After shaky start, federal and state authorities start to work in tandem

Category: News

Washington; Austin, Texas; and Rutledge, Ga.

When crisis hits, people often look to government for guidance and answers. In the American federalist system – with power divided among national, state, and local government – the layers can make for confusion and an uneven initial response.

But over time, experts in crisis management say, the United States has a history of getting it right. See the 9/11 attacks of 2001, the financial meltdown of 2008, and, in an earlier era, the Japanese attack on Pearl Harbor. 

And so it may ultimately be with the global outbreak of the lethal COVID-19 virus, which originated in China last December. President Donald Trump won praise for his Jan. 31 decision to ban travel to the U.S. from China, but has since faced fierce criticism over his initial downplaying of the threat on American soil, the delayed access to widespread testing, and missteps in communication

With the White House coronavirus task force now holding daily televised briefings, and with testing ramping up, the federal response appears to be getting more on track.

At the same time, many governors, mayors, and other local officials around the country have essentially taken matters into their own hands – closing schools and ordering restaurants, bars, gyms, and other establishments to close. To some, this piecemeal effort reflects the American federalist system at work, allowing local authorities to address local circumstances as they see fit. To others, it reflects a lack of federal leadership amid a viral outbreak that knows no geographic borders. 

“The feds have been asleep at the switch. If we do this on a regional basis, we are going to get through it,’’ New York Gov. Andrew Cuomo said Monday, after announcing a series of closures in concert with the governors of neighboring Connecticut and New Jersey. San Francisco Mayor London Breed, meanwhile, declared a lockdown until at least April 6 – the most stringent measure to date in the country.

On Monday morning, Mr. Trump told the nation’s governors in a teleconference that they should work on getting respirators and ventilators on their own, and not wait for the federal government. At a press conference Monday afternoon, the White House issued new guidelines for behavior, including home-schooling children, avoiding gatherings of more than 10 people, avoiding unnecessary travel, and avoiding eating in bars and restaurants. The Dow Jones Industrial Average lost 13% on Monday, falling nearly 3,000 points in the second worst day in its 124-year history.

To Patrick Roberts, author of the book “Disasters and the American State,” the American system of government is not designed for efficiency or unilateral decision-making. Preparing in advance for disaster is key, at all levels of government, he says. 

“The coronavirus pandemic isn’t totally out of the blue,” says Mr. Roberts, a political scientist at the Rand Corp. think tank. “Planning should be done ahead of time at the level of experts for how government, as well as the private sector and nonprofits, should respond.”

The Trump administration has been slammed for eliminating the National Security Council’s office on pandemic response in 2018. Former national security adviser John Bolton, who was fired last September, defended the decision in a tweet. “Global health remained a top NSC priority,” he wrote, citing the response to the 2018-19 Ebola crisis in Africa. 

Mr. Roberts notes that Americans’ expectations of the president during a crisis have grown since the founding of the republic, as the presidency and executive branch have taken on more power. 

“At the founding, disasters were the responsibility of states and localities,” he says. “In the 20th century, particularly the second half, the president really became a central figure in managing the response to large-scale disasters.”

A key ingredient, experts say, is trust – between citizens and government, and among different levels of government.

“The most important quality [in a response] is credibility,” says Joshua Sharfstein, vice dean for Public Health Practice and Community Engagement at Johns Hopkins University in Baltimore. 

Partisan tensions haven’t gone away, especially in a presidential election year. Earlier this month, President Trump referred to Washington’s Democratic governor, Jay Inslee, as a “snake” after the governor issued a critical tweet. Seattle is the original coronavirus “hot spot” in the U.S., logging the most deaths so far, though now second to New York in total cases. 

Yet amid the biggest national crisis since 9/11, there has also been praise across the aisle. 

California’s Democratic governor, Gavin Newsom, praised Mr. Trump last week for his handling of an outbreak of COVID-19 on a cruise ship that docked in Oakland, California. Specifically, Governor Newsom – who has been strongly critical of Mr. Trump on other occasions – thanked the president for the logistical support that allowed the passengers to disembark and then go into 14-day quarantine. 

“I am working to solve problems,” Governor Newsom told reporters last Thursday. “I’m willing to put aside our differences on a lot of issues to meet this moment.” 

The view from Georgia

Carey and Hadley Holmes frequently take their two young sons, Waylon and Walker, to a playground at Hard Labor Creek State Park. But since Georgia’s Republican Gov. Brian Kemp decided to place a quarantine facility there, “needless to say, we’re not going there anymore,” Ms. Holmes deadpans.

With seven trailers in a glade at the back of the 5,800-acre park, the containment camp is a unique and controversial move – managed not by public health officials, but the state’s Department of Natural Resources.

Mr. Holmes notes that the arrival of an asymptomatic person last week who had tested positive was the first known case of COVID-19 in the county, adding, “We didn’t have a choice in the matter.” (That individual is now heading home.)

Indeed, as states like Georgia take the lead in responding to the pandemic, the placement of a coronavirus containment camp in a county with no known cases underscores the degree of trust that residents have to maintain in their government’s response.

Outside the entrance to the camp, a state police trooper talks briefly to a photographer and then promptly sanitizes his hands. His demeanor is friendly, but firm.

Small, rural, yet close to both the Centers for Disease Control (CDC) and state government in Atlanta 58 miles away, Rutledge, Georgia, in many ways makes sense.

State officials have tried to be as transparent as possible about the camp, but Governor Kemp acknowledged last week that there has been widespread pushback.

Resident Lakeisha Daniel, taking a walk through the largely deserted town, says she still has questions about the potential impact on residents.

“Right now, it’s more like a wonder, rather than just venting on it,” she says.

The view from Texas

Since early February, Texas has had a front-row seat for federal containment efforts through accepting repatriated Americans from COVID-19 hot spots overseas and placing them into quarantine at Lackland Air Force Base in San Antonio.

In terms of Texas itself, there have been 68 confirmed cases, and on Friday Republican Gov. Greg Abbott declared a statewide public health disaster.

According to experts and officials, a relative lack of testing capacity in the nation’s second-largest state means there could be many more positive tests that haven’t been conducted yet.

There are nine laboratories in the state currently able to test 273 specimens per day, according to the Texas Department of State Health Services (DSHS). That testing capacity “is expected to increase here shortly to as much as 500 to 700” specimens per day, added William Ayres, a spokesman for the department, in a March 12 interview.

“With limited testing, you won’t know how many cases are in Texas,” says Rodney E. Rohde, an infectious disease expert at Texas State University. “We haven’t had an explosion in Texas yet, but I have no doubt we’re going to have more cases.”

A chaotic initial response means Texas has been contending with not only a limited testing capacity, but also an uphill public relations battle in recent weeks.

Two weeks ago, the CDC released a woman who had been exposed to coronavirus in Wuhan, China, from quarantine at Lackland only to discover on a second retest – after she had visited a San Antonio mall – that she was still “weakly positive” for the virus.

San Antonio and Bexar County declared a public health emergency days later, delaying the release of more evacuees brought from overseas for quarantine at Lackland. The next day, the CDC changed its quarantine release policy so that no one could be released with test results still pending, or without two sequential negative tests within 24 hours.

Indeed, while pandemics are by definition rapidly evolving, and thus guidance from the CDC around testing has to change frequently to keep pace, these frequent changes are what state agencies are working to stay on top of.

Tests from public health labs in the state now no longer are required to go to the CDC for confirmation, Chris Van Deusen, director of media relations at the Texas DSHS, said in an email Monday.

If the federal government approves automating part of the testing process, the public lab testing capacity is expected to rapidly expand, said Mr. Van Deusen. And as more private health lab testing comes online, “that will far exceed the capacity of the public labs.”

Texas received $35 million in federal aid last week, but with testing still limited – and thus confirmed cases hard to pinpoint – local cities and counties have been focused on monitoring potential cases and slowing the virus’s spread with “social distancing” policies.

In Hidalgo County, in the Rio Grande Valley, local officials have been monitoring individuals daily to see if symptoms develop. No tests have been necessary yet, Eddie Olivarez, chief administrative officer at Hidalgo County Health and Human Services said last week, and state agencies “are attached at the hip to us.”

Unlike most counties in the country, they have also been working closely with border agencies and the Mexican government to monitor cases in Mexico and in camps created for migrants seeking asylum in the U.S.

But while Hidalgo County doesn’t yet have to worry about confirmed cases, keeping the public calm is proving a challenge.

“Our hope is to get out ahead of it by constantly communicating where we stand,” says Mr. Olivarez.

Governor Abbott offered cause for optimism Friday, noting that all 90 Americans repatriated to Lackland for quarantine in early February have now returned home.

“This is not a death sentence we’re dealing with here. This is a typical outcome that we expect to see,” he said. “Working together, I know that we can do it.”

Staff writer Francine Kiefer contributed to this report from Pasadena, California.

https://www.csmonitor.com/USA/Politics/2020/0316/After-shaky-start-federal-and-state-authorities-start-to-work-in-tandem?icid=rss