Weekly Policy Watch: Struggling With Social Distancing

March 27, 2020
Community Health
Legislation and Policy

These are extraordinary times. A virus that was unknown before December has gripped the world, bringing public life to an abrupt halt and crashing economies.

We at the Colorado Health Institute are determined to help our state endure and recover from this COVID-19 crisis. We’re not frontline heroes like doctors, nurses, or lab technicians — or grocery clerks, delivery drivers, or police officers. Our strength is in identifying the policy solutions that Colorado and its communities will need to manage the response and safely restart our economy. When this outbreak subsides — and it will — CHI will be ready to support changes that make our health system stronger and fairer.

Today, we are launching a weekly policy roundup. Every Friday, we will provide a look at the key policy choices of the week. Over time, we hope to see positive results from the dramatic measures we are taking in Colorado and around the world.

CHI is working on several other fronts, as well, including with public health officials to plan strategies for safely lifting stay-at-home orders in the weeks ahead.

The Week in Policy

Mayors, county leaders, and Gov. Jared Polis wrestled with mandates for social distancing. Meanwhile in Washington, D.C., Congress cobbled together a massive economic rescue bill — by far the largest in American history.

Denver Mayor Michael Hancock led the way on Monday by issuing a stay-at-home order for the city, effectively closing non-essential businesses and telling people to stay inside their homes except for grocery shopping, exercise alone or with family, or seeking medical care. (There are other exceptions; read the order here.)

Polis had resisted a statewide stay-at-home order. Last week, he told Colorado Public Radio: “We don't live in a central-command structure, authoritarian country like China where people can be locked down. That's why this whole in-place thing is not viable here. … We have to, again, focus on where they're congregating, where the virus is spreading, reduce those vectors. We're using data and science every step of the way.”

But on Wednesday, other metro-area public health departments tightened restrictions. Tri-County Health Department, Jefferson County, Boulder County, and several others had issued stay-at-home orders by mid-week, and Polis followed with a statewide order Wednesday evening.

The governor’s stated reason for previously resisting a statewide stay-at-home order makes sense. Colorado is a geographically large state and enforcing the order in the sparsely populated mountains and plains will likely be impossible.

But there’s an equally strong case for extending the order statewide. Leaders in tourist destinations from Hawaii to North Carolina have complained about city dwellers fleeing to second homes or vacation rentals — jeopardizing these areas’ medical systems and competing with locals for food and household supplies.

Colorado’s leadership has made its policy choice for strict social distancing measures as the best way to fight the spread of COVID-19. The task in the coming weeks will be to keep up the policy while mitigating its side effects, including likely increases in mental health problems and, of course, profound economic impacts.

The Week in Politics

A partisan split is emerging on social distancing and stay-at-home orders. In general, states with Democratic leadership are adopting stay-at-home policies, while resistance is coming from Republican-led states and the White House.

To be clear, the push for stay-at-home orders comes from epidemiologists and public health experts. It’s motivated by science, not politics. But public officials are responsible for issuing the orders or not — and politics will enter into that policy discussion. We expect the political pressure on elected officials will increase over the coming weeks as the virus spreads and more people lose their jobs.

President Trump has chafed against the advice of public health experts to shut down most public activities, and he has declared that he “would love to have the country opened up, and just raring to go, by Easter (April 12).”

In Colorado, six Republican state legislators urged the Douglas County Board of Commissioners to terminate the county’s involvement with Tri-County Health Department after the department issued a stay-at-home order hours before the statewide order was announced. And Republican state Sen. Jerry Sonnenberg wrote an opinion piece calling the state’s response made Colorado “a police state on the verge of martial law.”

But not everything about the pandemic response is partisan. The U.S. Senate approved a $2.2 trillion bailout bill on Wednesday on a 96-0 vote. The dollar amount is more than twice as large as the 2009 stimulus bill during the Great Recession, which nearly every Republican opposed.

A unanimous vote on this historically large level of spending would have been unthinkable even a week ago. It’s a mark of how quickly the virus is reshaping politics.

What We’re Reading

The Four Possible Timelines for Life Returning to Normal. The Atlantic.

How does this end? That’s perhaps the biggest question on the minds of most people in lockdown at home. This article lays out a range of scenarios, from optimistic to grim, and lucidly conveys the public health rationale for social distancing.

Coronavirus: The Hammer and the Dance. Medium.

This article introduces a concept that’s getting a lot of attention in Colorado. The “hammer” is a hard lockdown for a period of weeks, not months. The “dance” is the complicated work of keeping the outbreak in check after the lockdown ends. This would be done through widespread testing, rigorous contact tracing of infected people, and selective quarantines. East Asian countries have used these techniques to great effect.

Coronavirus Threatens the Lives of Rural Hospitals Already Stretched to Breaking Point. Kaiser Health News.

Hospitals are clearing their wards and delaying elective surgeries to make room for an expected flood of COVID-19 patients. The trouble is that services like physical therapy and elective surgeries often keep rural hospitals financially afloat. One hospital CEO said he won’t be able to make payroll by May unless adequate federal help arrives.

Child Care Advocates Ask Feds for Help: ‘We’re the Frontline for the Economy’. Colorado Public Radio.

Hospitals aren’t the only critical service in trouble. Child care providers are at once necessary and endangered. Parents who have to work at essential jobs need a safe place for their kids. Meanwhile, many parents are at home and out of work, so they’re pulling their kids out of child care. The vital role of child care deserves more attention as stay-at-home policies take hold.

What’s Giving Us Hope

We at CHI are struggling like most Coloradans. We are anxious about the health of our loved ones and adjusting to stay-at-home orders. At the same time, we’re committed to doing our part — as individuals and as a health policy institute — to weather this crisis and to help all our Colorado communities recover.

It’s heartening to realize we are all contributing to a cause bigger than ourselves. We’re apart now, but people really are pulling together. We’d like to leave you with this Friday morning tweet from the Denver Police Department that shows people are taking their responsibility to their fellow humans very seriously. We can all be proud of that.

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