Pandemic Politics: Timing State-Level Social Distancing Responses to COVID-19

Christopher Adolph; Kenya Amano; Bree Bang-Jensen; Nancy Fullman; John Wilkerson

(3) those affected may be contagious during a prolonged asymptomatic incubation period, and many never develop symptoms distinctive from a mild flu, making it difficult to identify and isolate the infected before they pass the virus to others. (4) Broad public mandates for social distancing are also vital to help manage a key multiplier of COVID-19 fatality rates: a substantial fraction of patients require lengthy (on average 8 bed days) intensive care unit (ICU) support to survive acute respiratory distress, and uncontrolled spread of the disease is expected to generate at its peak far greater demand for ICU care than existing capacity can meet.(5; 2; 6) Public health experts have pleaded with officials to quickly mandate social distancing to flatten the curve of coronavirus infections -that is, reduce the peak caseload -before exponential case growth leads to hundreds of thousands or millions of deaths. In particular, it is important to keep peak levels low to prevent the fatality rate from rising to the levels seen in areas where hospitals are overwhelmed with cases. (7) In the United States, the emergence of the coronavirus has created a natural experiment in which elected officials face incredibly urgent and far-reaching policy decisions for which they typically have no personal experience or expertise, and for which the history of policy examples is either mere days old, or so dated as to be largely unknown except by public health experts. The most significant policy decisions of this kindboth in terms of their potential to mitigate the epidemic and their economic consequences -are mandates for social distancing through restrictions on public gatherings; closure or restriction of schools, restaurants, and other non-essential businesses; and orders for the public to stay at home. (8) Under the federal and state constitutions, the key actions fall to executives, and particularly to governors, whose powers in public health emergencies are typically singular and extensive.