Federalism and the failed pandemic response | Columnists | hampshirereview.com – Hampshire Review

Federalism is the concept that is an integral part of our form of government. There are state governments, and there is the federal government.

The Constitution specifies powers and duties that the state governments have, and those that the national government has. Among the potential benefits of this arrangement is that the states can be essentially laboratories that experiment with concepts that if successful, other states and even the national government can then utilize.

For example, before there was an Affordable Care Act, the state of Massachusetts had a similar program for health insurance access and affordability. Who was the governor of the state at that time? Republican Mitt Romney. He ran for president and lost to ... Barack Obama. You know, the Obamacare guy.

In a similar way, there has been a multi-state experiment regarding the approach to controlling Covid-19.

Some states were aggressive in encouraging the employment of mitigation measures to reduce the spread of the virus. Other states were somewhat more passive, and still others were actually resistant to measures such as social distancing, mask wearing, and encouragement of its citizens to get vaccinated against the Coronavirus.

The data is in and the data show that those states that were less aggressive in instituting these commonsense mitigation measures did and continue to do worse than those states that more thoroughly instituted these measures.

On an international scale, Sweden was a classic example of how not to respond to a pandemic. The Swedish government basically decided on a plan of attaining herd immunity naturally acquired infections with no mitigation strategy.

When the infection and death rates soared way above those of neighboring European countries, Sweden changed course. When questioned about the initial strategy, the Swedish health minister said Vell, eet realllly vos a doomb idea (OK, I made up that last sentence for a little comic relief.)

Despite the overwhelming evidence that the less aggressive, laissez-faire approach has failed, have attitudes or approaches changed?Hardly.

When one looks at mortality rates among white individuals between the ages of 25 to 64 in 2020, there was a difference of 225% between the states with the lowest mortality rates and those with the highest. In 1999 that difference was 166% (which is still a significant degree of disparity).

The states with the lower mortality rates were the ones thatused and encouraged mitigation measures. And that trend is very likely to remain unchanged or to worsen given the politicization of the pandemic response.

This is exemplified in a Washington Post story about a health department worker, who has basically given up trying to convince people to get vaccinated because the effort is futile. Simply put, those who are eligible and have not been vaccinated simply are not going to do so, come hell or high water, irrespective of the data that shows that being vaccinated reduces infections, hospitalizations, intensive care, and death.

Much of this is due to disinformation, misinformation and politics. This is why a coordinated uniform national pandemic plan, adhered to by all the states,is needed for an adequate response.

A couple of years ago, I wrote an article that basically stated that finding fault and assessing blame was far less important than finding out how to contain the virus.

Well, as we are entering into what is hoped to be the endemic phase of the pandemic, now would seen to bean appropriate time to objectively assess what went wrong.

There are people who need to be held accountable and their errors, deliberate and otherwise, publicized so that we can learn from the mistakes that were made. We, as a nation, need a coordinated plan to deal with the next pandemic (this one isnt even over and yes, there will be more coming).

We need a national pandemic plan, not 50 state strategies, many of which were woefully inadequate. We know whats worked, we know what hasnt.

Not only is a national plan needed; a worldwide plan is also needed. Despite herculean efforts with multiple lockdowns which helped for a long time, New Zealand finally gave up trying to isolate from the rest of the world as it just couldnt keep the virus out.

One of the most isolated nations in the world, North Korea, is now reckoning with outbreaks of Covid. As long as there are countries that are not getting adequate vaccinations due to supply or logistics, new variants will keep cropping up and will eventually break through borders and barriers.

The writer practices Internal Medicine in Hampshire County. Opinions expressed in this article are solely those of the writer.

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Federalism and the failed pandemic response | Columnists | hampshirereview.com - Hampshire Review