Using state mandates to fight the pandemic

Governor Kate Brown of Oregon has relied upon a combination of public education and executive orders to fight the coronavirus pandemic.

In contrast, Governor Kristi Noem of South Dakota told the Wall Street Journal, December 7, 2020, that:

“Rather than following the pack and mandating harsh rules, South Dakota provides our residents with information about what is happening on the ground in our state — the science, facts and data. Then, we ask all South Dakotans to take personal responsibility for their health, the health of their loved ones, and — in turn — the health of our communities. The state hasn’t issued lockdowns or mask mandates. We haven’t shut down businesses or closed churches. In fact, our state has never even defined what an ‘essential business’ is. That isn’t the government’s role.”

Which approach works best?

To draw a comparison between a state with a population of 4.22 million and a state with a population of 855,000 we need to use a common metric—the number of cases, deaths or hospitalizations from COVID-19 per 100,000 population (100K population).

According to the Center for Disease Control and Prevention (CDC) COVID Data Tracker:

• Since January 21, Oregon has had a total of 3,002 cases of COVID-19 per 100,000 population. Over the same period, South Dakota had a total of 11,669 cases of COVID-19 per 100,000.

South Dakota has had 3.89 times the number of COVID-19 cases as Oregon.

• Since January 21, Oregon has had 38 deaths from COVID 19 per 100,000 population. South Dakota experienced 179 deaths from COVID-19 per 100,000 population.

South Dakota has had 4.71 times the number of COVID-19 deaths per 100,000 population as Oregon.

According to the COVID ActNow Tracker, over the past seven days (ending January 11):

• Oregon has had an average of 27.6 daily new cases per 100,000 population, compared to South Dakota’s average of 46.1 daily new cases of COVID-19 per 100,000 population. Both of these figures fall into the “dangerous number of new cases” range.

• COVID is still spreading in each state, but slowly.

• Oregon had a positive test rate of 8.5, which indicates an adequate number of tests are being performed, while South Dakota’s positive test rate of 11.2 indicates that an inadequate number of tests are being performed.

• Oregon, with its 67 percent ICU capacity, and South Dakota with its 61 percent ICU capacity, are likely to be able to handle a surge in COVID hospitalizations. (However, according to newspaper accounts, Governor Noem inflated ICU capacity by including neonatal-intensive-care units in her figures.)

• Neither state has hired sufficient tracers to identify and isolate sources of disease spread fast enough to prevent new outbreaks.

A chief concern for slowing the spread of COVID-19 infections is to prevent a surge in patients with severe illnesses that would exceed area hospital capacity.

December 4, 2020, www.argusleader.com:

“The strain of a months-long surge in coronavirus cases has reduced hospital capacity to care for those with severe symptoms, making it increasingly uncertain whether the sickest South Dakotans will be able to get treatment in the state, health providers say. Meanwhile, ICU space is quickly evaporating in neighboring states as well.”

According to The Atlantic’s COVID-19 Data Tracker Project:

South Dakota currently has 28 patients hospitalized for COVID-19 per 100,000 population, which is 11 percent fewer than it had the previous week. Oregon currently has 11 patients hospitalized for COVID-19 per 100,000 population, which is 13 percent lower than the previous week.

Readers are invited to use a chart provided by the Washington Post, www.washingtonpost.com/graphics/2020/national/coronavirus-us-cases-deaths/, to compare U.S. and state-level hospitalization rates for COVID-19 since the start of the pandemic.

South Dakota has more than twice as many patients currently hospitalized for COVID-19 compared to Oregon.

While it’s not a perfect comparison, Governor Brown’s reliance on state mandates, along with public education, has led to fewer cases of COVID-19, fewer deaths from COVID-19, and fewer COVID hospitalizations compared to Governor Noem’s approach that places the burden of fighting the coronavirus pandemic squarely on the shoulders of each resident in her state.