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Though Iowa Gov. Kim Reynolds has been reluctant to order residents to shelter in place due to the COVID-19 pandemic, local officials are debating whether they should take that step themselves.

No local directives are imminent, according to Dubuque Mayor Roy Buol and Dubuque County officials. However, they have been exploring their options as the number of coronavirus cases continues to rise.

“Right now, it’s not something that’s going to happen (immediately),” Buol said ahead of a special City Council meeting Wednesday evening. “(But) the sooner the better.”

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State public health officials on Wednesday announced 21 new cases of COVID-19 in Iowa, a 17% hike from the day before. That brings the state’s total to 145.

The virus has been confirmed in 31 of Iowa’s 99 counties, and health officials Tuesday announced the state’s first COVID-19-related death — a Dubuque County resident aged 61 to 80 who died from complications related to the virus.

Reynolds has rebuffed calls to follow her counterparts in Illinois and Wisconsin by issuing an order closing all nonessential businesses, restricting all nonessential travel and urging people to stay at home to slow the spread of the COVID-19 virus.

Reynolds said positive cases are increasing in large part due to expanded testing.

“We are continuing to evaluate what those metrics look like,” she said, adding she wants to “make sure that we’re not shutting down a state where we don’t need to.”

But many local health care professionals, including oncologist Bobby Koneru, who recently was hired by Dubuque County to serve as a public liaison during the outbreak, said further restrictions are essential.

“We understand that there will be unintended consequences of these drastic measures, but the alternative is worse,” the health care professionals wrote in a letter to local officials. “If we cannot slow the rate of infection immediately, our health care system will be overwhelmed.”

A “surge” of patients needing to be hospitalized due to COVID-19 infection would result in “higher mortality” as doctors and nurses could be left unable to adequately care for critically ill patients, the letter states.

Andrew Butler, president and executive chairman of Dubuque insurance firm Cottingham & Butler, emailed Dubuque City Council members Wednesday requesting the city issue such a local order in the absence of a statewide one.

“During these trying times, doing the right thing to reduce and minimize the impact of COVID-19 offers no good choices,” Butler wrote to city leaders.

He said about 95% of the company’s 800 employees in Dubuque County already are working from home for the foreseeable future, with only essential staff in the offices.

“(Ordering residents to shelter in place) can only have a positive long-term result in preserving life and minimizing infection,” Butler wrote. “The federal government is working diligently to provide financial backstops for those most impacted.”

Local officials have the legal authority to issue such orders, according to Reynolds and Dubuque City Attorney Crenna Brumwell. Reynolds, though, preferred cities not issue their own stay-at-home orders, and urged coordination with emergency management agencies and public health officials.

Brumwell said differing shelter-in-place orders from community to community would create confusion.

According to news reports, Cedar Rapids’ mayor and officials in Linn and Johnson counties have discussed local shelter-in-place orders.

Buol, though, said Wednesday that he’d prefer the governor take that step, and he has told her chief of staff as much.

“It’s much easier and avoids issues of different messages from the cities and the state,” said Buol, who on Monday urged residents to stay home for at least the next 14 days in an effort to slow the spread of coronavirus.

“Everyone is working toward the same goal, and that is to protect the public and give our medical folks the best possible path to success to attack this virus,” he said. “Hopefully, we don’t talk past the point where it’s futile to make that declaration.”

Meanwhile, Dubuque County supervisors this week discussed the possibility of a countywide order shuttering businesses, restricting travel and directing residents to stay home and self-isolate.

Emergency Management Director Tom Berger sent a letter Wednesday to city leaders throughout the county to poll support, or lack thereof, for a countywide shelter-in-place order.

Mayors of some smaller municipalities, though, joined Reynolds in stating they do not think a shelter in place order is necessary at this time.

“We’re not really a hot spot here in Iowa,” said Dyersville Mayor Jim Heavens. “Everybody in Dyersville has done everything they can do to shut the businesses down to almost none. You can pick up food at a restaurant to go. If you need to go to the bank, you can make an appointment. But we’re doing our due diligence and respecting the seriousness of this. I’m content to let that stay where it’s at.”

Heavens said he and other agricultural producers could be hit hard by such an order, and borrowed a line from President Donald Trump recently: “We’re getting to the point where the cure is almost worse than the disease.”

Mayor Jim Adams, of Asbury, said he also believes the order would be overkill for his community.

“It seems like the order from the governor has nearly everything closed,” Adams said. “There’s already no place to go.”

Adams also questioned how enforceable such an order would be, but said he supports the consideration by supervisors “so they can move faster when the time comes.”

Peosta Mayor Jim Merten said he did not support deviating from state and federal guidance.

“One is, we don’t think as a city we have any more data, knowledge or skills to make a better decision than state or federal resources,” Merten said. “Second is, in the city, the residents and businesses are already behaving. We don’t see any benefit to gain by causing that kind of disruption.”

The Associated Press contributed to this article