Name: Fact check: Has Iowa really 'flattened the curve'? Our ruling: The claim needs more support
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Fact check: Has Iowa really 'flattened the curve'? Our ruling: The claim needs more support

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Des Moines RegisterView CommentsAs Iowa Gov. Kim Reynolds has defended her move to&nbsp;, she has said that Iowa has been able to "flatten the curve" in its battle against the spreading coronavirus."With the additional testing capacity, with some mitigation efforts that we put in place&nbsp;and the way that Iowans&nbsp;responded, we were able to flatten the&nbsp;curve," Reynolds said&nbsp;. "We were able to mitigate the impact on our health care resources, as well as not overwhelming our health care facilities."Late last month, the state began taking a phased approach on reopening some gatherings and nonessential businesses in counties with lower virus activity that Reynolds said have seen "a stabilization and a downward turn." On Friday,&nbsp;across the state, even in areas that have not seen the two-week period of sustained decline&nbsp;in virus activity recommended by federal guidelines.As Iowa's case counts and hospitalization numbers rose, Reynolds continued to talk about how Iowa has stabilized its position. During her press conference Monday, Reynolds acknowledged some areas of Iowa, such as northwest Iowa,&nbsp;are continuing to see increases while saying others in eastern Iowa&nbsp;appear to be tapering off.She said the state has been using strategies like targeted testing in areas with outbreaks to contain them. The state has so far tested more than 1,300 people in long-term care facilities and more than 9,400 employees in manufacturing plants.Reynolds also said during her news conference&nbsp;Monday that she on Tuesday.Emails to Reynolds' spokesman asking for more support for the data behind her "flatten the curve" statements for this article were not returned.Has Iowa truly flattened the curve? Here's what the current data and outside health experts say:When health experts refer to "flattening the curve," they are often discussing the bell curve on a chart that shows hospitalized&nbsp;COVID-19 patients over time,&nbsp;said Dr. Ryan Malosh, an infectious disease epidemiologist at the University of Michigan School of Public Health.Malosh said sometimes "flattening the curve" is also used to refer to the bell curve charting the daily number of new cases.&nbsp;People can also use it to refer to the number of ICU admissions or ventilators in use. Each of those graphs is an indicator of a virus's activity over time.&nbsp;As the coronavirus has spread, "flattening the curve" has been pictured by a&nbsp;&nbsp;of&nbsp;two bell curves. The first, a steep curve, represents how quickly cases from a disease will spread without preventive social distancing measures. The second, a gradual curve, shows that cases will spread more slowly over a longer period of time if the measures are taken.An important factor in this case is the horizontal line on the chart that represents the state's or region's hospital capacity. The goal of "flattening the curve"&nbsp;— or spreading the number of cases over an extended period of time rather than seeing a short-term spike — is meant to keep the curve below that&nbsp;line."The idea behind 'flattening the curve' is really to keep the peak of the outbreak, in terms of hospitalizations and ICU admissions, below the health care system's capacity," Malosh said.Over the seven-day period ending Sunday, Iowa has seen the number of new daily reported cases trend slightly downward, according to data from the .State data show there were 2,219 new coronavirus cases during&nbsp;that period, down from 3,556&nbsp;new cases over the previous seven-day period.The state tested more people even as that number declined: There were nearly 18,900&nbsp;reported tests during the past seven days, up from just over 18,300&nbsp;during the previous seven, according to data on the state's website, which includes numbers through Sunday.The percentage of positive tests hit its highest point so far April 27, when 33% tested positive. It has since decreased to as low as 10%.But the raw case data and test counts don't necessarily tell the whole story. Testing in Iowa is expanding but&nbsp;remains limited, as in many states.An showed Iowa would need 10,266 daily tests&nbsp;— more than triple its average daily testing&nbsp;— by May 15 to adequately test everyone who has the virus and their known contacts.&nbsp;Iowa was among 41 states that had&nbsp;not yet met that&nbsp;benchmark, which researchers said&nbsp;is recommended to get a handle on the outbreak.Iowa also has not reached the point where its daily&nbsp;positive tests are consistently below 10% of total tests, a benchmark . Saturday, the lowest day this month, was the only day that has been at a&nbsp;10% positive rate so far.Iowa recently launched “Test Iowa,” a coronavirus testing program with drive-through sites that has a goal of adding 3,000 tests per day once it’s fully operational. It remains unclear how many tests can so far be attributed to "Test Iowa," as the state is not separating testing statistics by source.&nbsp;On Thursday, 3,805&nbsp;people were tested in Iowa, a new single-day high.Also on Thursday, the state saw the first day of decreasing hospitalizations, dropping from 417 to 407. The number has since dropped to 394, its lowest point since May 3, as of Sunday.The number of ICU patients dropped for the third straight day on Sunday, to 152.Iowa has approximately 49% of its inpatient beds, 76% of its ICU beds and 74% of its ventilators available statewide, according to state data.As of Monday, the state has reported 271&nbsp;deaths after adding another six in that day's report.When Reynolds made her April 29 remarks, confirmed cases and hospitalizations were continuing&nbsp;to rise, as was the percentage of positive tests.Reynolds explained her position by referring to the fact that Iowa appears to have the necessary medical capacity, which is the goal of flattening the curve."As we've shown&nbsp;Iowans for the last several weeks with the RMCC (Regional Medical Coordination Centers)&nbsp;data&nbsp;—&nbsp;and you can go online every day and look at that&nbsp;—&nbsp;you'll see that they've been able to manage the resources, the number of hospitalizations have not been anywhere near to what the early models projected," she said.At the time Reynolds made her claim, a &nbsp;showed Iowa would fall well within the range of available hospital beds. The model has been updated multiple times since that statement but continues to show Iowa within its capacity.The most current version of that model shows Iowa may have already hit its peak of&nbsp;estimated cases in&nbsp;mid-April and could have peaked in the number of hospitalizations last week.The model assumes that&nbsp;mitigation measures of closing schools, limiting social gatherings and closing some businesses will extend through Aug. 4."Models will have to change as mitigation measures change, and Iowans should continue to practice social-distancing, good hygiene&nbsp;and seek care when needed,"&nbsp;Iowa Department of Health spokeswoman Amy McCoy said in an email.&nbsp;"The governor continues to make her decisions on a county-by-county basis with the latest information available from public health."In a &nbsp;last month, a team of researchers&nbsp;at the University of Iowa College of Public Health said it&nbsp;had found signs of a slowdown in infection and mortality rates in the state, but not that Iowa's counts had peaked.The report warned that lifting&nbsp;mitigation efforts would make&nbsp;a second wave of infections likely.&nbsp;The researchers are working on another phase of the report that includes an Iowa-specific data model.The Des Moines Register&nbsp;reached out to researchers at the University of Iowa for this article, but spokesman Dan McMillan said faculty would not have time to respond to the Register's request.Dr. Megan Srinivas, an infectious disease physician from Fort Dodge,&nbsp;said Friday that she does not believe that the state has flattened the curve, pointing out that the state has not shown a sustained leveling off in&nbsp;hospitalizations or use of ICU beds."The whole concept of flattening the curve is dependent on being able to plateau the infection trajectory, and then to eventually come down from that,"&nbsp;she said. "If&nbsp;we don't plateau, then we never flattened it."The gradual reopening of the state has been premature, she said, and&nbsp;she believes the state could begin to see the impact in another two to three weeks&nbsp;after the virus has had time to spread and&nbsp;incubate.She said projections may show Iowa within its health care capacity, but those projections&nbsp;have not fully taken into account the state's reopening plans. The health care system is challenged in other ways besides beds and ventilators, she said, pointing to availability of personal protective equipment and workforce.Yumou&nbsp;Qiu, assistant professor of statistics at Iowa State University, tracking the virus's rate of transmission in all 50 states. He&nbsp;said Friday the state has been on a good trajectory in recent days but needs to sustain it.The Iowa State&nbsp;shows&nbsp;the average number of&nbsp;people to which an infected person will transmit the virus, A value above 1&nbsp;means the virus is spreading exponentially, while a value below 1&nbsp;means the rate of transmission is controlled and decreasing. shows&nbsp;the number&nbsp;has trended downward since mid-April and&nbsp;dropped below 1&nbsp;on May 1, meaning that&nbsp;it’s "controlled and decreasing." But Qiu told the Register that it could easily go back up.“We don’t know what the future will look like," he said Friday.&nbsp;"We are still close to&nbsp;1,&nbsp;so it can easily go above&nbsp;1&nbsp;if we don't be careful.”Malosh agreed that&nbsp;the lowering percentage of positive cases and other trends puts the state&nbsp;on a&nbsp;good trajectory. He said it's possible for the state to continue to add cases even though&nbsp;social distancing is working because the rate of increase is slowing."It looks like it's trending in the right direction," he said. "The percent positive number was quite a bit higher a week ago than it is now, and so that's an encouraging sign, I would say."But he&nbsp;also cautioned that lowering the trajectory of a curve doesn't mean it can't rise again."Just because you’ve flattened it once doesn’t mean it’s going to&nbsp;stay&nbsp;flat," he said.We&nbsp;rate this claim as needing more support. Experts say Iowa has begun showing some positive signs as statewide numbers for cases and hospitalizations trend downward and testing trends upward. But, like many aspects of the virus, some say it’s likely too early to tell that Iowa has, for a fact, fully “flattened the curve.”Reynolds' statement&nbsp;that, after taking mitigation measures, the state appears to be on pace to stay within its capacity of beds and ventilators on a statewide basis is true. Reynolds' claim is backed up by models such as the&nbsp;IHME model, which currently shows&nbsp;Iowa will not exceed hospital capacity and may have already peaked. After hitting a high on Wednesday, the number of hospitalizations statewide also decreased in three of the following four days.But experts dispute whether that proves Iowa has flattened the curve.&nbsp;Reynolds initially made the claim April 29&nbsp;as the numbers of positive tests and hospitalizations were still rising. Those numbers have now shown some gradual short-term declines.&nbsp;Despite improvements in its testing capacity,&nbsp;the state&nbsp;has yet to reach&nbsp;the testing threshold recommended by experts to obtain a full picture of the virus’s activity.Iowa has also not shown a prolonged&nbsp;decrease,&nbsp;and experts like Srinivas worry that the loosening of mitigation measures taken by the governor could lead to a spike. It also remains unclear how the further reopening of the state will&nbsp;affect projections.Iowa&nbsp;has yet to publish its own form of modeling&nbsp;that would back up claims that the state has flattened the curve.Experts contacted by the&nbsp;Register also emphasized that, once the curve flattens, it doesn't mean the curve will remain that way. Ian Richardson covers the Iowa Statehouse for the Des Moines Register. Reach him at , at 515-284-8254, or on Twitter at .Your subscription makes work like this possible. Subscribe today at .View Comments

Des Moines RegisterView CommentsAs Iowa Gov. Kim Reynolds has defended her move to&nbsp;, she has said that Iowa has been able to "flatten the curve" in its battle against the spreading coronavirus."With the additional testing capacity, with some mitigation efforts that we put in place&nbsp;and the way that Iowans&nbsp;responded, we were able to flatten the&nbsp;curve," Reynolds said&nbsp;. "We were able to mitigate the impact on our health care resources, as well as not overwhelming our health care facilities."Late last month, the state began taking a phased approach on reopening some...

Fact check: Has Iowa really 'flattened the curve'? Our ruling: The claim needs more support

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