The spread of COVID-19 is surging in Iowa, with the state reporting an additional 189 infections, including 86 employees of a Tyson food plant in Louisa County.

Six additional Iowans were reported Tuesday to have died as a result of the virus, bringing the total number of deaths in the state to 49.

On April 6, Tyson Foods announced the suspension of operations at its plant in Columbus Junction, noting that two dozen employees at the facility had tested positive for COVID-19. On Monday, the company said it would keep the plant closed at least through the end of this week.

That same day, National Beef announced that it was suspending operations at its Iowa Premium plant in Tama until April 20, due to a COVID-19 outbreak among employees.

At her daily news conference Tuesday, Iowa Gov. Kim Reynolds indicated the plants are being “proactive” and have already taken the steps necessary to protect workers by providing them with screening, masks and face shields, and by encouraging workers already sickened to stay home.

“We’ve also reached out to other packing plants and businesses with the guidance that the Department of Public Health has provided to businesses,” she said.

Asked what steps the state itself is taking to mitigate the spread within Iowa’s food processing plants, Reynolds said, “Actually, when I reached out to the CEOs of both the plants, they indicated they had already taken the steps. So they’re trying to be very proactive to not only protect their workforce but to make sure they can, you know, can keep the plant up and going.”

As for any role the state might play in determining when the food plants might resume operations, Reynolds said, “They’re making those decisions … We’re going to continue to work with them, continue to test, continue to understand what the scope of that looks like and how we can, you know, do everything we can to that in a safe and responsible manner. And so they are making those decisions.”

More COVID-19 cases at long-term care facilities

Three of the additional infections reported on Tuesday involve residents of long-term care facilities: the Bartels Lutheran Retirement Community in Bremer County; Trinity Center at Luther Park in Polk County; and On With Life, a residential rehabilitation facility in Polk County.

The staff and residents of Iowa’s long-term care facilities account for 10% of all confirmed cases of COVID-19 in the state, and the residents account for 53% of all related deaths.

The Iowa Department of Inspections and Appeals, which inspects the state’s nursing homes, said on March 30 that its inspectors do not have any personal protective equipment, or PPE, to use when they go inside nursing homes.

The agency has said that it relies on the facilities themselves to provide PPE, adding that the equipment “is not needed” for some inspections.

Asked whether she’s concerned about that, Reynolds said, “PPE has been a concern from the very beginning and we’re continuing to do everything we can to make sure that we ’re ordering, and that we’re ordering from every possible opportunity that we have to bring resources into the state in addition to standing up businesses and the Department of Corrections and families that are working to provide the additional PPE that we need.”

She said the state “continues to monitor, to manage, and to let the facilities know how they can utilize the PPE that they have and to make sure they understand where they need to go through to order it if they’re not ordering it on their own.”

Asked whether any of the state’s nursing home inspectors have tested positive for COVID-19, Reynolds said, “I don’t believe they have. To my knowledge, they have not.”

The state inspectors’ reliance on nursing homes’ infection-control equipment coincides with a recent directive from the federal Centers for Medicare and Medicaid Services instructing the inspectors to focus on those homes and hospitals cited for the most serious infection-control violations.

CMS says state agencies like DIA are “constantly evaluating” their inspectors to ensure they’re unlikely to transmit a virus when entering a facility.

The federal agency says that while state inspectors may have been in a different care facility with COVID-19 cases during the previous 14 days, the fact that they wear PPE means that “they pose a low risk of transmission in the next facility, and must be allowed to enter.”

Iowa has not restricted the use of temporary, employment-agency caregivers who may work in two or three different nursing homes per week.

Instead, the Iowa Department of Public Health is “encouraging” the facilities to limit the use of such workers and is trusting the owners to, in the department’s words, “manage their workforce and ensure adequate patient care.”