Brooks Jackson, the dean of the Carver College of Medicine, said there wasn’t a need to call a halt to all nonessential travel because of Johnson County and Iowa’s demographics, and that doing so would put a stranglehold on a supply chain of tests, groceries, and personal protective equipment that is already strained as well as create unnecessary alarm.

“We do want to flatten that curve in order to successfully manage the epidemic as well as minimize the number of hospitalizations or deaths, and there are reasons to believe that we may be able to do this without an order to stay in place for several reasons,” Jackson said. 

However, he said that he didn’t want to rule it out as a mitigation tool, but a number of metrics showed that Iowa didn’t need to call for a shelter-in-place order immediately.

“These are metrics that I think need to be looked at as well as our capacity to take patients, staff beds are all being looked at with the [Iowa Department of Public Health] that would at some point might trigger a stay-in-place, so I don’t think we should rule it out. But I think in the meantime, it’s extremely important that community leaders stress the importance of minimizing contact with others,” he said.

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He added demographics are different for each county and state — in Johnson County, for example, the average age is 30, compared to a nationwide 38. Iowa City is home to the UI, with an abundance of young students.

According to the Centers for Disease Control and Prevention, older adults and people of any age who have serious underlying medical conditions may be at higher risk for more serious complications from COVID-19.

He added that Iowa is much less dense per acre than states hit hard by the pandemic such as New York City — 120 times less, in fact, he said, meaning that less people were interacting within the same public spaces. 

“We don’t have mass transit, which these vehicles can serve very well for transmission as well as very large apartment buildings with thousands of people in them that may have shared ventilation systems that are almost like cruise ships. We don’t typically have that in Iowa or Johnson County,” Jackson said.

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Mercy Iowa City President and CEO Sean Williams also recommended against a shelter-in-place order because of creating unnecessary panic and said it would lead to an unnecessary use of valuable personal protective equipment.

“Mercy Iowa City does not support a shelter-in-place that is being contemplated. We believe this would disrupt not only our supply chain and our staffing, but also would create anxiety and in some cases, panic and we would expect a number of healthy individuals that would be coming in for testing and utilizing equipment, testing procedures, and PPE equipment that we want to conserve for the expected surge that we are all preparing for,” Williams said.

Another reason for not putting in place a stay-at-home order is that the governor and the UI had already put in measures to prevent rapid community spread, he said. Iowa Gov. Kim Reynolds limited gatherings to 10, closing restaurants, bars, movie theaters, and as of March 20, also closed salons, swimming pools, and massage parlors. The UI closed residence halls and campus buildings, and moved instruction online for the rest of the semester.

Jackson said that while these methods are in place, it was unnecessary to call further restrictions which, he said, would be disruptive to the economy, impair the hospitals’ supply chain, and disproportionately affect underrepresented communities and low-wage workers.

“We’re a very large organization with I think a 17,000-person headcount and probably a couple thousand are close to working from home, but we need people at the hospital and these clinics and hospitals, and they come from all over. They don’t come just from Johnson County, they come from other counties as well, traveling 24/7 there,” Jackson said. “We also depend on thousands of other people that are not UIHC employees, but provide services. These are small businesses, for example, that potentially provide services.”

Jackson said UIHC had consulted with 40 patients who’d tested positive for COVID-19. Not all of those, he stressed, were inpatients or Johnson County residents . Currently, UIHC has five inpatients being treated for COVID-19.