With Coronavirus Cases Set to Soar, State Coalitions Are Mostly Talk

(Bloomberg) -- Born last month to organize a 50-state free-for-all, regional coalitions to combat the coronavirus have so far been more ornamental than operational.

Seven Northeastern states said they will purchase masks, ventilators and sanitizer as a team, but officials provided few details about how the system will work or how goods will be apportioned. Western state officials confer regularly but aren’t organizing supply orders, and states are operating on their own timelines. And in the South, where many politicians resisted restrictions on commerce, governors discussed a coalition but never actually formed one.

Now, as the federal government pushes for an economic reopening despite signs that virus cases could still soar, coalitions are under pressure to present more concrete plans -- and fill a void left by a White House ready to move forward whether states are ready or not.

“In the absence of federal leadership, states have been required to step up, not only individually but to coordinate regionally,” said Harry Heiman, a professor of public health at Georgia State University. “I’m not seeing any tangible production coming out of that yet.”

In the past week, estimates of the pandemic’s death toll surged even as more states reopen at President Donald Trump’s behest. As many as 135,000 could die, according to University of Washington modeling, but the president has said Americans should think of themselves as “warriors.”

The Trump administration maintains that state executives have the main responsibility for fighting the pandemic. “We want the governors to call those shots,” the president said April 29.

Since then, the White House shelved a detailed document meant to guide states back to safety, according to the Associated Press, and the Federal Emergency Management Agency is discussing moving on from its lead role in securing supplies.

Even governors who have avoided criticizing the president are expressing frustration. “I would love to have a national strategy other than ‘You do it,’” Minnesota’s Tim Walz said during a news conference Thursday.

Coalitions on the coasts and in the Midwest -- together, encompassing 19 states and more than 50% of the U.S. population -- are meant to fill the void. When they were formed, governors said a unified approach was crucial to end ferocious competition for supplies and to protect citizens from a disease that doesn’t respect political or geographic boundaries.

Ashish Jha, director of the Harvard Global Health Institute, said the coalitions aren’t the best way to fight the pandemic, but that they are “the best we can do.” He predicted every state will eventually join one.

“They have to figure this stuff out on their own, and the federal government is not likely to do much to be helpful,” he said. “A group of states working in a coordinated way is better than every state doing it on their own. But this is not born out of the ideal situation.”

Purchasing Power

The most tangible action so far has been the Northeastern group’s purchasing consortium. The states, which include New York, New Jersey, Massachusetts, Pennsylvania, Connecticut, Rhode Island and Delaware, are also exploring ways to produce their own protective products.

But specifics about how the arrangement will work remain unclear, including how supplies will be ordered or divided. Spokespeople for governors in the coalition either declined to share details or didn’t reply to requests for comment.

Pennsylvania Governor Tom Wolf in a Wednesday news conference described a loose structure, with staff members from different offices talking regularly by phone or Zoom. “By combining all the seven states we have more buying power, more brain power,” he said.

Federal officials know that states lack protective equipment and are predicting a new surge of cases that could create another shortage of ventilators, Politico reported this week. But top FEMA officials privately suggest the biggest part of their job, providing PPE, is done. They believe that Project Airbridge -- a program created by the president’s son-in-law Jared Kushner -- has stopped shortages by flying in at least 746 million pairs of gloves, 71 million surgical masks and 10 million surgical gowns.

However, FEMA and the U.S. Department of Health and Human Services are still regularly seeking contractors to supply personal protective equipment like nitrile gloves, Tyvek coveralls, surgical gowns, and face shields. This increases competition with the states. And FEMA regional offices are putting out their own requests for proposals, a sign some areas still lack supplies.

The Western States Pact isn’t unifying around equipment. Instead, members are mostly communicating about reopening. Colorado Governor Jared Polis described the pact as a “strong information-sharing platform.”

California’s Gavin Newsom said there are weekly phone calls among governors’ chiefs of staff. Representatives from Oregon and Colorado recently presented plans that would allow rural counties to open more quickly than urban places. Newsom called those drafts “very very helpful” in creating his own guidelines, some of which will be announced this week. Washington Governor Jay Inslee is also using them as a guide, according to a spokesperson.

But a tell-tale piece of vague management-speak recurs: A spokesperson for Nevada Governor Steve Sisolak said pact members were sharing “best practices.”

The pact “could be more collaborative in the PPE space and sharing best practices on antibody tests,” Newsom said.

Midwestern states “are continuing to communicate and we are continuing to talk about best practices,” said Kentucky Governor Andy Beshear, who cast his lot with Illinois, Michigan, Ohio, Wisconsin, Minnesota and Indiana.

But all those best practices haven’t stopped states from moving on divergent timelines. Colorado partially reopened in late April, almost two full weeks before California will ease some restrictions. Indiana, Michigan and Ohio have had partial reopenings as well, while the rest of the coalition remains in lockdown.

“We all make our individual nuanced decisions based on the culture within our states, but it has been very helpful,” Beshear said during a Wednesday news conference in Frankfort.

Geoffrey Heal, an economics professor at Columbia Business School, said that acting alone defeats the purpose of the regional groups, particularly in areas like the Northeast where states are small and travel is easy.

“It really doesn’t make much sense to try and close down one part and not the other, or to open up one part and not the other,” Heal said.

The true benefits, though, may be as much about politics as anything else, he said. Having the cover of a group helps governors ensure they “don’t do something that makes them look like a total outlier.”

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