Gordon Larsen
Senior Advisor for Federal Affairs, Office of Utah Governor Cox
Coming Together
Gordon Larsen has spent his career working to solve problems across political divides. He spent time as a staffer in the House of Representatives and with the U.S. Agency for Global Media, which oversees Voice of America and Radio Free Europe. In 2020, he was serving as the Federal Affairs lead for Utah Governor Herbert and stepped into an unanticipated role of pandemic advisor.
Telling the Truth
The COVID-19 pandemic brought with it many unknowns. As state leaders and public health officials and communicators struggled with those unknowns, public trust was at-risk.
Then Utah Governor Gary Herbert and his team called on former Utah Governor Mike Leavitt for advice. As Secretary of Health and Human Services during the George W. Bush administration, Leavitt had dealt with 9/11, the 2001 anthrax attacks, SARS, and fears of an H5N1 flu pandemic. Leavitt’s counsel and cautions laid the foundation for Utah’s pragmatic, measured COVID-19 response.
Former Secretary of HHS Mike Leavitt had two concrete pieces of advice that I remember. He said, first of all, you ought to buy a copy of John Barry’s The Great Influenza and read it, which I did immediately. And, second, he said you’ve got to recognize that no matter what you do, you’re not going to win either way. If you do it right and lives are saved, then people will see it as an overreaction that was not necessary, and if you don’t take it seriously and it’s bad, then that will cost you your credibility and your career. He was right to encourage us to just do what was right.
“The last few pages of John Barry’s book talk about the importance of just telling the truth and acknowledging what you know and what you don’t know. In March and April 2020, we were seeing just a handful of cases, and then – when you go back – the genetic sequencing shows that there were probably 70,000-80,000 cases at that point, but the CDC had blown the testing so that we just didn’t know.
“I think Barry’s point is, once you’ve given the public the opportunity to wrap their head around what you do know and what you don’t know, then they can make their risk calculations.
“I think that there’s a blind spot in the public health community in terms of behavioral economics. Again, this goes back to the importance of just telling people the truth. The federal government’s early decision to downplay masking – because they didn’t want to have everybody buy the masks and take them away from public health and from the healthcare workforce – cost so much credibility. Then, later on, when public health officials were saying other things that were absolutely true and absolutely important, many people said, yeah, but you lied to us about this, and you tried to manipulate our behavior on this. So I would stress the importance of telling the truth, and not just looking at it from a traditional public health point of view, but also looking at it from a point of view about how people are going to behave.”
Utah never actually issued a stay-at-home order the way that some states did. We were one of maybe 6 or 7 states that never actually did that. We did encourage people to avoid traveling and to stay away from other people. Even before we issued that directive, the traffic had dramatically dropped about 7 days earlier. If you look at Google mobility data, which tracked with our Utah Department of Transportation data, people had already started assuming the risk on their own with whatever information they had available to them. I mention that in the spirit of public officials just telling the truth – saying what you know and what you don’t know, it was so important.
Leading from the Top
Utah led its COVID-19 response from the top, deciding in early March to move to a unified command structure to bring in all of the relevant data and experts.
“States were in the driver’s seat of a lot of the policy, including in roles that we hadn’t planned on. I was Governor Herbert’s policy director, but immediately I was pulled into becoming one of a couple of staffers tasked with supporting then-Lieutenant Governor Spencer Cox. He was asked to run the state’s response and became the liaison with our hospital systems, other providers, and with our agencies, including with our Department of Health at the time, and with outside experts.”
In March 2020, we appointed the head of our Department of Public Safety as the head of a Unified Command that could pull together data and feedback from a broad swath of our community, including public health, education, hospital systems, and others to help keep everyone informed and allow real-time decision making with the best available data.
Every morning we would have a call at 8:00 or 8:30 a.m. where everybody would run through their reports. At the time there was a lot of focus on contact tracing and how contact tracing infrastructure was being set up and how it was working. Our epidemiologists and our contact tracers were heavily involved in that. That infrastructure, which was set up in March…lasted throughout the response and had different subgroups focused on those areas – all working to feed information up to the decision makers.
A multidisciplinary team
Pandemic response requires a multi-sectoral team and a focus on socio-economic impacts, yet states didn’t have the tools or the team to tackle those issues holistically.
“As the pandemic went on…we recognized that we couldn’t only be getting information from the public health community. There is an economic component…so we bifurcated the response and…brought on board Taylor Randall, who at the time was the head of the University of Utah’s Business School now he’s the President of the University of Utah – just a remarkable leader. He brought to bear an enormous amount of data about what sorts of decisions would have what kinds of economic impact.”
Keep Legislators in the Loop
Responding to the pandemic was inherently political, and, like other states nationwide, Utah had to strike the balance between public health and other considerations that affected people’s lives – including by being judicious about using executive powers at the expense of buy-in from state lawmakers who they would need as critical partners for support and resources.
“The legislature played a really important role, and I think it was an early lesson for us: if we acted as though executive authority was the only lever, then they were going to quickly try and retract some of the governor’s authority, which they did early on.”
Setting a Pragmatic Example
As the pandemic unfolded, and flashpoints developed around issues like masking and vaccination, Utah leaders endeavored to take a measured and pragmatic approach, building on a culture of volunteerism and philanthropy, high social mobility, and pride in civic institutions, as well as the strong influence of faith leaders within the Church of Jesus Christ of Latter Day Saints.
When it came to wearing masks, the governor took the same approach as he did with the stay-at-home directive. That approach was: we’re not going to order people, because there’s a resistance to being told, particularly by the government, that you have to do this. In some settings, maybe that’s what had to be done, and maybe it worked. But, early on, we discovered a pretty high rate of success with efforts to drive collective action. The idea was that we were all in this together, so let’s try and protect each other with the importance of both people wearing masks versus just one person wearing a mask. We saw a fairly high uptake of masking early on just by encouraging people to do it for the sake of their community – and to protect vulnerable populations.
“At some point, probably, that late spring or early summer of 2020, we implemented a system that ratcheted masking requirements and other restrictions up and down for large group gatherings, but it was based on data that everybody had public access to, which was created primarily in-house by our Department of Health…with help from our Department of Technology Services.”
As we compared our masking rate to other places, we were happy with how it worked. Later on, we did hear from a lot of the retail community that they didn’t want to be the bad guys, but they did feel like they needed to protect their customers and would appreciate it if the State would be willing to have a mask mandate that gave them cover. We designed a matrix that was based on hospitalization rates, case counts, and other factors, which created a way for our legislature and others to say masking requirements or restrictions on large group gatherings weren’t arbitrary but based on data and had the ultimate goal of protecting our hospital capacity.
The Church of Jesus Christ of Latter-Day Saints played a role in Utah in building trust in health measures, issuing a letter read in congregations throughout the church in March 2020 that signaled their move to remote services. The Church worked with hospital systems to promote the wearing of masks and to help make surgical masks to fight shortages.
“The Church of Jesus Christ of Latter-day Saints took the COVID-19 pandemic very seriously, and they went to remote church services in March of 2020. This immediately signaled to the millions of members of the faith, not just in Utah but throughout the world, that the pandemic was something to take seriously.”
When it came time to mask, the church led an effort with a lot of our hospital systems and other civic institutions, to design and volunteer to make masks. Early on, when there were massive shortages of PPE, people like my own mother volunteered and were sent the materials, and they created surgical masks. They were given very clear instructions, and they made hundreds of thousands of these masks that were shipped to hospital workers and to the healthcare community to use.
“At the same time, when we got our early shipments of the vaccine in November or December of 2020, Church of Jesus Christ of Latter-Day Saints President Russell Nelson was one of the first who, in a very public way, got the vaccine, and I think that made a huge difference…in strongly encouraging members of the faith to follow suit.”
What’s at Stake: American Democracy Itself
The COVID-19 pandemic – in particular, choices around masking, vaccination, and schools – became polarizing. Organizations like the National Governors Association are now challenged in their work to bring state leaders together around health emergencies.
“The single most important role the NGA played in the pandemic was nothing that they did in terms of policy suggestions. Instead the NGA provided a forum for governors to share best practices, and it became very clear that governors were in the driver’s seat of this.”
An early lesson we offered to our federal partners was that the most useful thing you can do for states is just get out of the way. We said this repeatedly to the White House and to federal agencies in both administrations. Cut the red tape on everything from telehealth regulations to FEMA regulations…and then provide funding resources. That’s all we need you to do. Stop trying to micromanage this because you’re not on the ground. Usually you’re two or three weeks behind what’s actually happening on the ground.
Some leaders like Larsen’s boss and current NGA Chair, Utah Governor Spencer Cox, are concerned about persistent polarization in pandemic policymaking and how it might leave America less prepared for the next biological crisis.