WASHINGTON — President Trump’s mad dash to campaign with in-person rallies and other events this week will take him to Iowa, a state that even the president’s own Covid-19 task force has warned is seeing an uptick in preventable deaths due to the coronavirus.

He’ll visit Pennsylvania and North Carolina, too, both of which have also seen cases spike in the last week. Monday night, he held an event in Florida.

But the Iowa stop is the most audacious move, particularly after Trump himself was hospitalized roughly one week ago with Covid-19. The state is experiencing record high hospitalizations, with 463 reported on Monday alone. Iowa’s statewide positive rate is up 9.5% over the last two weeks, according to STAT’s Covid-19 Tracker. Public health officials are struggling to contain the outbreak; Republican Gov. Kim Reynolds has refused to implement a number of public health best practices that are meant to contain the spread.

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“Iowa is one of the states where the virus is out of control,” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.

Angela Rasmussen, a virologist at Columbia University, told STAT that it’s impossible to say how likely the rallies are to turn into so-called super spreader events. She said that upon learning of the event she was not surprised, but had a reaction closer to “banal horror.”

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“He got coronavirus for having events that are in-person without masks, that downplay the seriousness of this pandemic,” she said. “I’d still like to think that at some point the president will perhaps take stock of having those types of events.”

The Trump team’s rapid return to the campaign trail is extraordinary given Trump’s inner circle has been roiled by Covid-19 cases. At least 10 officials tied to the Trump administration have tested positive for the virus, including Trump, first lady Melania Trump, and White House press secretary Kayleigh McEnany.

Tim Murtaugh, director of communications for the Trump campaign, downplayed the risks of the event, citing that it is being held outdoors and that attendees will have their temperature checked and masks will be distributed.

“The event is at an open door airplane hangar where people will be expressing their First Amendment rights and hearing from the President of the United States. We will have safety protocols in place,” he wrote in a statement to STAT.

Few supporters could be seen wearing masks during Trump’s rally Monday in Florida. The lack of masks was especially shocking given the campaign said they would hand out masks to attendees, as they will in Iowa, and Trump even threw out masks to his supporters as he took the stage in Florida.

Wednesday’s rally in Iowa will be held at Des Moines International Airport.

Attendees, however, are not required to socially distance. At the rally held Monday night in Florida, attendees stood shoulder to shoulder. The lack of social distancing protocols stands in start contrast to his challenger, Joe Biden, who typically requires attendees to sit in their own “bubbles” far away from other attendees.

In recent days, Biden has held small events in Georgia and Pennsylvania, both of which have seen rises in Covid-19 cases over the last week, according to STAT’s coronavirus tracker. 

At the event in Iowa and other states, the Trump campaign is requiring attendees to agree to liability waivers, which state “you understand and expressly acknowledge that an inherent risk of exposure to COVID-19 exists in any public place where people are present.”

When there’s such a high level of community transmission, like in Iowa, “you’re almost guaranteed” to have some transmission of the virus, even when a rally is held outdoors, explained Johns Hopkins Adalja.

“Along with all of your supporters, the virus is likely to be there as well,” he said. “You’re going to get exposures, you’re going to have cases there. It’s a question of: Will they be manageable?”

Even Trump’s own team has already acknowledged the dire situation unfolding in Iowa. On Oct. 4, his White House coronavirus task force warned that the state was in the “red zone,” meaning it had one of the highest Covid-19 transmission rates in the country. The task force also warned that Iowa is seeing “many preventable deaths.”

Iowa is also likely doing worse than the already alarming publicly reported metrics suggest, because the state is doing the “bare minimum” number of Covid-19 tests per day, according to Cyrus Shahpar, the director of the Prevent Epidemics Team at Resolve to Save Lives.

“We are kind of getting an incomplete picture,” Shahpar said. “Iowa … is probably a little bit worse than what the case number actually reflects.”

Another cause for concern: Iowans aren’t following public health advice for mitigating the spread of the virus. Few wear masks and public health officials have even heard anecdotal cases of Iowans handing out the phone number of local health departments and telling people not to answer when they call, according to Lina Tucker Reinders, the executive director of the Iowa Public Health Association.

“We’ve moved from a stage of disease prevention to quarantine avoidance,” she said. “One of our biggest concerns is simply getting people to follow mitigation strategies that we know work.”

Reynolds, the governor, has also publicly clashed with public health officials and refused to implement a statewide mask mandate. She has called city mandates unenforceable. She mandated that schools conduct at least half of their instruction in person, prompting a standoff with the Des Moines school district. And she crafted her own state quarantine policy, which clashes with the CDC’s own recommendations and does not require people who are potentially exposed to Covid-19 to quarantine if both people were wearing masks during the potential exposure.

“We don’t need a super spreader event in Iowa,” Tucker Reinders said. “Our local public health departments are so tasked already.”

Were it not for the pandemic, the campaign in Iowa would seem logical. Polls show that Trump is in a dead heat with Joe Biden in the state, despite winning it by more than 9 points during the 2016 election. One of the state’s Republican senators, Sen. Joni Ernst, is struggling to stave off a vigorous campaign from Democratic challenger, Theresa Greenfield.

“Do I think [the rally is] something that he has to do? Probably, yeah,” said John Stineman, a longtime Republican strategist based in Iowa. “There’s a reason why he’s coming, and it’s because Iowa is tight.”

Stineman said the Trump campaign has a responsibility to take precautions to prevent the spread of Covid-19, but he asserted that political benefits of the event, including local media coverage and increased enthusiasm from his base, would likely outweigh any negative press generated from the rally.

“For them it’s worth it to take the hit,” Stineman said. “There is nothing more powerful than a presidential visit.”

Dave Peterson, a professor of political science at Iowa State University, isn’t convinced the rally is a winning strategy, especially if Trump’s rally flouts basic public health best practices.

“If it’s not following social distancing, or people aren’t wearing masks, it’s just going to remind a lot of people who are working very hard and are struggling to get through this that the rules are going to be flouted,” Peterson said. “And if the rules are going to be flouted, I think that makes a lot of people pretty angry.”

  • How can Trump do this to people that are so willing to support him that they will risk life, limb and loved ones to show up at a gathering that he holds despite the risk to them? It increasingly appears that Trump uses people and readily trashes them out because they mean nothing to him.

    • Well said Sam. And Trump either did not have Covid (using his own favorite line : it’s fake news !!) or the effect on his brain is “increased rot” as displayed in full disregard of what sickened millions and killed over 200,000 (and counting).

  • The stupid brash defiant rally in Iowa is early enough for attending careless people to succumb to super-spreader effects before election day – and that might be the wake-up call needed for lax / careless / selfish people to shape up. To the strained health care workers in Iowa in this hopeless scenario precipitated by wrong attitudes (even by the “leader”) I would say : move out – you will be very much welcomed in smarter states elsewhere.

  • data source CDC; period: Feb1-Oct03
    -Iowa official COVID19 deaths: 1399
    -Iowa Excess deaths: 1757-2278
    as compared to same period for years 2015-18 (adjusted for demographic increase)

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