The Division of a Nation: How Politics are Hindering Public Health Responses

By Christopher Kulesza, Ph.D.
Research Analyst, Child Health Policy Program


Quianta Moore, M.D. J.D
Fellow in Child Health Policy




In a blog post one month ago, we discussed partisan divisions that gripped the United States’ policy response to Covid-19. Since our first post, the United States has struggled to keep the national rate of Covid-19 infections under control. Instead, the geography of the pandemic has markedly changed, where states that were relatively unaffected are now experiencing rapid growth in both cases and hospitalizations. New cases have primarily shifted away from states in the Northeast and Midwest, where strict lockdowns were enforced to reduce the number of new infections. Perhaps the most notable example is New York, where cases dropped from a high of nearly 10,000 in April to a current average of 700 new cases per day, allowing Governor Cuomo to gradually relax the state’s lockdown. In contrast, states in the South and West, which were among the first to reopen their economies in May, are currently recognized as Covid-19 hotspots, including Texas, Florida and Arizona. The economic situation across the United States also remains dire, with nearly half of the population currently unemployed. Even in states that have reopened, many businesses have closed again due to outbreaks among their employees.

There are some hopeful signs, however, that as the pandemic’s epicenters move to new states, partisan divisions might be abating among some policymakers. A new consensus regarding how the virus spreads is emerging among health care professionals, which may be the driver behind the change in policy. It’s now understood that transmission is primarily driven by close personal contact indoors over periods of 15 minutes or more. Surfaces, on the other hand, are not likely to spread the virus easily. There is also overwhelming evidence that masks can be highly effective at reducing a population’s spread of Covid-19. According to a recent study by Texas A&M, wearing a mask may offer more protection than social distancing. This could allow for policies that will reduce transmission of the virus while still allowing some economic activity to resume. Should public mask-wearing become a national requirement, new research from Goldman Sachs predicts that we may prevent a 5% loss of our national gross domestic product.

Various governors have recently changed the trajectory of their state’s reopenings after experiencing a spike in cases. Many states have been placing their reopening plans on hold or even taking steps to reverse them. Perhaps the most notable example is Texas Governor Greg Abbott, who recently scaled back Texas’ reopening by closing bars and limiting restaurant capacity to 50%. In a similar fashion, Arizona Governor Doug Ducey also closed bars and limited large gatherings through July 27. Further, California Governor Gavin Newsom reinstated stay-at-home orders in various counties after showing considerable reluctance. Governors are also becoming more open to public mask requirements regardless of party affiliation, and Republican Senate Majority Leader Mitch McConnell recently urged Americans that “we must have no stigma” about wearing masks. That said, none of the Southern or Western governors have publicly considered instating a lockdown similar to that which brought the New York City epidemic under control. Senators across the aisle have also increased their advocacy for federal support for Covid-19 relief packages and have encouraged safety guidelines. When President Trump planned to end federal support for Covid-19 testing sites, Texas Senators Ted Cruz and John Cornyn successfully intervened to ensure funding remained for cities like Houston and Dallas.

Trends in polling demonstrate, however, that governors of these states may find it difficult to appease their voters while responding to the pandemic. There is still a wide gap between recent medical research findings on Covid-19 and public opinion. Indeed, recent evidence suggests that partisan divisions among the public have only worsened in the past two months. According to a Pew Research poll, 61% of Republicans stated in June that the “worst is behind us” when asked about the problems associated with the Covid-19 pandemic. This is compared to 42% of Republicans who said the same in April. Democrats were relatively pessimistic, with only 23% believing that the “worst is behind us.” A June CNN poll found that 73% of Republicans were ready to return to their regular routine compared to 53% of independents and only 23% of Democrats.

These differences in opinion among the political party bases may have deleterious consequences for the enforcement of strengthened state guidelines. A second Pew Research poll showed that most Americans are wearing masks, but rates differ by individual party identification. A little over half of Republicans stated that they wear a mask most or all of the time compared to 76% of Democrats. A Quinnipiac poll from May found that only 40% of Republicans agreed that “everyone should be required to wear face masks in public,” whereas 75% of Democrats felt the same way. Local government officials, who are arguably closer to constituents than state policymakers, have been especially caught between voters and state health guidance in Republican areas. In some rare instances, we have witnessed elected local law enforcement officials who refuse to enforce state orders.

Perhaps nowhere is the partisan difference among the rank and file more apparent than each national party’s plans for their respective nominating conventions. The current approach for holding national conventions by the two major political parties primarily reflects the way each respective base perceives the Covid-19 pandemic. The Democratic Party relocated their national convention to a smaller venue in Milwaukee and asked their delegates not to attend due to Covid-19. Former Vice President Joe Biden, the presumptive Democratic nominee, may not even make a physical appearance. The Republican Party took quite a different approach after North Carolina Governor Roy Cooper stated it was unlikely that he would allow a full convention to take place in Charlotte. Instead, the Republican Party decided to keep the formal business of their national convention in Charlotte, but will hold President Trump’s nomination speech in Jacksonville, Florida. Here in Texas, the Republican Party still plans on holding their state convention in Houston in mid-July, while the Democrats conducted theirs virtually.

It is more critical now than at any time during the pandemic to set aside partisanship and to direct policy using an evidence-based approach. Initial findings from the International Monetary Fund show that the pandemic’s economic impact is worse than initially feared. Many of the temporary benefits enacted by Congress are set to expire soon, though House of Representatives Speaker Nancy Pelosi and Senate Majority Leader Mitch McConnell have given public support to further stimulus measures. And not all state leaders are willing to take additional precautions as cases rise, including Florida Governor Ron DeSantis, who has ruled out slowing Florida’s reopening.

We will be most prepared to restart the economy when we can further reduce the transmission of Covid-19 using medical research to guide our response. State and local policy officials may need to make decisions that are unpopular with their respective voter base to ensure a safe return to work. If they do not, we risk prolonging the pandemic and further delaying our economic recovery and experiencing a greater loss of life.

Public health should not be a political issue. John Adams worried that the division of these great United States “into two political parties … is to be dreaded as a great political evil.” While it may not be a political evil, the division between the public across party lines is hindering our progress as a nation to restore the health and vitality of our country and its residents. We must set aside political ideologies and follow data, evidence and science.