Canceling Everything Was the Easy Part

Shutting entire states down was painful but clearly necessary. Governors still have many ugly choices ahead of them.

Medical personnel in Miami
Chandan Khanna / AFP / Getty

About the author: Juliette Kayyem, a former assistant secretary for homeland security under President Barack Obama, is the faculty chair of the homeland-security program at Harvard’s Kennedy School of Government. She is the author of The Devil Never Sleeps: Learning to Live in an Age of Disasters.

Ron DeSantis and Donald Trump are political allies, but the Florida governor still wasted weeks playing a deadly game of chicken with the president. Neither man wanted to be the one to tell residents of the third-most-populous state to stay home. Doing so was DeSantis’s job all along, but he was still insisting earlier this week that he would act only if the president told him to. Never mind that Florida has a large elderly population, that the state’s case count had soared past 7,000, or that the White House’s medical experts had been trying to signal the governor to issue an order. Yesterday, after needlessly jeopardizing his own citizens, DeSantis finally made the choice that more than 30 other governors had made, in some cases weeks before.

He wasn’t the only holdout; Brian Kemp, the Republican governor of Georgia, belatedly issued his own order yesterday, insisting that he had only just learned that “this virus is now transmitting before people see signs.” In hindsight, the length of time that he, DeSantis, and others dithered over the stay-at-home orders will look all the more reckless because the decisions that public officials—and especially governors—will have to make are only going to get harder. The choices these officials face will in some cases pit citizens against one another. In many cases, there will be no correct answer, just choices among miserable options.

Quick, decide: If 20 percent of a city’s police department is infected or quarantined because of the coronavirus, how should the remaining officers decide which problems to take on? Already, some police departments are closing buildings to the public. No more walk-ins. Others are focused on providing only essential services, such as investigating violent crimes, and are leaving the investigation of nonviolent or property crimes for another day. Houston Mayor Sylvester Turner, who on Monday begged criminals to “chill,” has been roundly mocked. “Until the coronavirus is resolved,” Turner said, “criminals take a break, okay. Stay home. Stay home and don’t commit any crimes.” But he was only saying out loud what mayors and police chiefs around the country know: that their ability to protect public safety may be substantially diminished. In a society that can no longer satisfy all public-safety demands, where do you place a phone call about a marital argument that could escalate against the possibility that a police officer will be infected? Should a late-night dispatcher be left to determine which calls to ignore, or should someone higher up the chain—someone accountable to the public—establish a basic policy?

Also decide: Which patients should doctors and nurses prioritize for life-saving efforts if hospitals simply become overwhelmed? Who wants to write that policy? Across the United States today, states are revising their triage standards in anticipation of seeing more COVID-19 patients than a limited number of health-care workers can adequately treat with the supplies they have at hand. This is not only an ethical dilemma that can be left to individual doctors and hospitals; governors and legislators must determine what sort of liability protection hospitals should get if such triage standards have to be applied and patients are denied care. Public officials should and inevitably will be drawn into arguments about what those standards should be. “Focus on the otherwise healthy patients who are most likely to recover”—the general standard enshrined in state plans examined by The New York Times—is an easy thing to say. But many patients’ health status aligns with economic and social status. Racial disparities abound. Older people and those with disabilities are rightfully concerned that triage standards may exclude them. As doctors confront one wrenching decision after the next, will governors help establish moral and legal norms—or look the other way?

Then decide: Should schools even try to open anytime soon? As for schools and educational standards, one can only hope that kids return to classrooms in the late summer or fall. But the progression of the pandemic is still unpredictable. Even if New York City hits its peak later this month, the virus will keep spreading across the nation in waves and could well resurge in areas after seeming to subside. The United States has a high volume of cases unevenly distributed across a huge geographic area. Schools in many states begin in mid-August; many school and university facilities are being retrofitted for use as makeshift hospitals or for other pressing public needs; colleges and universities that have students from many states may be unwilling to open for fear that students from post-peak states will mix with those from states still with strong community spread. If you were a principal or a superintendent or a university president, what would you do?

On these and other ugly questions, recent experience suggests that the White House is unlikely to do anything more than provide broad guidance to states—and then leave the hard part to them. That’s no way to fight a 50-state disaster, but federalism is a convenient way for a president to let somebody else take the blame.

Soon enough, the painful decisions that governors made to keep residents inside—and to shut down major sectors of their economies—will seem obviously correct, especially as evidence mounts that social distancing is working to flatten the curve. But that makes the curve longer and the need for people to stay inside all the more pressing as time goes on.

And then one day, after we’ve figured out a way to manage life with the virus through testing and tracking, treatments and other efforts, we will finally have a vaccine ready for mass distribution—if we are lucky—sometime in 2021. Vaccines will be sent to the states with some guidance about priorities. But the vaccine will be distributed in waves; we don’t need to wait for full manufacturing to start getting it into people’s arms. Everyone will be clamoring for it. Medical professionals and first responders will go to the front of the line, as they should. But who goes next? Elderly people, who are more vulnerable, or healthy young people, who are more mobile, more likely to be infected without symptoms, and more likely to be working in jobs requiring contact with others? Those in urban areas, who are more likely to be exposed by casual transmission, or people all across a state? You or me? Decide quickly.

For all these questions, the best answer will feel like a Pyrrhic victory. The only wrong answer is to take action too late.