Should all states mandate a stay-at-home order?
- On January 21, 2020, the first U.S. case of the “Wuhan coronavirus” is confirmed in Washington state .
- On March 13, 2020, President Trump declared a state of emergency over the coronavirus pandemic .
- The media-reported worst-case scenario prediction of “2.2 million [coronavirus deaths] in the U.S.” originated from UK public health experts via the Imperial College Study released on March 16, 2020 .
- California became the first state to implement sheltering in place on March 20, 2020 .
- According to the Johns Hopkins Center for Systems Science and Engineering, there are around 557,571 confirmed Covid-19 cases across the country, with nearly 25,000 deaths to date .
Some in the media suggest all states follow a lock-down policy amidst the COVID-19 pandemic . This sort of uniform approach is not only unconstitutional, threatening the American system of liberty, but is unnecessary due to the geographical and social diversity of the nation. America is a federalist republic--the states are responsible for the wellbeing of their citizens with the sovereignty to handle any crisis as it pertains to them . States decide on the public safety measures that apply best to their cities and economy.
It isn’t necessary every state mandate a stay-at-home order as populations vary across state lines. Currently, Wyoming reports 261 coronavirus cases and no deaths with a population of ~578,000 spanning over 100,000 square miles [3,4]. The risk of an increased outbreak is slim, and they shouldn’t be expected to shelter-in-place. The states, listed by reporters in the media , are not facing a New York City-level crisis, with a population of over 8 million spanning 300 square miles and 8,627 deaths . This is like asking Arkansas to tackle their homelessness problem the same as California . States are capable of encouraging citizens to take local responsibly, according to each city’s particular circumstance. Allowing healthy populations to work and support the local economy as much as possible will save more lives than risk .
Moreover, Americans should be concerned by such sudden increased government control. If authorities can entertain massive lockdowns when there are zero deaths, what’s to stop a lockdown over actual contagion-related deaths (27 people died from flu in Wyoming in 2019)  or over anything that can save “just one life” [10,11]?
National Institute of Allergy and Infectious Disease Director and coronavirus task force member, Anthony Fauci, thinks all states should mandate stay-at-home orders and with good reason . The numbers clearly show the value of aggressively seeking to slow our Covid-19 infection rate.
According to Health Affairs , a peer-reviewed health policy and research journal , infection rate projections range between 20-60 percent in America’s 329,502,476 population . The American Hospital Association (AHA), as cited by the Society of Critical Care Medicine (SCCM), estimates 30 percent will be infected, with about 4.6 million requiring hospitalization . 1.9 million are projected to need ICU care, with about 960,000 requiring mechanical respiratory support.
Contrast those potential needs with what we actually have . We entered Covid-19 with, according to the AHA, 924,107 “total staffed beds in all US hospitals.” That includes 96,596 ICU beds, only 1 percent of which are in rural areas [7,8], and 62,000 full-featured ventilators, according to the SCCM. Even with the 98,738 older ventilator models that could be pressed into service, we’re still short. Field hospitals and Navy ships have added beds [9,10], but they may not be enough if cases continue to increase.
We’re more vulnerable to Covid-19 than we think . It’s not only the 52 million elderly at greater risk [12,13]. It’s also the 6-in-10 Americans  with a chronic disease , the 4-in-10 U.S. adults with multiple chronic diseases , and the 42.4 percent of Americans  who are obese . Already, healthcare professionals are experiencing protective gear shortages [19,20]. All states participating in stay-at-home orders can help reduce travel spread infections , slow the overall infection rate, preserve medical system functioning, and buy time to rebuild supply levels.