Iowa Gov. Kim Reynolds holds a news conference on COVID-19 at the State Emergency Operations Center on Tuesday, April 28, 2020, in Johnston Iowa. (Brian Powers/The Des Moines Register via AP )

Iowa Gov. Kim Reynolds holds a news conference on COVID-19 at the State Emergency Operations Center on Tuesday, April 28, 2020, in Johnston Iowa. (Brian Powers/The Des Moines Register via AP )

IOWA CITY, Iowa (AP) — A team of experts advised Gov. Kim Reynolds last week not to relax social distancing rules, warning that doing so at this point could cause a second wave of infections and that Iowa could suffer “catastrophic loss of life” even under strict limits, according to documents released Tuesday.

Days after receiving that warning, the Republican governor signed orders to partially reopen 77 of Iowa’s 99 counties and allow in-person church services and farmers markets to resume statewide. She said Monday that the state must learn to live with the coronavirus and balance health and economic concerns.

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The warning came in a research paper authored by seven professors of biostatistics and epidemiology at the University of Iowa’s College of Public Health. The governor’s office released the paper Tuesday after Reynolds outlined her rules to reopen restaurants this week.

Pat Garrett, a spokesman for Reynolds, said mitigation strategies remain in place even in the counties that are partially reopening, including bans on gatherings of more than 10 people.

Researchers warned that their modeling found a huge degree of uncertainty in how the pandemic will unfold, “from relatively low fatalities to catastrophic loss of life.”

One model predicted that Iowa could see 747 deaths by May 28, and that a range of 316 to 965 by then seemed likely. But researchers warned that death tolls in the thousands were also plausible, even assuming that business closures and other limits remained in effect.

The state had reported 136 deaths and more than 6,300 confirmed cases as of Tuesday. The actual number of infections is thought to be far higher because many people have not been tested and studies suggest that people can be infected without feeling sick.

The researchers said that the spread of the virus in Iowa was slowing, but it had not peaked.

“There is considerable uncertainty still in how many cases and deaths Iowa could eventually have, with possible projections between 150 and 10,000 total deaths. Therefore, prevention measures should remain in place,” they wrote. “Without such measures being continued, a second wave of infections is likely.”

Researchers said the the state’s interventions, including closing schools and some businesses, slowed the spread but may not be “sufficient to prevent a return to higher rates of transmission and corresponding mortality.”

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Reynolds is one of the few U.S. governors who didn’t issue statewide stay-at-home orders.

In another paper released Tuesday, researchers warned that a widely-cited University of Washington model “likely underestimates the potential for significantly more severe outcomes” in Iowa. That model projects that Iowa will have 349 COVID-19 deaths through Aug. 4.

The Iowa Department of Public Health signed a contract with the college to help model the pandemic this month, and its work continues.

One of the researchers, professor of epidemiology Eli Perencevich, warned Tuesday on Twitter that the state is “opening up at the exact wrong time,” calling it a tragic error that could soon overwhelm hospitals.

He said that he had been most worried about outbreaks at long-term care facilities, including one confirmed Tuesday at the Iowa Veterans Home in Marshalltown. The home is one of the nation’s largest for veterans, housing more than 500.

“High levels of community transmission places these vulnerable veterans at very high risk,” Perencevich wrote.

Health officials reported Tuesday that an additional 508 people in Iowa had tested positive for COVID-19 and nine more people had died of the disease. Another 304 were hospitalized, one-third of them in intensive care.

The state’s numbers reflected testing through Monday at 10 a.m. and didn’t include 405 additional cases announced in Black Hawk County, one of the state’s hot spots. The county said that 1% of its 131,000 residents had tested positive, most of them linked to a Tyson Foods pork processing plant in Waterloo that closed last week.

Reynolds said the state would open a mobile testing site Wednesday in Waterloo for essential workers and others who qualify. She said another would open soon in Woodbury County, which has seen a surge of infections tied to an outbreak at a Tyson beef plant in Nebraska.

Despite the worsening situation in some cities, the governor moved ahead with her partial reopening plans. Restaurants, some bars, malls, retail stores, libraries and gyms will be allowed to reopen Friday in 77 counties under new health rules.

The governor said 98% of Tuesday’s cases and 7 new nursing home outbreaks were in the 22 counties that have tighter restrictions in place through May 15. She encouraged residents to soon return to their favorite restaurants, saying they will be safe to visit.

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