James A. Marchand
A year ago, my essay “Rankings Show Iowa’s COVID-19 Policy Poverty” documented how the United States, compared to other G-7 countries, had the second highest COVID-19 death rate. 19 highest (65.2 per 100,000) compared to UK (86.9), Italy (59.9), France (50.6), Canada (26.1), l Germany (11.3) and Japan (1.3).
At that time, Iowa was found to have a higher COVID-19 death rate (49.5 deaths per 100,000) than surrounding agricultural-economy states – North Dakota (46.2), Minnesota ( 39.1), Missouri (35.8), South Dakota (31), Nebraska (27.8), and Wisconsin (25). Iowa was then the only U.S. state that did not require school masks to be worn and also required students to return to school in person.
In order to see how things have changed in a year, my comparisons of country and state rates are again based on data from the Institute of Health Metrics and Evaluation. This world leader in health statistics modeling uses uniform methods to compare the country and state COVID-19 metrics described here – mortality, vaccine completion and mask use, as of October 14.
After:Editorial: Iowa Board of Regents Raise Bow to Republican Lawmakers Above Health and Safety
The country rankings for cumulative mortality from COVID-19 are now: Italy (283 deaths per 100,000), United Kingdom (243), United States (238), France (227), Germany (161), Canada ( 126) and Japan (14) . Despite being the world leader in the development of highly effective vaccines, the United States (65%) lags behind all G-7 countries in terms of people who have received at least one vaccine injection – l Germany (68%), Italy, Japan and the United Kingdom (74%). %), France (76%) and Canada (80%). Japan leads in mask use by a wide margin (93%), followed by Canada (65%), Italy (62%), France (47%), the United States ( 41%), Germany (39%) and the United Kingdom (27%). %). Japan and Canada have widespread use of masks, as well as high vaccination rates, and have again best prevented deaths from COVID-19, reduced health care impacts and costs and related disruptions of their economies, communities and schools.
Cumulative COVID-19 death rates among farm-economy states in our region now find Kansas to have the highest rate (368 per 100,000), followed by Missouri (364), South Dakota (307 ), Iowa (281), Nebraska and North Dakota (239), Wisconsin (235), and Minnesota (182). With the highly infectious delta variant now prevalent, the chances of infection are more similar between states, and death rates are now more reflective of state mitigation policy. Vaccination rate comparisons are as follows: Minnesota (65%), South Dakota (62%), Nebraska and Wisconsin (61%), Kansas (60%), Iowa (59%) and Missouri (56%).
Mask use is now well established as effective in reducing community spread of COVID-19. Upper Midwestern states’ rates are consistently lower than the US average – Missouri (34%), Kansas (29%), Nebraska (25%), Wisconsin (24%), Minnesota (22%) and Iowa (21%) ) the fourth-lowest rate of mask use in the United States, ahead of only Wyoming (19%), South Dakota (16%) and North Dakota (15%). North and South Dakota and Iowa are national outliers in the use of masks to protect residents.
After:Children sick with COVID and other bugs flooded hospitals in the fall. Doctors are worried about what winter will bring.
It is instructive to compare Iowa and Minnesota, which have nearly identical proportions of their populations at high risk due to age 65 and older (17%). Minnesota, however, has nearly double the proportion of minorities, a second well-established risk factor for increased mortality from COVID-19. Yet Iowa has suffered 99 more COVID-19 deaths per 100,000 people than Minnesota, a total of more than 3,000 excess preventable deaths for Iowa’s population of 3.155 million in 2019.
Minnesota’s strong public health mitigation efforts began with its governor and include its state and local health departments, health care providers, hospitals, academics, many community leaders and businesses who, together have protected the health of their public, saved lives, avoided hospitalizations, reduced health care costs and impacts on their health care providers, economy and communities.
Iowa’s ban on preventing local school districts from mandating mask use, a law passed by the General Assembly and signed by Gov. Kim Reynolds, is now blocked by a court-imposed preliminary injunction. until a lawsuit filed by the Iowa Arch and the American Civil Liberties Union made its way through the courts. Some large school districts have again mandated the use of masks in schools, but the vast majority of Iowa school districts have followed the state mandate that prevents local control of mask use in schools. .
The Biden administration is now proposing to require large employers to vaccinate their employees. Some already are. A 2014 article I co-authored, “Employment Status Matters,” based on a statewide survey in Iowa, found that self-employed people had higher prevention and job quality scores. lives even higher than the high scores of people employed by an organization. This data, collected in an era before the politicization of public health measures, suggests that the vast majority of all employers would follow such a federal mandate. However, Reynolds has vowed to oppose this pending Department of Labor rule.
The Biden administration has also been actively pursuing COVID-19 vaccinations for children ages 5 to 11, and federal regulators are expected to approve emergency use of a vaccine in that age group soon.
After:Iowa Immunizes pediatrician and chair: Plenty of reasons kids get the COVID-19 vaccine
It is hoped that Reynolds will take this opportunity to protect the children of Iowa. With the federal employers’ proposed vaccine mandate, vaccinating children and thereby reducing the spread of COVID-19 in the community would provide an opportunity to significantly advance the control of this pandemic, support economic recovery and return to a more normal community life.
Dr. James A. Merchant is a former director of the NIOSH/CDC Division of Respiratory Disease Studies, Professor Emeritus of Medicine, and Professor Emeritus and Founding Dean of the College of Public Health at the University of Iowa.