Opinion/Blog

Governors and the public wage war on COVID-19

By David Toscano

On December 31, 2019, a brief release
<https://www.who.int/csr/don/05-january-2020-pneumonia-of-unkown-cause-china/en/>
appeared on the website of the World Health Organization (WHO). Captioned
“Pneumonia of unknown cause – China,” it briefly reported about a
number of cases of pneumonia of unknown etiology (unknown cause) detected
in the city of Wuhan, a port city of 11 million inhabitants. Few in this
country took note, with the notable exception of scientific specialists in
the areas of infectious diseases and public health.

Halfway around the world, Governors and state legislators were preparing
for their annual legislative sessions.  Virginia was among the first of
the states to convene, and they did so on January 8.  Major changes were
contemplated for the state, since the Democrats had just taken control of
the legislature and held the Governor’s office as well.  On the other
side of the country, Washington state convened its own session on January
13.  Both states were making history as each elected their first women
Speakers in history — Eileen Filler-Corn in Virginia and Laurie Jinkins
in Washington. And Democratic Governors Jay Inslee of Washington and Ralph
Northam were optimistic about making their marks on their states in light
of a strong economy and Democratic majorities. Within two months, they
would join other Governors across the nation, as they confronted the
greatest challenges of their administrations, and their states would be
plunged into the most serious crisis since the Great Depression.

Like much of the public, few state lawmakers  noticed when the US Centers
for Disease Control(CDC) issued a travel warning
<https://wwwnc.cdc.gov/travel/notices/warning/coronavirus-global> advising
against any nonessential travel to China on January 6, or when the virus
began to affect other countries.  Legislators in both Virginia and
Virginia were focused passing their agenda –gun safety legislation,
expanding the minimum wage, energy transformation, and redistricting
reform. Neither legislature seemed worried about COVID-19.  That attitude,
however, changed quickly in the Evergreen state; with its closer ties to
China and the far east, the report that 35-year-old Washington man had
tested positive for COVID 19 after returning from Wuhan appeared ominous.
 By the end of February, Washington had reported 2 deaths, and was
becoming a “hot spot
<https://www.washingtonpost.com/world/2020/03/01/coronavirus-live-updates/>”
for the growing number of cases reported throughout the United States. On
February 29, 2020, Washington Gov. Inslee, at the instigation of public
health officials, declared a state of emergency
<https://www.usatoday.com/story/news/nation/2020/02/29/coronavirus-outbreak-live-updates-oregon-case-italy-level-3-california/4904296002/>.
 COVID-19 had been unleashed upon America.

Washington’s new House Speaker, an attorney who had worked in health
care for years, including a stint in the executive branch, understood
immediately the implications of the disease for her constituents and the
state, and was an immediate supporter of the Governor’s action. “When
we looked at the data, it was clear that we had no choice but to get ahead
of the curve by encouraging social distancing,” she explained.  “We
also had to do some education; some of our members initially viewed this
as a ‘hoax.’ Fortunately, our minority leader stepped up, stating that
the data was there to support decisive action.”

In early January, as both legislatures met, the WHO sent directives to
hospitals around the world suggesting immediate action to control the
virus. Since there was no vaccine, the purpose of the warning was to
prevent the spread of the virus, complicated by the fact that many
“carriers” were asymptomatic and therefore did not realize that they
were putting others at risk. On January 15, an  emergency committee of
international experts met
<https://www.reuters.com/article/us-china-health-pneumonia-factbox/factbox-what-we-know-about-the-new-coronavirus-spreading-in-china-and-beyond-idUSKBN1ZJ039>
in Geneva to assess whether the outbreak constituted an international
emergency.  The same day, crowds cheered as the Virginia legislature
ratified the Equal Rights Amendment (ERA)
<https://www.usatoday.com/story/news/politics/2020/01/15/virginia-passes-era-38th-state-amendment-women/4477813002/>,
becoming the 38th state to do so.

A growing concern

By the February midpoints of the legislative sessions in Washington and
Virginia, a full-scale epidemic was underway in China, and cases were
being reported in places as diverse as Iran and Italy.  South Korea had
initiated a massive testing program
<https://www.propublica.org/article/how-south-korea-scaled-coronavirus-testing-while-the-us-fell-dangerously-behind>
and Singapore was vigorously engaged in fighting the spread of the virus.

The spike in Italian cases did not occur until early March, and thoughts
of a pandemic had not seriously crossed the minds of many state lawmakers,
especially in the Commonwealth, which seemed so far away from China and
even Washington state.  Some Virginia public health officials, however,
were growing increasingly concerned.  Dr. M. Norman Oliver, the
Commissioner of Public Health, and Dr. Lilian Peake, the state
epidemiologist, appealed to Northam, himself a doctor, to act. Despite the
lack of one reported case, Gov. Northam wanted the Commonwealth to be
ready. On March 3, he informed the public about the state’s plan,
attempting not to frighten citizens before the threat was clear.  It would
not take long for the fear to materialize.

On March 10, 2020, after the COVID-19 viral disease had swept through at
least 114 countries and killed more than 4,000 people, the World Health
Organization formally labeled it a pandemic
<https://www.cdc.gov/flu/pandemic-resources/2009-h1n1-pandemic.html>, the
first use of the term since the 2009 H1N1 “swine flu” outbreak.  The
Virginia legislature was about to pass its two-year biennial budget; it
was a time when most lawmakers were scurrying to push their respective
bills over the finish line for passage and looking forward to adjournment.
 While they were now aware that Virginia had reported its first case
<http://www.vdh.virginia.gov/coronavirus/> of COVID-19 on March 7, they
were up against the constitutional deadline for producing a budget.  The
hope remained that “it can’t happen here.” On March 12, they
finished their work and adjourned.

Like Virginia, the Washington state legislature was preparing to adjourn
on March 12, but in a very different environment.  As of that date, the
state had confirmed 457 cases across 13 counties, and recorded 31 deaths
linked to the virus(as of March 27, Virginia had 17).  Before adjourning,
lawmakers gave Inslee budgetary authority to send $200 million for
assistance to the public and rural hospitals.  Inslee had just issued a
new order
<https://www.seattletimes.com/seattle-news/politics/with-crowd-restrictions-to-slow-coronavirus-inslee-uses-emergency-powers-in-a-way-rarely-seen/>
preventing gatherings of 250 or less in the most affected counties. He
then ordered the closing of the schools in those areas. It was only the
beginning.

Ignoring the scientists

The Trump administration largely ignored the warnings
<https://www.nytimes.com/2020/03/19/us/politics/trump-coronavirus-outbreak.html>.
 On Jan. 22, asked by a CNBC reporter whether there were “worries about
a pandemic,” the president replied: “No, not at all. We have it
totally under control
<https://www.nytimes.com/2020/03/17/us/politics/trump-coronavirus.html>.
It’s one person coming in from China, and we have it under control,”
and Larry Kudlow, the President’s Chief Economic Advisor, stated in late
January that the virus would have “minimal impact
<https://www.foxbusiness.com/healthcare/coronavirus-minimal-impact-us-economy-larry-kudlow>”
on the U.S. economy.  Even after the Federal Reserve Board said the
effects
<https://www.politico.com/news/2020/02/25/kudlow-white-house-coronavirus-117402>
“could… spill over to the rest of the global economy, and the warnings
of the CDC”  Kudlow persisted:  “I don’t think it’s going to be an
economic tragedy at all,” he proclaimed
<https://www.politico.com/news/2020/02/25/kudlow-white-house-coronavirus-117402>.
  State Governors knew better and could no longer wait for a federal
response.

Flattening the curve

State Governors possess extraordinary emergency powers
<https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2020/03/05/states-have-immense-powers-to-fight-coronavirus>,
and began using them. Emergency declarations permit governors to mobilize
the National Guard, close schools, invoke curfews, and prevent gatherings.
 They allow states to redirect health care workers to where they are
needed and organize hospitals to meet the demands of an outbreak. They can
seize properties to create emergency medical centers if hospital beds are
not available. They can impose quarantines. And it now appeared that they
would use every tool at their disposal.

With the federal response lagging, the action would be in the states. The
mobilization against the virus involves local and state health
departments, state emergency preparedness offices, and state and local
first responders, all of which are under the control of individual states.
  Most of the testing would likely be coordinated through state auspices,
even if the federal government eventually stepped up to provide the kits.
And finally, coordination of hospital beds, which were threatened to be
overrun with virus cases, is largely a state responsibility. If there was
ever an argument for “why states matter,” this was it.

From the first recognition of the crises, most Governors, independent of
party, knew that the best prospects for confronting the virus involving
“bending the curve” of transmission.  Use of the term “social
distancing” became commonplace, as chief executives first implored, and
then compelled, citizens to remove themselves from extensive contact with
others.  New York’s  Andrew Cuomo declared a state of emergency
<https://www.nytimes.com/2020/03/07/nyregion/coronavirus-new-york-queens.html>
on March 7, and then  deployed the state National Guard
<https://www.nytimes.com/2020/03/10/nyregion/coronavirus-new-rochelle-containment-area.html>
to New Rochelle, a small community north of New York City, to enforce a
1-mile “containment zone” in response to a sharp uptick in cases. On
March 12, he effectively shuttered Broadway
<https://www.usnews.com/news/health-news/articles/2020-03-12/new-york-bans-large-gatherings-closes-broadway-as-coronavirus-spreads>
with his prohibitions of gatherings over a certain size. New York was
about to pass Washington state in reported COVID-19 cases, and Cuomo was
asserting control
<https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2020/03/20/governors-leapfrog-feds-on-coronavirus-response?utm_campaign=2020-03-20+SD&utm_medium=email&utm_source=Pew>.
 “Be upset at me,” he said. “The buck stops on my desk. I assume
full responsibility.”

Cuomo and other  Governors were now seeing exponential increases in the
reported cases that appeared eerily similar to the trajectory in Italy,
and felt compelled
<https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2020/03/20/governors-leapfrog-feds-on-coronavirus-response?utm_campaign=2020-03-20+SD&utm_medium=email&utm_source=Pew>
to act.  On March 17,  Texas Governor Gregg Abbott joined 20 other state
Governors, including those in California, Florida and Arizona, in
mobilizing the National Guard
<https://www.houstonchronicle.com/news/article/Abbott-Texas-National-Guard-activate-coronavirus-15137717.php>.
 By March 20, 2020, 45 states had closed all or a portion of their
schools; this meant that at least 118,000 U.S. public and private schools
were closed
<https://www.edweek.org/ew/section/multimedia/map-coronavirus-and-school-closures.html>,
affecting at least 53.7 million school students. Several state Governors
cancelled their presidential primaries
<https://apnews.com/1cf882a5a45b584e30e0663fb7667421>, with Ohio Governor
Mike DeWine doing so the day before voting. On March 19, Gavin Newsom, the
Governor of California “shut down
<https://www.latimes.com/california/story/2020-03-19/gavin-newsom-california-1-billion-federal-aid-coronavirus?utm_campaign=2020-03-20+SD&utm_medium=email&utm_source=Pew>”
the most populous state in the nation by directing residents, with certain
exceptions, to remain at home, affecting not only  40 million
inhabitants, but an economy which is 6th largest in the world. Even state
legislatures adjourned or suspended their sessions in response to the
crisis.  By March 20, 20 legislatures had either postponed, suspended, or
adjourned their sessions
<https://www.ncsl.org/research/about-state-legislatures/2020-state-legislative-session-calendar.aspx>
due to the outbreak. It would fall mainly to Governors to manage the
crisis.

Hobbesian choices

For the most part, the public has backed the action of state Governors.
The words “flatten the curve” are heard and seen everywhere, from
internet sites to billboards to Barack Obama’s twitter posts.  But to
say that it has been an easy choice for states to curtail business with
stay-at-home edicts is simplistic at best.  Although Governors clearly
understand the public health rationale for keeping citizens at home, they
are also mindful of the economic impacts of such plans. There are
significant political and ethical dilemmas for chief executives worried
not only about the curve which represents the spread of the virus, but the
downward spiral of their economies without the influx of dollars which
flow from employment and economic activity.  When people do not work, and
businesses are not open, families are left with fewer resources to buy
food and pay their bills.  And the state government is not receiving the
revenue necessary to pay for schools and key services.  When  Nevada
Governor Steve Sisolak imposed a month long freeze on gambling
<https://apnews.com/a5dcac18b0637e1b7a103bd0c37532fb> in mid-March, he was
undoubtedly cognizant of how his action would affect an industry that
fuels the state’s tourism and hospitality-powered economy. It was a risk
he was willing to take, because the alternative appeared much worse.
Similarly, Governor Cuomo, while acknowledging  his state’s economy was
taking a hit, has placed health concerns above all else
<https://nypost.com/2020/03/20/coronavirus-in-ny-cuomo-orders-lockdown-shuts-down-non-essential-businesses/>.
Announcing the shutdown of all non-essential services in the state on
March 20, he explained,  “I want to be able to say to the people of New
York — I did everything we could do….“And if everything we do saves
just one life, I’ll be happy.”

Governors around the country are struggling to find the appropriate
policies that keep some level of economic activity while flattening the
curve of infection.  They will continue to do so if only because they will
eventually have to decide when to relax some of the most severe measures.
Some, including Gretchen Whitmer
<https://www.wlns.com/news/health/coronavirus/livestreaming-now-whitmer-updates-states-covid-19-response/>
of Michigan, Kate Brown of Oregon, Ralph Northam of Virginia, and Jay
Inslee, had not yet issued stay-at-home orders, even as they left open
that possibility.  As they do, they also they are also understanding the
impacts on their state economies and budgets.  All are working feverishly
to bend the curve, relaxing testing requirements so that medical providers
and first responders would know whether they had the virus, collecting and
distributing masks and protective gear, and planning to expand hospital
capacity to address a potential surge in patients. Nonetheless, the states
are feeling the economic impact; n Washington state, Employment Security
Department commissioner Suzan LeVine reported that “[t]his week, every
day, the new claims
<https://www.seattletimes.com/business/washingtons-unemployment-system-flooded-with-claims-as-coronavirus-fallout-grows/>
we are receiving are at the level of the peak weeks during the 2008/2009
recession. “Virginia unemployment claims in the week of March 16 were
greater than for all of 2019
<https://www.virginiamercury.com/blog-va/more-virginians-filed-unemployment-claims-this-week-than-in-all-of-2019/>,
and the Governor’s economic advisors were warning of a massive downtown
in state revenues in the 2nd quarter, a fact that would undoubtedly force
major budget cuts.

Life takes precedence

Governors have substantial power– and all realize the choice; flattening
the viral curve will almost certainly make the economic curve steeper.
And most have chosen efforts to save lives,  heeding the advice of
National Institutes of Health’s Dr. Anthony Fauci, who recently stated
<https://www.vox.com/future-perfect/2020/3/20/21179040/coronavirus-us-italy-not-overreacting>
“Some will look and say, well, maybe we’ve gone a little bit too
far,” he said. [But] when you’re dealing with an emerging infectious
diseases outbreak, you are always behind where you think you are if you
think that today reflects where you really are.”  As Northam put it in a
media briefing on March 22, “this is a health crisis and we will be
dealing with this for months, not weeks.  Our economy will be stronger as
soon as we get this health crisis under control.” Our economy will be
stronger as soon as we get this health crisis under control.”

By March 29, the COVID-19 case reporting curve in Virginia was bending
upward; 890 cases had been reported in the Commonwealth, and 22 had died
from the disease.  By contrast, in Washington state, the Department of
Health announced the adding of 1000 cases on March 28, bringing the
state’s total to 4310, including 189 deaths, undoubtedly a reflection of
the earlier appearance of the virus.

Coming confrontation with Washington

Throughout the month of March, the public was treated to daily press
briefings from the White House illustrating frequent differences of
opinion between Trump and the scientific experts as well as foreshadowing
an emerging political and legal confrontation between the President and
state Governors. By contrast, the daily press briefings of New York
Governor Cuomo, with their combination of empathy, scientific information,
and warnings had become “must see TV” for those starved for leadership
at the federal level. Trump’s proclamation that he “ would love to
have the country opened up and just raring to go by Easter” roiled
Governors as they witnessed exponential growth in cases in their states
and saw dire forecasts of what might be coming.  Sophisticated modeling at
the University of Washington, for example, was predicting
<http://www.healthdata.org/research-article/forecasting-covid-19-impact-hospital-bed-days-icu-days-ventilator-days-and-deaths>
that Virginia would experience its peak impact of cases and demands for
hospital beds in early May,   even with all the regulations remaining in
place; because Washington state began prohibitions earlier, its peak was
projected for mid-April, and its death toll would be marginally less than
the Commonwealth’s.  Governors were increasingly concerned about their
state’s resources being overtaxed and whether federal help would be
available in a coordinated fashion. They were also worried that relaxing
regulations in one state might allow the spread of the virus into their
own. “The patchwork remains a patchwork as long as the federal
government doesn’t step up and recognize this is a war,” Illinois
Governor J.B. Pritzker argued
<https://www.politico.com/news/2020/03/27/coronavirus-trump-governors-152539>.
“The federal government needs to lead and until it does, we will be a
leader here in Illinois.”

Regional efforts continued to increase coordination and consistency across
state lines. In late March, Connecticut, New Jersey, New York and
Pennsylvania coordinated their regulations regarding the closure of bars,
movie theaters, malls and bowling alleys, all in an attempt to avoid a
patchwork of prohibitions. Many observers speculate on what will occur if
Trump attempts to “reopen America,” whether it occurs at Easter or at
some other time.  He may be met, at least in some sections of the country,
by massive disobedience, especially if the death toll continues to rise
precipitously.  More significantly, it is not clear what power he has to
force relaxation of state prohibitions.  Governors appear to have the
constitutional powers
<https://www.brookings.edu/blog/fixgov/2020/03/25/trump-or-governors-whos-the-boss/>
to impose these rules and, absent the President withholding certain types
of aid from states who fail to comply with his edicts, it is unclear what
he can do. We may be headed toward this confrontation, the results of
which may determine the extent to which states matter.

Toscano served seven terms in the Virginia House of Delegates representing
the 57th District, which includes all of Charlottesville and parts of
Albemarle County.

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