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States are considering how, and when, to reopen their economies. But the process looks different across the country, and there's a considerable variety even in the Midwest. Side Effects Public Media鈥檚 Brittani Howell spoke with Indiana Public Broadcasting鈥檚 statehouse reporter , KBIA health reporter and Iowa Public Radio health reporter about how their states have reacted so far, and what they might do going forward.
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To start, let鈥檚 recap what these three states 鈥� Indiana, Missouri and Iowa 鈥� have done so far in terms of reacting to the coronavirus?
Gov. Eric Holcomb鈥檚 first "Stay-At-Home" order for Indiana and looks similar to the orders issued in Kentucky, Ohio, and Illinois. The order was renewed twice: , when Holcomb tightened some restrictions and guidelines; , when he extended the "Stay-At-Home" instructions until May 1.
Missouri Gov. Mike Parson instituted a statewide "Stay-At-Home" order on and it was set to be in place until April 24. That order was extended until May 4. However, it is not as restrictive as Indiana鈥檚.
鈥淥ur 鈥楽tay-At-Home鈥� order is primarily directed at individuals,鈥� Valdivia said. 鈥淚t鈥檚 not ordering restaurants and bars to close their dine-in areas, but asking Missourians to avoid dine-in bars and restaurants.鈥�
That鈥檚 similar to the situation in Iowa, where Gov. Kim Reynolds has not issued a "Stay-At-Home" order at all. Starting in mid-March, she began issuing executive orders that closed restaurants except for carry-out, closed gyms and limited gatherings to no more than 10 people. , she announced schools 鈥� which she had closed weeks earlier 鈥� would not be returning for the end of the academic year.
鈥淚t鈥檚 very similar to Missouri 鈥� a big emphasis on sort of asking for people to do the right thing,鈥� Krebs said.
Sebastian and Natalie, what were some of the arguments you each heard from your state governments for the delay in issuing an order? Did you notice anything in common between the arguments state officials made for their response?
In Missouri, Parson has argued that a blanket, statewide order could have an outsized effect on rural areas, which make up about 30 percent of Missouri鈥檚 overall population. Part of his argument was that rural areas were not experiencing many coronavirus cases 鈥� though that is changing, Valdivia said.
鈥淲e鈥檙e seeing more outbreaks in rural counties tied to ,鈥� Valdivia said. Iowa is seeing similar outbreaks in its own rural areas, .
Reynolds has also emphasized concerns about the economic impact of a statewide "Stay-At-Home" order.
鈥淚owa produces about a third of the nation鈥檚 pork supply, and that would have this huge economic impact on companies and farmers in the state,鈥� Krebs said. 鈥淎nd I think that鈥檚 really the feeling behind her not wanting to issue this 鈥楽tay-At-Home鈥� order.鈥�
However, the northeast part of Iowa has been placed under some stricter restrictions to help mitigate the virus鈥� spread. Can you tell us more about that?
The Iowa officials have carved the state into six regions and established a 12-point assessment to determine what management practices should be applied. Hospitalization rates, the number of senior citizens, and the number of positive COVID-19 cases in long-term care facilities all factor into that assessment.
The northeast region of Iowa, which includes 14 counties, ranked a 10 on that 12-point system. That triggered additional measures from Reynolds鈥� office, though the measures still aren鈥檛 considered official "Stay-At-Home" orders.
鈥淓ssentially it means people can鈥檛 gather with people other than their family members. The only exceptions are weddings, funerals, religious activities 鈥� and that鈥檚 still restricted to 10 people,鈥� Krebs said.
Those restrictions will be in place until April 30.
The restrictions are applied based on that 12-point assessment. While the southeast region of the state has had some outbreaks, Reynolds ranks the situation below a 10 and has not instituted similar restrictions.
Indiana has to discuss when and how to reopen economies: Illinois, Kentucky, Michigan, Minnesota, Ohio and Wisconsin. What does it mean that these states are working together? What does this cooperation look like, functionally?
So far, the cooperation appears to be very informal, Smith said. The states are keeping lines of communication open.
One of the concerns among the states is how reopening will affect communities who live close to state borders. If, for instance, Indiana were to reopen more businesses faster than Illinois, there is some concern that people from Illinois could flood into Indiana鈥檚 northwest region outside Chicago to go to businesses that aren鈥檛 yet available in their own state.
Indiana鈥檚 latest "Stay-At-Home" order, which is in effect until May 1, mentioned that elective surgeries might resume in early May. Other than that, Holcomb has resisted naming an exact date so he doesn鈥檛 have to walk it back if health data indicates a later start date would be better. Details are also pending as to what businesses might be able to resume first.
鈥淲hat he has been clear about is, however this happens, it鈥檚 going to be slow,鈥� Smith said.
Meanwhile, Missouri is striking out on its own.
Illinois governor J.B. Pritzker said Parson declined to join the loose coalition of Midwestern states. At a press briefing in mid-April, Parson said Missouri could not rely on outside entities. However, he has coordinated with Kansas Gov. Laura Kelly for the "Stay-At-Home" extension, which both states issued on April 16. Valdivia noted that the Kansas City metropolitan area spans both states.
St. Louis also shares part of its metropolitan area with a different state. And residents could be in for some confusion if the timelines for reopening Missouri and Illinois aren鈥檛 aligned.
And Iowa Gov. Kim Reynolds is taking her cues from the federal level.
鈥淪he has said that her phasing plan looks a lot like Donald Trump鈥檚,鈥� Krebs said. 鈥淪o kind of expecting things to open up a little more slowly.鈥�
She has indicated that she is in conversation with officials in Nebraska and North and South Dakota.
Have you heard from health officials about how 鈥� or whether 鈥� the "Stay-At-Home" measures have flattened the curve for states?
Dr. Kris Box, the state health commissioner in Indiana, has said at the governor鈥檚 press conferences that she鈥檚 encouraged by the "Stay-At-Home" orders, and that the initial projections were worse than what the state is seeing currently. And not all of what the state sees is necessarily disclosed to the public.
鈥淗ospital admissions is something I know Indiana officials are tracking really closely. They don鈥檛 share that with the public, but they are encouraged by what they鈥檙e seeing there,鈥� Smith said.
They鈥檙e also encouraged that the number of intensive care unit beds and ventilators available in the state have remained consistent.
鈥淎bout 40 percent of our hospital beds have been free throughout this entire pandemic so far,鈥� Smith said.
Some local governments in Missouri issued "Stay-At-Home" orders before Parson instituted a statewide order, and health officials in the state鈥檚 central area have attributed the lack of growth in cases to those early efforts.
Statewide, it鈥檚 a little less clear, Valdivia said. The Missouri government recently set a benchmark for how many tests it will have to run per week as part of its considerations for reopening. But officials have indicated that Missouri is faring better than models initially predicted, and credited the "Stay-At-Home" orders and social distancing for that.
How have health experts on your beats reacted to these reopening discussions? At the federal level, Dr. Anthony Fauci told Good Morning Americathat reopening too quickly could be problematic.
Krebs hasn鈥檛 seen much resistance in Iowa so far, but that could be because Reynolds has not given any solid indication when Iowa might start to reopen. But health officials she has spoken to would prefer things to stay closed through May.
Smith hasn鈥檛 heard much pushback either, though it鈥檚 possible that some communities 鈥� like Indianapolis, which has the highest number of cases in the state 鈥� may choose to extend their local "Stay-At-Home" orders past whatever date Holcomb selects. Cities in Missouri, such as Columbia, are contemplating similar decisions, Valdivia said.
Will your states be expanding testing in advance of any possible reopenings?
Indiana is ramping up its daily testing and , but other obstacles remain. Missouri is allowing more people to get tested as well, and is implementing 鈥渂oxing-in鈥� strategies at hotspots like meat processing facilities and testing everyone in the vicinity. Iowa has entered into a to increase its testing capacity over the next year as well, though some of its testing is only online, and only in English, which could leave out non-English speakers or Iowans without broadband access.
Currently, local health departments face a shortage of testing supplies 鈥� swabs, reagents, etc. It鈥檚 also not clear how contact tracing will be implemented statewide, or where the supplies will come from.
But when it comes down to it, it鈥檚 not going to be possible to test everyone.
鈥淎s we start to let people go back to work, not knowing who really has it, or who has had it and might be immune to it at least for a period of time, is going to be a problem,鈥� Smith said.
He said that鈥檚 why Holcomb has said any reopening strategies will take place slowly in Indiana.
How might reopening the economy affect unemployment benefits for people who may be at particular risk of complications for the coronavirus? How might it affect the court systems?
With unemployment benefits, it鈥檚 a bit too early to tell. As far as the court system goes, it will likely depend on where you live. Indiana courts have been taking their cues from the state government, but even when the state reopens, courts located in hotspots may take more time to reconvene physically, Smith said.
Missouri鈥檚 court system is also making the decision at the local level. Iowa, however, is making the decision at the state level, and that decision is still pending.
Indiana Public Broadcasting, Side Effects and WFYI are asking Americans about health issues, as part of the initiative. To contact us directly with a question, email health@wfyi.org.
America Amplified, a public media initiative funded by the Corporation for Public Broadcasting, is using community engagement to inform and strengthen local, regional and national journalism. Follow on Twitter at @amplified2020.
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