Public mistrust, partisanship and public health

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

and

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

Partisan division is still severely inhibiting the United States’ COVID-19 response 10 months after the pandemic began. As we discussed in our post last July, there were hints that governors and federal authorities recognized the positive impacts of social distancing and mask use. Yet we have witnessed further policy entrenchment from most Democratic and Republican officials. The health consequences of this political divide could not be clearer as the pandemic has grown beyond many experts’ worst predictions. Last June, Dr. Anthony Fauci warned that the United States might experience over 100,000 confirmed COVID-19 daily cases during the winter months. The United States has now reached over 200,000 confirmed COVID-19 daily cases while death rates are at levels not seen since May. Unlike the first days of the pandemic and the summer surge, the current increase in infections is not isolated to any country’s specific area. Nearly all states are experiencing growth of more than 25 cases per 100,000 residents. Yet individuals are undoubtedly suffering from pandemic fatigue, with millions deciding to travel for the recent holiday season. Joblessness is stubbornly high, further motivating individuals to attempt a full return to normalcy.

Political divisions have transcended traditional policy disagreements. Indeed, faith in our government institutions continues to erode, including those of health agencies. A significant segment of the American public refuses to accept health advice from the CDC to take the vaccine. According to Pew Research, approximately 70% of Democratic voters plan on taking the vaccine compared to only 50% of Republicans, which is significantly lower than the 90% required to achieve herd immunity. Even a large portion of frontline health care workers are refusing to take the COVID-19 vaccine. Republicans are still much less likely to wear face masks in public. As state legislatures begin their sessions, many chambers with Republican majorities are not mandating masks for their members.

While in the midst of the pandemic, we are also witnessing a purposeful degrading of our election procedures and integrity. Some policymakers are challenging the results of the 2020 election, demonstrated by the objections of various senators and representatives to the Electoral College results. These objections occurred while rioters broke into the U.S. Capitol while the Congress was meeting in a joint session to certify the Electoral College. There has been no compelling evidence of election fraud, yet Congress and the state legislatures have been forced to devote precious time away from responding to the pandemic in order to respond to these claims. Polling shows that up to a third of voters believe that the election of former Vice President Joe Biden is illegitimate.

The 2020 election did little to help bridge the ongoing policy divide in response to COVID-19. Voters did not send a completely clear message about the failure of the nation’s COVID-19 response to policymakers. Contrary to most polls, the election failed to produce the expected landslide victory for Democrats in Congress and the statehouses. Former Vice President Joe Biden won both the popular and Electoral College vote over President Donald Trump, yet Democrats were much less successful down-ballot. None of the state legislatures flipped from Republican to Democratic control heading into the 2021 redistricting cycle. The only change in majorities was in New Hampshire, where the state House and Senate changed to Republican hands. Republicans also gained at least 11 seats in the federal House of Representatives, giving Democrats the slimmest majority in two decades. The U.S. Senate will be evenly divided, providing Democrats a technical majority in the chamber. That said, West Virginia Sen. Joe Manchin and Arizona Sen. Kyrsten Sinema oppose the elimination of the legislative filibuster, potentially forcing Democrats to develop a power sharing agreement with Republicans similar to the one developed in the first months of the 107th Congress.

The deadlock is also prevalent across the nation’s statehouses. Favorable state election results further motivated Republicans to challenge public health mandates, even when the governor is also a Republican. In Ohio, where Republican Gov. Mike DeWine was among the first to issue a stay-at-home order, the state legislature passed restrictions on the executive’s ability to issue COVID-19 regulations. In Texas, there is a legislative proposal to establish an “Emergency Powers Board” to strip Republican Gov. Abbott’s power to make emergency declarations. This board will be composed of the lieutenant governor, speaker of the House, and the chairs of the House and Senate Affairs Committees. These measures may greatly reduce the ability to quickly respond to the virus’ potential spikes through the winter season and further politicize the process by introducing more actors who must be responsive to their own unique constituencies.

The prospects for COVID-19 relief will likely improve once the Democratic Party assumes the U.S. Senate majority. COVID-19 aid was consistently held up by divisions between House Speaker Nancy Pelosi and Senate Majority Leader Mitch McConnell. A bipartisan proposal led the way for a $908 billion stimulus package in December that included $600 relief checks for individuals. Calls for a larger $2,000 relief check quickly followed, but was blocked by current Senate Majority Leader Mitch McConnell. Incoming Senate Majority Leader Chuck Schumer declared that the higher stimulus will be the first action of the new Senate. That said, Democrats enter with the smallest possible majority and will need approval by all 50 caucus members for any future package, including progressive members like Vermont Sen. Bernie Sanders and conservative members like West Virginia Sen. Joe Manchin.

Fortunately, the end of the pandemic may now be in sight with the successful development of three vaccines by Pfizer, AstraZeneca and Moderna. Republicans and Democrats both generally agree that a vaccine is our best chance of ending the pandemic. However, partisanship has even found a place in vaccine development. As the pandemic worsens, there are partisan disagreements about the distribution and safety of the vaccines. Gov. Andrew Cuomo initially resisted the Federal Drug Administration’s findings that the vaccines are safe and effective, stating, “The people of this country don’t trust this federal government with this vaccine process,” while vowing to conduct independent state government-led reviews. Vice President-elect Kamala Harris also cast doubt on the vaccine’s development, but similarly softened her stance considerably and took the vaccine.

Partisan quarrelling is quite apparent with vaccine distribution. There has been little federal guidance on how to prioritize and administer vaccines, leaving states to plan dissemination largely on their own. Disagreements have arisen as to which populations should  receive the vaccine first, especially as a large percentage of vaccines remain unused in hospitals. Many states are devising their own procedures for vaccinations that deviate from CDC recommendations.

The U.S. Congress, state legislatures and the incoming administration must focus on delivering solutions that will stop the virus’s spread and provide economic relief. The present division is hindering nearly all meaningful progress on fighting the virus. We need a well-developed plan separated from political motivations to ensure that the vaccines are distributed efficiently and that businesses are not harmed further. This is especially so now that researchers have identified a more transmissible strain. If not, we risk losing precious time as the virus spreads. As we predicted in the summer, pandemic fatigue has made lockdowns increasingly unpopular. This shift in public opinion forced President-elect Biden to reject any future nationwide business closures. Until the vaccine is ready for improved distribution, policymakers may need to enact legal yet unpopular measures to reduce the current uncontrollable growth of COVID-19 cases. Yet politicians will not be motivated to do so until constituents hold them accountable for their unacceptable behavior. We had an opportunity to show our disapproval with our vote, but now that the election is over, it is not too late. A bipartisan effort will be required to navigate through 2021 and beyond and help our nation heal.