Politics vs. public health: The pervasiveness of political agendas in the midst of a pandemic

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


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




With the 2020 presidential election looming, political partisanship is strongly influencing the United States’ response to Covid-19, potentially leading to a suboptimal balance between reopening the economy and protecting public health. Officials are undoubtedly faced with pressures to reopen the economy as the rate of increase of Covid-19 cases stabilize in the United States. Yet, several states are experiencing spikes in cases since the relaxing of stay-at-home orders, and we still do not have an effective treatment for Covid-19.

Approximately nine weeks ago, states enforced full or partial lockdowns to promote physical distancing and lower transmission rates of Covid-19. Thus far, the United States is currently on a downward trend of new cases, signaling that the lockdown measures may have been effective at reducing the virus’ spread. According to John Hopkins University, the five-day moving average of new Covid-19 cases has trended downward since April. Still, the pandemic is far from over, with many researchers, including members of the White House Coronavirus Task Force, concerned about a second wave of cases should lockdowns get lifted prematurely.

At the same time, the pandemic is placing unprecedented strain on the economy. Thus far, economic trends are nothing short of dire. According to the U.S. Department of Labor, approximately 36.5 million Americans have filed for unemployment claims since the beginning of the pandemic, eliminating all job gains made since the end of the Great Recession. The economic impacts of the lockdown measures have been particularly damaging for low-income households. According to the Federal Reserve, nearly 40% of households with an annual income of less than $40,000 reported job losses.

As the economy deteriorates, Republican and Democratic officials have largely placed themselves into distinct camps, weakening our ability to respond to the crisis. While it is early to know what approaches will best combat the ongoing pandemic, Democrats and Republicans alike have become entrenched in various policy positions and both political parties have responded to this crisis through a partisan lens. For example, congressional Democrats used the federal stimulus package to press for additional spending priorities, delaying passage of the bill for over a week. Currently, Democrats are pressing for additional money for state governments, some with unstable state budgets from before the pandemic. On the other hand, the original Republican version had little oversight for corporations receiving stimulus funds. Lockdown policies have also been quite different between the parties. Republican governors, like Brian Kemp of Georgia and Ron DeSantis of Florida, have enthusiastically reopened their states, being among the first to do so. Republican elected officials have also been quick to use the court systems or other legal means to strike down stay at home orders of Democratic governors. Democratic governors, like Gretchen Whitmer of Michigan and Laura Kelly of Kansas, have been far more hesitant to lift their stay-at-home orders.

Neither side of the aisle is drawing resistance against their policies from their respective base, limiting policymakers’ incentives to shift their positions. At first glance, there are signals that the American public is as polarized as elected officials, only feeding into an already divided national response for tackling the pandemic. Anti-lockdown protests have rocked state capitals across the country, including Texas, Michigan and Pennsylvania. The reality of the public’s attitude on Covid-19, however, is somewhat more complex than these protests may suggest. In the early stages of the lockdown, most Americans supported stay-at-home orders. A nationwide Kaiser Foundation survey from April showed that approximately 80% of the American public supported strict shelter in place policies. Still, there were signs of a partisan opinion divide, where 94% of Democrats versus 61% of Republicans supported the stay-at-home orders. Approximately 84% of independents supported stay-at-home orders. A slight majority of Republicans (53%) believed that the worst of the virus had already passed. Texan public opinion on Covid-19 is similar to national trends. A University of Texas poll from April demonstrated that most Republicans and Democrats in Texas considered Covid-19 a “significant crisis.” Yet, when asked what a bigger threat to the country was, 83% of Democrats mentioned “not keeping people at home long enough in response to the coronavirus/Covid-19,” while 32% of Republicans said the same. The survey found that 55% of Republicans stated, “keeping people at home for too long in response to the coronavirus/Covid-19” was a bigger threat to the country. It is difficult to tell, however, if leaders originally influenced partisan public opinion on Covid-19 or vice versa. An empirical study will need to be conducted to better understand this relationship. That said, we seem to now be in a feedback loop where both the public and political actors are feeding into each others’ actions and opinions.

Both reopening the economy and protecting public health are important principles to guide policymakers, and they need not be diametrically opposed. The reality is that the United States cannot maintain current lockdown policies ad infinitum. At the same time, however, it is risky to reopen without adequate testing and a consistent reduction in infection rates. Last month, President Trump announced a three-phase reopening plan titled “Opening Up American Again” that would gradually reopen state economies. Under these guidelines, states may only move to the next phase by meeting various “gating” criteria centered around cases, symptoms and hospitals in a state or region. Reopening under this plan falls to the discretion of the governors. At first, there were positive developments, with bipartisan groups of governors in the West, Northeast, and Midwest forming regional pacts to coordinate reopening efforts. Most states that are currently reopening, however, have not met the “Opening Up American Again” federal guidelines, having been seemingly disregarded by governors on both sides of the aisle, with Republicans moving ahead faster and Democrats demonstrating hesitance. Indeed, at least 17 states are experiencing an increase of cases.

Texas policymakers must move forward with caution. Overall, Texas has done relatively well keeping infections and deaths low, possibly because the state issued a stay-at-home order before the virus had widespread community transmission. It is understandable that Texas officials will want to reopen the economy as soon as possible. That said, rates of Covid-19 cases do not slow down based on our desires to reopen businesses. The virus’ infection rate will be impacted, however, by the policy decisions of our elected officials. The Democratic mayors of both Houston and Dallas have been critical of Gov. Greg Abbott for reopening parts of the economy. Thus far, we cannot conclusively determine if state re-openings from the end of April and the beginning of May have led to a spike in new cases. Arizona and North Carolina have experienced increases since reopening. In Georgia and Florida, the impact of reopening on Covid-19 cases has been somewhat unclear, but both states have faced scrutiny regarding their reporting of Covid-19 case data.

There are some limited signs that Covid-19 may be increasing its foothold in Texas. Since reopening three weeks ago, the Texas panhandle has witnessed a significant rise in new Covid-19 cases, largely from a meat packaging plant in the area. In addition, intensive care unit use in southeast Texas has recently surged. Houston Mayor Sylvester Turner also announced that the city’s homeless shelters were experiencing Covid-19 outbreaks. Thus far, these specific instances are not indicative of a broader trend. Houston and Dallas, however, are in particularly precarious situations for a possible second wave of infections, according to models developed by the Children’s Hospital of Philadelphia and the University of Pennsylvania. Dr. Peter Hotez, professor of pediatrics and molecular virology and microbiology at Baylor College of Medicine and a health policy fellow at the Baker Institute, recently noted that Texas has not deployed enough tests relative to the size of the population to contain a potential summer outbreak.

We have seen some governors — like Charlie Baker of Massachusetts, Larry Hogan of Maryland, Mike DeWine of Ohio, Â Laura Kelley of Kansas, and Gavin Newsom of California — have had some success at bridging the partisan divide to develop policies that put public health at the forefront as they move to reopen their state’s economies. For example, Baker and Hogan, both Republicans, were quick to criticize the Trump administration’s response to the Covid-19 crisis when they perceived it to be inadequate. DeWine, also a Republican, recently criticized the politicization of mask wearing. Newsom, a Democrat, built an early bipartisan bridge with the Trump administration and Kelly, also a Democrat, met personally with Trump at the White House to discuss the U.S. food supply.

An important consideration in the tension between policies that support reopening and those that do not and the rate of coronavirus infections depends on the American public. Even if Covid-19 cases increase, many policymakers may have no choice but to face an increasingly mobile public that resists stay-at-home orders. Evidence from cell phone use demonstrates that the American public is beginning to experience “quarantine fatigue,” where one’s mental wellbeing is burdened by social and physical distancing measures. According to the University of Maryland’s Transportation Institute, the number of Americans who practice social distancing has dramatically declined in recent weeks. Warmer weather has enticed many to ignore stay-at-home orders. Economic pressure will only increase the longer the lockdowns remain in place. Federal Reserve Chairman Jerome Powell recently suggested that the economic recovery will last well into 2021, and thus far, there is hesitance among Senate Republicans for another round of major stimulus. State policymakers may need to win over public opinion to reverse their decisions to reopen should Covid-19 cases increase. As of now, many state leaders are failing to develop a systematic approach to reopening their economies without putting the public’s health at risk.

The tension between political ideologies and agendas and what is best for this country has never been more evident than it is now. Yet, the prudence of setting aside politics to advance the health — both physical and economic — of the United States has never been more paramount. We need leaders who can weigh the emerging science and data related to Covid-19 with the economic reality to make wise decisions on how to mitigate the negative impact to both. This is a difficult task, with no single path forward, yet as members of the public we must set aside our political ideological differences and demand more balanced, evidence-driven approach from our policymakers.


The views expressed in this blog are those of the authors and do not necessarily reflect the views of the Baker Institute.