Iowa hospitals overwhelmed, Wisconsin health care system on brink of collapse amid exponential rise in COVID-19 cases

Iowa officials reported on Sunday that the number of deaths from COVID-19 rose to more than 200 for the first time during any seven-day period of the pandemic. In the first weeks of November, Iowa recorded more than 30,000 cases of COVID-19. The state has just over 3 million residents.

Until last week, Republican Governor Kim Reynolds had remained a holdout against even the mildest form of disease mitigation, a statewide mask mandate, in the service of big agribusiness, including the meatpacking companies.

The state has been accused of obscuring the real scope of the outbreak in its effort to keep workers on the job and try to limit social opposition. The Iowa Gazette reports the state is using a formula that includes numbers not available to the public, producing positivity rates lower than what can be calculated with public data. KCRG reports the state government is barring local public health departments from releasing information on hospital capacity.

Voters masked against coronavirus line up at Riverside High School for Wisconsin's primary election Tuesday April 7, 2020, in Milwaukee (AP Photo/Morry Gash)

COVID-19 hospitalizations in Iowa have shot up from under 500 in mid-October to about 1,400 late last week, mid-November. Hospitals in rural Iowa have been overwhelmed with patients and staff are suffering burnout. Iowa nurse Whitney Neville told The Atlantic, “It was doable over the summer but now it’s just too much. Last Monday we had 25 patients waiting in the emergency department. They had been admitted but there was no one to take care of them.”

The state reported on Friday that 77 percent of those incarcerated in the Anamosa State Penitentiary have tested positive since March, many having recovered, and 124 prison staff have been infected.

Iowa ranks fourth in the nation for prison infections. Family members of those incarcerated at the Anamosa told Iowa Public Radio that they fear speaking out publicly will result in their loved ones being retaliated against. More than 3,400 prisoners and staff have been infected and 8 prisoners and 1 staffer have died throughout the state’s prison system.

The official response to the outbreak in Anamosa prison is to keep the facility on lockdown 23 hours a day, moving the few prisoners who tested negative out of the facility, transforming the entire prison into a sick ward.

Anamosa was surpassed by North Central Correctional Facility in Rockwell City for the worst outbreak, with 90 percent of inmates testing positive for the disease.

Last week, the state of Wisconsin marked its deadliest week of the pandemic. From Nov. 14–20, deaths from COVID-19 averaged 54 per day, a 17 percent increase from the prior week. The state surpassed 350,000 cumulative cases as of Saturday and 3,000 cumulative deaths.

Three of the state’s highest daily death tolls were recorded last week: Nov. 17 saw the highest with 92 deaths, a record for the state, followed by 83 deaths Nov. 19 and 78 deaths on Nov. 20. In the state there have been 1,000 deaths in November alone. The Institute for Health Metrics and Evaluation predicted deaths from COVID-19 in Wisconsin will reach 4,000 by the first week of December, 5,000 by the year’s end, and 8,000 by March 1, 2021. Like Illinois to the south, COVID-19 is now the third leading cause of death in the state.

Case positivity rates in the state for first-time positive tests have hovered around 30 percent and remain astonishingly high despite declining slightly from the prior week. Some news outlets predict that the state may have reached its peak in the last week, yet with the lack of any real lockdowns or other public health measures to contain the spread of the virus, positive cases could very well follow the predictions for the rest of the US in surpassing their previous high rate in the weeks following the Thanksgiving holiday.

Some state health officials had made worst-case scenario preparations before cases began rising exponentially in Wisconsin, only to see these efforts prove to be too little in the face of the current situation. In an interview with the New York Times, Dr. Ben Weston, the director of medical services for the Milwaukee County Office of Emergency Management, said, “Wisconsin is in a tough place right now… Despite much talk, we are not turning the corner, nor are we flattening the curve. In fact, our curve is steepening with no end in sight.”

Wisconsin Democratic Governor Tony Evers passed Executive Order 95 and Emergency Order 1 on Friday. These orders declare a public health emergency in the state and implement a statewide mask mandate. Both expire after 60 days and details as to how they will be enforced were not given. In announcing the new measures, Evers explicitly noted that hospitals and medical staff in the state are overwhelmed.

Under the orders, anyone over the age of five years old in an enclosed space that is not their own residence should wear a face covering and continue to maintain six feet of distance from others. There are no directives to close non-essential businesses or schools under the order, nor are there any size limits or bans placed on gatherings to mitigate the spread.

Evers’ declaration came after the Wisconsin Hospital Association wrote a letter to him and other state legislators on Thursday, calling for immediate action to help curb the pandemic. The letter warned that the outbreak will soon qualify as a “catastrophe” with the unmitigated rise in cases and deaths having “burned out” the medical workforce. The letter notes that it took “roughly seven months” to reach over 100,000 cases in the state, only 36 days to get to over 200,000 cases and now only 18 days to surpass 300,000 cases. The exponential rise in cases is clearly pushing hospitals and staff past their breaking point.

State health officials published a release last week on the state of Wisconsin’s hospital system, outlined in Evers’ emergency. The numbers paint a sober picture of a dire health emergency. Nearly every intensive care unit bed and every medical-surgical bed is full in the majority of hospitals throughout the state. Over a third of all hospitals in Wisconsin are operating at peak capacity and are unable to admit new patients. Twenty-one percent of medical-surgical beds and 32 percent of intensive care unit beds are occupied by COVID-19 patients.

Staffing shortages are of top concern to doctors throughout the state treating COVID-19 patients in overrun hospitals. Bellin Health emergency medicine physician Dr. Paul Casey told Fox11 News, “We fluctuate from about 150 to 200 staff on quarantine either having COVID or exposed to COVID so that is a significant part of our workforce.” The hospital is relying on health care workers and nurses working overtime—which causes more burnout, fatigue and other health problems. Some are resorting to staffing agencies to fill ICU positions.

The situation in Wisconsin is particularly dangerous for residents of its many rural counties, some of whom will need to travel hundreds of miles or across state lines to the nearest hospital as beds fill up rapidly.

The ruling class sought to extract ever more profits from the already dilapidated health care system before the pandemic spiraled out of control placing hospitals at a major disadvantage. In Wisconsin and in neighboring states, thousands of health care workers have been laid off since the start of the pandemic.

Throughout the pandemic, state Republican legislators and conservative groups have opposed even the most limited attempts to control the spread of the virus. Earlier this month, Wisconsin’s Third District Court of Appeals ruled that the governor’s Executive Order 3, which limited public gatherings indoors to 25 percent capacity across the state, was “invalid and unenforceable” just as it was about to expire. The order was signed Oct. 6 and blocked amid several lawsuits, all which went virtually unchallenged by state Democrats, rendering it worthless.

As Evers is aware, the latest mask mandate may never truly go into effect under pressure from state Republicans. A mask mandate issued previously is still before the Wisconsin Supreme Court as part of the lawsuit that challenged Executive Order 3.

Governor Evers has not opposed the efforts of Republicans to block his executive orders, which do not require the public to take any action, only “urging” precautions. To the contrary, he is eager to collaborate with them in carrying out efforts in the interest of the corporate ruling class to keep profits flowing by keeping non-essential industries operating while holding mass opposition to the disastrous herd immunity policy of the ruling class at bay.

The same day that he issued his latest executive orders, Evers met with Republican lawmakers Senate Majority Leader Devin LeMahieu and Assembly Speaker Robin Vos to come to an agreement on austerity measures and limited health protocols.

Vos told the Wisconsin State Journal that the meeting “was a productive discussion and as expected, there were issues we agreed on and some that we didn’t… I see today’s conversation as a positive step forward to finding common ground in developing a more unified state response to the coronavirus pandemic.”

Republicans have asked for more testing, a mere doubling of the already inadequate number of contact tracers, assistance for small businesses and cuts to unemployment insurance. Republicans are also pushing for legislation to prevent liability lawsuits against businesses, schools and local governments operating during the pandemic. None of these will face any opposition from the Democrats.

The Wisconsin state Department of Administration reported that state revenues would “modestly increase” over the next three fiscal years. Evers has already forced state agencies to cut spending over $370 million for the 2020–21 fiscal year to address increased costs due to the pandemic. This amount will not be nearly enough to address the public health crisis and leaves untouched the vast amounts of wealth piled up by the ruling class from the start of the pandemic. The cuts will be borne by the working class, who will see less funding for public education, health care, employment and other social services.

Like everywhere else in the world where the pandemic is overwhelming health care systems, the current state of affairs in Wisconsin was not inevitable. With no unemployment protection from the state, workers have been thrust into unsafe workplaces with little to no protection from the virus and their children forced back into schools so they can go to work producing profits for the financial elite. Years of austerity and underfunding of the health care infrastructure in Wisconsin at the hands of both Democratic and Republican lawmakers have created a crisis that the capitalist system cannot solve.

Workers and students in Wisconsin and Iowa who are opposed to the reckless endangerment of their lives for the sake of profit will find allies in the working class across the US and internationally. It is essential to build rank-and-file committees and neighborhood committees, independent of the Democrats and Republicans. Only the independent, internationally-coordinated intervention of the working class will be able to advance the demand for a halt to non-essential production and full compensation for all workers in order to bring the pandemic and its mounting death under control before an effective vaccine becomes widely available.