Why State Laws Make Local Leaders Fear the Next Pandemic - U.S. News & World Report
Legislators applaud Tennessee Gov. Bill Lee as he delivers his State of the State address Monday, Jan. 31, 2022, in Nashville, Tenn. In October, Lee signed a bill into law that made it next-to-impossible to institute mask mandates in Tennessee. The Associated Press
As local mask mandates rapidly fall by the way, public health officials fret that restrictions placed on them during the pandemic by state officials could hamper future efforts to contain the next virus that hits America.
A case in point is Tennessee, where the state last year passed a law that prohibits mask mandates in public buildings and schools and prohibits most employers from requiring vaccines.
The law tied the hands of folks such as Nashville Mayor John Cooper, whose spokesperson said that “If it were possible under state law,” the mayor would certainly reinstate a mask requirement.
Tennessee’s county public health departments, particularly those in major metropolitan areas, had a large degree of control over the decisions made with regards to their communities prior to the controversial legislative session of October 2021, says Dr. Michelle Taylor, director of the health department in Shelby County, home to Memphis. For example, when the delta surge coincided with the start of the 2021-2022 school year, the health department in Shelby County analyzed the data and “instituted a universal mask requirement for all of our K through 12 schools, pre-K and daycares,” she says.
But by the time omicron started to devastate the country this winter, they’d lost that flexibility.
“The Tennessee State Legislature called a special session,” she says, “and the world changed for us in the health department, at least in regards to pandemics.”
The law passed by Tennessee and similar legislation in other states will “almost definitely” make it harder to address future pandemics, says Francesca Weaks, a public health expert and consultant for the Local Solutions Support Center, an organization which coordinates with local officials to counter preemptive laws.
Weaks says that preemptive laws passed in the wake of the pandemic were often done by state legislatures with little input by public health officials. “Those who are actually public health experts are having no say in these policies,” she says.
Tennessee’s sweeping piece of legislation passed in the fall prohibited mask-mandates unless a county had at least 1,000 new infections for every 100,000 people over the course of 14 days. Even then, the governor would still need to declare a state of emergency for mandates to be permissible.
When the legislation was enacted, the highly-contagious omicron variant had not yet broken out in the United States. In the following months, cases skyrocketed, exceeding the legal threshold. Yet at no point during the omicron surge did Gov. Bill Lee take action to do away with bans on mask mandates.
“The law was written by the Tennessee State Legislature not by the Tennessee Department of Health. It was not written in consultation with any medical professionals or any public health professional,” says Taylor. “When you read the law, that becomes very clear.”
Traditionally, in the United States, public health has been administered at a local level, says Courtnee Melton-Fant, a professor at the University of Memphis’ School of Public Health. “In Tennessee there's a lot of variation in the population: We have rural and suburban areas, we have cities.” Public health had been very localized, she says, to allow health departments to respond to their communities’ specific needs.
While the omicron surge has leveled out, it’s still having an impact in the state. Close to 800 people are currently hospitalized with COVID-19 and 172 people are currently in intensive care units. At the peak of the omicron surge, there were 3,404 people hospitalized, with 668 in intensive care. In January, 23% of hospitals in Tennessee reported staffing shortages.
In Tennessee schools, however, there was no requirement that students and teachers wear masks at the height of the omicron surge. Many Tennessee employers are legally barred from requiring their employees to get vaccinated, with exceptions applying mostly to businesses with relationships to the federal government, such as contractors and Medicaid-enrolled health care providers. And local government officials have little power to change this.
“We’re in a strange legal environment,” says Joda Thongnopnua, the chief of staff for Chattanooga mayor, Tim Kelly. “We [couldn’t] say, ‘If you have a positive case, you have to stay home. There was no ability for the city of Chattanooga to require masks in public buildings.”
For cities like Chattanooga, Memphis and Nashville, the pandemic has accelerated what was already a growing trend – state governments preempting cities and towns, preventing local governments from responding to local issues.
A study conducted in 2018 by the American Public Health Association found that 60% of mayors and 72% of local public health officials either delayed or abandoned policies as a result of state preemption. According to Governing Daily, the pandemic has only exacerbated this issue. In almost half the states, some form of legislation has been introduced which limits the ability of public health authorities to respond to the pandemic.
In addition to the issues this causes for addressing COVID-19, specifically, Weaks says that it also creates broader issues for implementing any public health policy. When governors and state legislatures pass laws overriding local officials, she says it creates breakdowns in policy at all levels.
“The hardest thing is when we have state officials who make those local decisions, and then the local officials have to implement it,” Weaks says. “And they get pushback from the community or it doesn't get implemented properly, or it doesn't get implemented at all, because the locals don't feel like that is what's best for their community.”
Some experts say that this will only continue to be a problem for public health officials.
“COVID hypercharged existing trends across a full gamut of the policy spectrum,” said Brooks Rainwater, the senior executive and director of the National League of Cities’ Center for City Solutions. “Preemption was already growing as a challenge for local governments. What COVID did is make it tremendously harder for local governments to make decisions in a very fast paced changing policy environment.”
“If legislation like this continues to be passed, it is going to make it more challenging because we have fewer tools in our toolkit,” says Taylor. “Basically, what you're asking me to do is fly the plane with one engine and one wing, when the plane would fly so much better if I had both engines and two wings.”
source: https://www.usnews.com/news/best-states/articles/2022-03-11/why-state-laws-make-local-leaders-fear-the-next-pandemic
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