COVID-19 cases and related deaths in the U.S. continue to exceed that of any other country in the world. What actions by our government, at all levels (federal, state and local), could have prevented this result?
A priority goal was to communicate to the American people, both by word and deed, an accurate, clear and consistent message about the serious risks posed by the virus, and also about actions individuals and communities could and should take to reduce those risks. We have been fortunate in New Mexico to have Gov. Michelle Lujan Grisham and her administration sounding a clear, consistent message, but neither the federal government nor many other states met this goal.
An equal priority was to organize our governmental response; i.e., decide on the actions the government could take and also which level of government, and which department or agency, should take the lead.
Where was the federal government action required? Within the federal bureaucracy, where was the authority and responsibility lodged? Which challenges should be left to the states? What could we do to protect against virus spread in nursing homes and other congregate living facilities? Should the federal government encourage states to issue statewide health orders? Where the federal and state government actions were inadequate, could we realistically except local governing bodies to meet the need?
Early in the pandemic, the Centers for Disease Control and Prevention and the White House Coronavirus Task Force issued guidelines and recommendations on how individuals and communities could slow the spread of the virus. These included prohibitions on large gatherings, and recommendations for mask-wearing and social distancing in public settings. The federal government made clear these were only guidelines, and that if enforcement were to occur, state and local governments would have to assume that responsibility.
Some governors took aggressive action and issued public health orders to implement the CDC and task force recommendations. Our governor did so, and New Mexico has benefited from her decisive action.
In most states, governors initially took steps to follow the recommendations, but statements and actions by the White House quickly undermined those public health guidelines, and several states followed White House guidance instead.
In Kansas, the state adopted statewide requirements but provided that each county’s governing body could opt out. A CDC study has shown the rate of increase in new cases was greatest in counties that took that option.
Other states issued statewide health orders, but those orders directly contravened CDC and task force advice and preempted local officials from acting to follow public health recommendations.
In Georgia, the governor initially opposed local mask mandates and sued the city of Atlanta to block such a mandate. Later he revised the statewide order to allow, but not require, counties with at least 100 confirmed COVID-19 cases per 100,000 people over the previous 14 days, to require mask-wearing.
In Texas, the governor issued an emergency order permitting certain nonessential businesses to remain open. When an El Paso County judge attempted to keep those businesses closed, the Texas attorney general successfully sued to invalidate the county judge’s order.
The Sept. 21 Government Accountability Office report on COVID-19 quotes one public health official who described the federal response as “incoherent, confusing and uncoordinated.” Unfortunately, that description might equally well apply to the efforts of some states and local governments.
A more effective response would have avoided much of the harm, and many of the resulting deaths.
It is important we determine what that more effective response might have been.