Democrats in Iowa believe that Reynolds’s inaction has always been about politics. Early on, she’d assumed an important role making sure that Trump would win Iowa in the November election, State Senator Joe Bolkcom, who represents Iowa City, told me. “She did that by making people feel comfortable” about going out to eat, going to bars, and going back to school. “She mimicked Trump’s posture” to get him elected. Ultimately, Reynolds was successful in her efforts: Trump won Iowa by 8 points. But Iowans lost much more.

Iowa’s problem is not that residents don’t want to do the right thing, or that they have some kind of unique disregard for the health of their neighbors. Instead, they looked to elected leaders they trust to tell them how to navigate this crisis, and those leaders, including Trump and Reynolds, told them they didn’t need to do much at all. (Although some residents have certainly deliberately ignored the advice of public-health experts.) “When our strategies are not consistent with CDC evidence, when we are not adhering to even the advice of the White House task force, it raises questions in people’s minds on the seriousness of the pandemic and the validity of the mitigation strategies,” Lina Tucker Reinders, the executive director of the Iowa Public Health Association, told me. “People don’t necessarily know what the right thing to do is.”

Which means that not only are health-care professionals tasked with saving sick Iowans’ lives, but it’s also fallen on them to communicate the truth about the pandemic.

Before last spring, Brian Gehlbach told me he was decidedly not a “social-media person.” Now, though, the 51-year-old critical-care physician spends hours on the weekends carefully crafting long Facebook posts about COVID-19. He writes about masks’ effectiveness in preventing the virus’s spread, attaching illustrations and graphs as evidence; he offers warnings about the precarious state of Iowa’s intensive-care units; and he patiently unpacks the concept of the tragedy of the commons. (Occasionally he throws in a photo of his cat for levity.)

Gehlbach told me about his weekend routine while we sat outside the hospital on a cold park bench, as the straps of his mask pulled down on his ears, making him look like a gray-haired elf. In his posts, which are public and in many cases widely shared, Gehlbach never mentions Trump or Reynolds by name, and he doesn’t refer to Republicans or Democrats. Framing the pandemic around partisan politics makes Iowans tune out, he says, and right now, health-care workers desperately need them to listen. “I just feel compelled to try to reach as many people as I can so that we can save lives, so they won’t have regrets, so we have beds, so that my colleagues will suffer a little bit less,” Gehlbach told me.

The crisis in Iowa’s hospitals could be improved in a matter of weeks if Iowans started wearing a mask whenever they leave the house and stopped spending time indoors with people outside their households. But doctors posting diagrams to Facebook can do only so much, Gehlbach acknowledges. Without state leadership on board, none of those changes will happen. “The endgame of uncontrolled spread is a choice between massive death and suffering and overflowing hospitals, or shutting things down,” he said. “This is the equivalent [of] choosing between death or amputation—when you could have had an earlier surgery, which would have been painful but would have prevented this scenario from developing in the first place.”

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