How States Can Tackle Covid-19 in the Absence of Federal Support

The White House has abandoned states. Here’s some advice for frustrated governors.

Andy Slavitt
Medium Coronavirus Blog
4 min readOct 13, 2020


Credit: Peter Zelei Images / Getty Images

I had a call with a Republican governor of a state in trouble and it gave me a sense of where we are. Here is what I learned.

The biggest concern is in rural communities. Some 90% of people in urban areas are wearing masks and spread is in better control. Rural community spread is from large family and community gatherings without masks.

This compares to the spring in the Northeast where spread was almost entirely in urban areas and to summer when it spread in Southern states more evenly. Governor believes masks and public health compliance are the biggest difference.

There’s also no expectations of help from the federal government. Interaction with FDA, CDC, and White House Task Force were surprisingly limited. The sense of “we are on our own” was complete and final.

This was a marked difference from the spring when states were still hoping for federal government support of some kind. Trump wanted 50 states, with 50 sets of resources, bidding for the same things against one another with no central guidance. That’s what we have.

States are more on top of the data we lacked in the spring and are watching things closely. Testing, test positivity rates, hospitalizations are all being tracked locally. That’s the good news.

But owing to a lack of federal resources for contact tracing and other state support, the real data that states need isn’t easily available. It’s hard to pinpoint hot spots. States don’t know whether positive cases are isolating.

They are hearing calls to “just isolate the old people” and stop focusing on public health. I’ve yet to meet anyone who has looked at the data, including this governor, who believes that works. It’s viewed almost entirely as a political argument of convenience.

It is an argument that gives up on people. Many older people live with younger family members who go to work and school. Many vulnerable people are not actually old.

Governors have seen the results. When cases go up in a community, hospitalizations and…