Iowa leaders prioritized politics over public health during the coronavirus pandemic — contributing to disproportionate COVID-19 infections, unnecessary deaths and low vaccination rates in Black communities, Black leaders and critics said.
“We are such a small number they don’t feel they have to act on our concerns,” said Donna Henderson, owner of Henderson’s Highland Park Funeral Home, one of two Black-owned funeral homes in the state.
About 90% of Iowa’s population is white; 4% is Black. More than 407,838 Iowans have tested positive, and more than 6,170 people have died from the disease, as of July 22. Blacks accounted for 12,158 cases, and 157 Blacks have died from COVID-19, according to the Iowa COVID-19 Tracker, an independent tracking site.
“The COVID-19 virus was running rampant in our community,” said Henderson, whose funeral home has been a fixture in Des Moines for 20 years. “The impact of the deaths aren’t as shocking here because of the small number of minorities in Des Moines. It doesn’t sound like a lot — unless it’s your family.”
When the pandemic — and year of social unrest following George Floyd’s murder — swept across Iowa upending lives, Blacks braved outbreaks on the front lines, on unemployment, in prisons, unhoused, distanced from their places of faith and skeptical of the institutions that were supposed to protect them.
‘What the pandemic did was lift a band-aid off of a long-festering wound of inequities in all parts of our lives as Black people,” said Jacquie Easley McGhee, state area health chair for the Iowa-Nebraska NAACP Conference of Branches.
This inequality is painfully apparent in the realm of health care.
“We were overwhelmingly susceptible to getting the virus because we’ve suffered disproportionately with these comorbidities,” said Easley McGhee, who is also director of health equity and community and diversity resources for MercyOne Des Moines Medical Center.
Nationally, Blacks are twice as likely as whites to die of COVID-19 and nearly three times more likely to be hospitalized, according to data from the Centers for Disease Control and Prevention. According to July 22 provisional death counts by the National Center for Health Statistics, around 90,917 Black Americans have died of COVID-19. Health experts said long standing systemic inequities fuel the disparities.
Dr. Michihiko Goto is an assistant professor in the division of infectious diseases at the University of Iowa Carver College of Medicine whose work includes limiting infections in hospital systems and nursing homes. He said Iowa is in a much better situation now than a year ago, but coronavirus mutations remain a concern.
“Still, about half of Iowans are probably still susceptible to COVID-19,” said Goto. “They are not immune to it.”
Now, six months after the release of three effective vaccines, Johnson & Johnson, Moderna and Pfizer, 46.6% of Iowans are fully vaccinated, but Blacks have for a variety of complex reasons been slower to get vaccinated. Critics said it’s a serious problem that hasn’t received enough attention. Health officials worry the gaps could lead to further inequities as delta and other variants, which are highly contagious coronavirus mutations, circulate in the state, which has outlawed face mask mandates in schools, cities and counties.
“Even as we transition into the recovery stage of the pandemic, IDPH remains invested in the COVID-19 response, including ensuring testing capacity, data accuracy and transparency and vaccine deployment,” Sarah Ekstrand, public information officer for the Iowa Department of Public Health, said in an email.
COVID-19 news stories regularly lack a key component: the number of infections and deaths for Black Iowans in particular, which makes it hard to measure the virus’s toll. Now, finding state COVID-19 data will be even harder. As of July 7, the Iowa Department of Public Health has stopped updating its coronavirus website several times a day and instead began weekly updates, which has implications for Blacks.
“Like with many things when it comes to the health of communities of color, you can expect to see repercussions echo louder in these communities,” said Dr. Taison Bell, an assistant professor of medicine in the divisions of Infectious Diseases and International Health and Pulmonary and Critical Care Medicine at the University of Virginia, in an email.
Daily COVID-19 updates allow people to know sooner if cases are increasing rapidly, as is the case in several states, he said.
A critic of the governor and the state’s handling of the pandemic, especially in terms of transparency and data, Sara Anne Willette, CEO and founder of the Iowa COVID-19 Tracker, said the state never collected the socioeconomic and demographic data that would have given them needed information about the toll of the virus on Blacks, Indigenous and people of color. The data would have “painted a picture” about the groups’ access to testing and vaccinations and could have helped inform decisions, she said.
“I view all the deaths by race and ethnicity as high because the deaths were preventable through masking and distancing,” she said. “If the governor had properly prioritized and created strategic rules for circuit-breaker lockdowns during times of high transmission, we would have prevented many of the deaths.”
Willette spends several hours a day sifting through the data and updating her website with the goal of informing Iowans.
“It’s a gut punch every time a person of color is represented in the data,” she said.
Iowa has a Republican governor and Republican-controlled Legislature. From the pandemic’s onset, state officials publicly downplayed the severity of the virus, Henderson and Willette said. Two months into the pandemic, Gov. Kim Reynolds signed an executive order loosening restrictions. For nine months, Reynolds balked at face mask mandates, opting to take a piecemeal approach last year during a fall surge. Throughout the pandemic, Reynolds and state leaders have ignored guidance from the CDC and pleas from doctors, faith-based and Black organizations to institute mask mandates and close businesses to stop the virus’s spread.
Reynolds’ mantra at press conferences was direct: “I trust Iowans to do the right thing.”
The result was that many Iowans simply decided for themselves what kind of pandemic they wanted to have. And, they didn’t want one. That meant Blacks who are estimated to be more than 10.2% of health care aides, 25% of the prison population, 6.5% of K-12 students and overall less likely to be able to work from home, remained on the front lines and exposed to the virus.
Controversy swirled around many of Reynold’s pandemic-related decisions, which Willette, Henderson and others said put the focus on politics, not public health.
The Iowa-Nebraska NAACP State Area Conference of Branches asked Reynolds on April 9, 2020, for racial data and disparities to be tracked, monitored and considered in the state’s “decision-making processes,” for the state to take “careful and deliberate measures” to close any gaps in the availability in health care, economic impact and education resources related to COVID-19 and for that data to be made public.
Two months after the pandemic began, Reynolds lifted business restrictions despite high caseloads in Iowa.
When former President Donald Trump demanded meatpacking plants remain open through an executive order, Reynolds refused to close meatpacking plants in the state at a time when outbreaks were rampant and more than 1,000 employees at Tyson Foods in Waterloo were infected and some workers died. She also signed a bill that protected businesses from COVID-19-related liability.
The state’s $26 million no-bid COVID-19 testing program, TestIowa, which originated from a tip from actor Ashton Kutcher, faced early concerns about barriers to access, among other issues.
The Des Moines Black Liberation Movement repeatedly called for the release of people in Iowa’s prisons, citing concerns about COVID-19 outbreaks, which state leaders rejected. In an unrelated situation, state lawmakers allotted the Iowa Department of Corrections $20 million to boost staffing and security after two staff members were killed at Anamosa State Penitentiary and low staffing issues were raised, instead of reducing the overall prison population like Des Moines BLM had requested.
Reynolds had long rejected a mask mandate, a move which some medical professionals and organizations said put Iowans’ health at risk.
Tom Ahart, superintendent of the Des Moines School District, faced discipline and possible loss of his superintendent’s license for defying Reynold’s mandate for students to return to in-person classes, instead of remote learning, which he felt was safer.
The state auditor is conducting an ethics review of Reynold’s coronavirus media campaign for allegedly violating a state law “prohibiting self-promotion with taxpayer money,” according to the Iowa Capital Dispatch.
“It was all politicized,” said Henderson, who battled COVID-19 twice before becoming fully vaccinated in May. “It should have been about public health.”
‘I don’t think that the state cared at all about protecting anybody. They cared more about their pockets than they cared about our lives,” said Coy Bundy, a Des Moines grandmother who became a TikTok sensation during the pandemic and has 2.8 million followers for her viral dance videos.
A Des Moines Register and Mediacom Poll in June found 51% of Iowans approved of Reynolds’ job of handling the pandemic.
Willette counters that the state’s COVID-19 response was inadequate.
“We need to have a better preparedness plan, like on a city level, county level, state level, federally,” said Willette. “And if we don't have preparedness and logistics just in place prior to a potential pandemic or epidemic, our response is going to suck because we're trying again to do what we did in this pandemic which was build the car as we drove it because there was no plan, especially here in Iowa.”
Willette, whose background is in data science, said there are numerous problems with Iowa’s data dashboard, which show percentages, instead of raw data. Raw data is needed to uncover trends about people of color, she said. Other states provide “completely transparent data” and allow users to “drill all the way down” by age and zip codes, she said.
“The state doesn’t even collect socioeconomic data on [COVID-19] positives, which honestly I think we would need because then we can cross-correlate and look and see if there are discrepancies for people of color in certain socioeconomic groups for access to testing, access to vaccinations. Those kinds of things we don’t even have,” she said.
A large percentage of data for race and ethnicity is missing, according to the state’s website. The state labels its missing data as unknown or pending investigation:
20% of positive COVID-19 tests by race are labeled as unknown
21% of positive COVID-19 tests by ethnicity are labeled pending investigation
3% of positive tests are among Blacks
74% of positive tests are among whites
Willette said race is also missing for “roughly 2% of deaths.”
“Are they people of color?” Willette said. “We have no idea.”
The missing information, which is a problem for other states and the CDC, could have provided important details about access to testing and access to vaccinations, which have been a hurdle for Black Iowans, Willette said.
The Urban Indian Health Institute graded each state on its quality of COVID-19 racial data and effectiveness in collecting and reporting data on American Indian and Alaska Native populations. The institute graded Iowa a B- overall, but gave it a D for its percent of cases with complete racial information reported on its dashboard.
Dr. Nicole Del Castillo, director of the office of diversity, equity and inclusion at the University of Iowa Carver College of Medicine, says the pandemic's aftermath is causing large health systems to engage in more dialogue about health care inequities and bias — something she and others have been wanting to address for years.
“I hope that momentum continues. In my mind I don't see this going away,” Del Castillo said. “COVID made it harder to deny.”
During the darkest days of the pandemic, when many Iowans eschewed wearing face masks, infections spread faster than gossip and outbreaks infested long-term care facilities, meatpacking plants and schools, Black Iowans kept going.
A recent Kaiser poll asked respondents to think about their risk of exposure to the coronavirus and how safe they felt working outside of their home. The poll found 51% of Blacks cited “somewhat safe,” 6% cited “not too safe” and 3% cited “not at all safe.”
Nationally, a disproportionate number of Blacks work on the front lines in several industries, including meatpacking and in health care, with 24% as registered nurses, according to National Nurses United, and 29% as health care aides and 22% as direct contact support workers, according to the Kaiser Family Foundation.
During the pandemic, Henderson, 66, who has several chronic health conditions, helped families make final arrangements for their loved ones. N’yla Whitson worried about her young children’s health and education but couldn’t afford to stop working. Couple Andre Crosby and Brandee Harris lost their apartment in Wisconsin and ended up in a Des Moines homeless shelter.
Henderson limited the size of funerals, required protective equipment during embalming and increased the frequency of cleaning, disinfecting and sanitizing.
It wasn’t enough.
“None of that was fool proof,” said Henderson, a funeral director for nearly three decades. “We all came down with COVID; like dominoes we fell.”
She battled COVID-19 and pneumonia for 10 days.
“I got to day three and I was like, ‘Am I going to die?’” she said. “And day four or five, ‘God, just let me die.’ And then a couple of days after that, ‘OK, I guess I’m not going to die so I’m not giving up.’”
Those who isolated themselves away for 16 months are now struggling to reemerge in a society without life preserving face masks required in public, which were largely abandoned by many people after the CDC’s mask guidance in May. Some cities and counties in other states have already opted to reinstate face mask mandates to cope with rising cases fueled by delta. National Nurses United, the largest union of registered nurses, has called for the CDC to reinstate a mask mandate to protect essential workers and others.
Bundy, the Des Moines grandma, is still a little concerned about being outside the safety of her home, but is ready to interact with her family.
“I haven’t seen my mom since October,” she said.
The pandemic weighed heavily on people — especially children — and caused increased anxiety, depression and grief. Pediatric Psychologist Joyce Goins-Fernandez is a clinical assistant professor and vice chair for diversity, equity and inclusion in the Stead Family Department of Pediatrics at the University of Iowa.
“When something tragic happens, children depend on their parents and guardians to determine how they respond to a crisis, and at that time as adults, we didn't know what to expect,” she said.
N’yla Whitson, 31, of Des Moines, an adult mental health care provider, worried about rising cases because her son was born prematurely with respiratory issues.
“I did have fear, but my job doesn’t stop,” she says. “I have to continue to work.”
Helping her children navigate the changes caused by schools shifting from in-person to online learning added yet another challenge in a year and a half filled with them.
“We could have been warned a little sooner,” Whitson says. “They could have done a little more educating and resource finding and problem-solving.”
Easley McGhee said she knew the pandemic was serious when Corinthian Baptist Church where she attends temporarily stopped holding in-person services and moved online.
The pandemic exacted an even worse toll on Henderson’s church, Faith Missionary Baptist Church, which had sat empty for nearly 15 months while services were shared via Facebook Live, Henderson said.
“Our church died with the pandemic,” she said.
Many Blacks lacked the financial safety nets and the ability to weather the pandemic from home offices. Instead, they kept working, or filed for unemployment or worse — searched for a homeless shelter.
A recent Department of Housing Urban Development study reported more than 580,000 people experienced homelessness on a single night in the U.S. in 2020, up from 2.2% from 2019.
Nationally, Blacks account for 34% of the unhoused.
Despite the nation’s economic recovery, Blacks continue to have the highest unemployment rate at 9.2% in June, compared with 5.2% for whites, according to the Brookings Institution.
In 2020, the unemployment rate for Black Iowans was 10.4%, compared with 3.7% for the state, according to Iowa Workforce Development.
Andre Crosby, 34, and Brandee Harris, 37, had their work hours cut and the couple lost their apartment in neighboring Wisconsin. Faced with few options, they temporarily left their nine children with family members and moved to Des Moines when a Google search for jobs ranked Iowa at the top of the list.
Crosby and Harris stayed at a Des Moines homeless shelter for a week, then motels with the help of local social service organizations. They quickly found fast food jobs. But now, they struggle with housing.
“We can’t find an apartment. Every apartment either says something about your criminal record or your credit,” said Crosby, who has a felony in his background. “The credit was good up to the point we lost our jobs.”
They are not alone in their struggle. Polk County is projected to add more than 100,000 new jobs in the next 20 years but it will also and will need an additional 57,000 housing units to keep up, according to a regional study.
Nationally, COVID-19 outbreaks devastated crowded prisons, with 512,864 cases among staff and incarcerated individuals, according to a joint tracking project by the Marshall Project and the AP.
Blacks make up 4% of Iowa's population, but 25% of its prison population. When the pandemic hit in March of 2020, the Iowa Department of Corrections developed an 11-page plan, ended in-person visits — which have recently resumed — and took steps to fight the virus’s spread among 3,669 employees and 7,630 incarcerated individuals. Even so, outbreaks plagued the prison system (which was over capacity by 10%), according to the department’s website:
4,881 incarcerated individuals were infected; 19 died.
709 staff members were infected; two died.
Four incarcerated individuals died of COVID-19 where Sy Roeuth is incarcerated at the Fort Dodge Correctional Facility. He constantly worried about catching COVID-19 while prison staff fumbled efforts to stop the spread, he said.
“It could have been done way better,” he said, in a phone call from the facility. “It was nuts. It was chaos. When it first came out, it was really chaotic. It was messy. They were moving people left and right to different units. It was crazy.”
Quarantining in a small area with strangers proved disastrous.
“That’s how I caught it. They moved people from a different unit trying to clear space assuming that they were negative, but found out they were positive, and I caught that,” he said.
Then came the chills, headaches and the shakes, he said. He was sick for two weeks, but slowly recovered. In May, he got the Moderna vaccine and had only minor side effects.
“It was mismanagement,” he said.
Other prisons faced issues.
After two staff members were killed at Anamosa State Penitentiary last March and inadequate staffing issues were raised, state lawmakers voted to provide the Iowa Department of Corrections with $20 million to boost staffing and security.
In another Iowa prison last April, two nurses were fired for giving 77 men incarcerated at the Fort Madison Correctional Facility six times the proper dose of the Pfizer vaccine, according to the Des Moines Register.
Last month, Des Moines BLM gave Reynolds an “F” grade in seven categories: education, health care, migrant rights, LGBTQ rights, racial justice, serving Iowans and voting rights. The organization held multiple press conferences last May calling for the release of incarcerated people and presenting a list of demands, which included decarceration, ending solitary confinement and long periods of lockdown, not quarantining those who have tested positive with others who haven’t, among two dozen demands.
“Incarcerated people inside Iowa prisons are effectively facing death sentences as the COVID-19 pandemic continues to spread,” the group said in a press release.
Henderson remembers picking up her first COVID case from a Des Moines nursing home in March of 2020 — before outbreaks would become synonymous with long-term care facilities. More than 11,341 long term care residents in Iowa had COVID-19, and 2,429 died from it, according to federal data.
Just 18% of Iowa’s nursing homes meet industry benchmarks for having at least 75% of staff fully vaccinated.
In Iowa, 89% of residents and 60% of staff have been fully vaccinated.
Nationally, 78% of residents and 56% of health care workers are fully vaccinated, according to AARP’s analysis.
The Des Moines nursing home staff would not allow Henderson to go inside their “COVID ward,” she said. Nursing home staff wheeled a Black woman’s body through the dining area where residents were seated.
“You’ve got people saying, ‘Am I going to get cornflakes for breakfast?’ And you’re wheeling a body through that has COVID,” she said.
No masks, isolation, plastic or dignity, she said.
It was the first in a long list of mistakes, then disinformation and misinformation and partisan decisions during an unprecedented health crisis that signaled the state was “flying by the seat of its pants,” Henderson said — and convinced her and others those decisions would result in worse health outcomes for Black Iowans.
“We were ignored as usual,” she said.