The country is recording more than 158,000 new cases per day on average, the highest so far of the pandemic; more than 76,000 people are hospitalized with the virus nationwide, far higher than earlier peaks; and deaths are again on the rise. President Trump has largely ceded the pandemic response to governors, and the states where the virus is emerging at the highest rates — North Dakota, South Dakota and Iowa — are all Republican-led.
In Iowa, Ms. Reynolds had been facing pressure for months — from mayors, doctors, nurses and farmers, who feared that rising cases could lead to interruptions to the food supply chain in a state where agriculture and meat processing are major industries.
Like most other governors, Ms. Reynolds closed down businesses in the spring, but she resisted issuing a stay-at-home order and did not require masks as communities reopened.
Now, as the virus surges across the Midwest, more than 4,100 people are testing positive for the virus in Iowa every day on average, an 86 percent increase over the last two weeks. Hospitalizations have doubled in the same period, and coronavirus patients now make up one out of every four hospitalizations in the state.
The crisis led to a significant move last week, when the Iowa State Board of Health, whose members Ms. Reynolds appointed, urged her to issue a mask mandate. The board’s vote was itself a sign of how the virus’s worsening toll has forced people to change their thinking. Board members, most of whom are Republicans and work in health care, had discussed face coverings at previous meetings but did not come out in favor of a mandate.
At the most recent meeting, however, they voted 7 to 2 to encourage the governor to issue the order.
“Circumstances have changed enough in Iowa,” said Chris Atchison, the board’s vice chair, who said he could recall only one other instance in which members had made a recommendation to the governor in his more than three years on the board.