- States across the country have taken aggressive action, like closing school, bars, restaurants, and limiting public gatherings to combat the spread of COVID-19.
- Four states - Idaho, Nebraska, Missouri, and Texas - have offered recommendations and guidance to citizens, but have left major decisions on closures up to cities and school districts.
- Italy and Spain last week placed residents on almost total lockdowns as the countries deal with the largest outbreaks in Europe.
- Health officials in the US fear a similar situation could play out in the US without aggressive social distancing.
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As states across the country enact new policies and procedures to combat the spread of the novel coronavirus, four states - Idaho, Missouri, Nebraska, and Texas - have had a notably tepid response compared to other states nationwide.
Ohio Gov. Mike DeWine, for example, has been lauded as a model for other states' responses to COVID-19. At his urging, the state postponed its primary election - scheduled to occur on Tuesday - even after a court ruled against the decision. The state was one of the first to close schools statewide and to announce the statewide closure of bars and restaurants.
State leaders throughout the country, like New York Gov. Andrew Cuomo and Washington Gov. Jay Inslee, have followed suit in mandating the closure of bars and restaurants - besides to-go and delivery services - as the Trump administration recommended Monday that Americans limit groups to 10 people or fewer for at least 15 days.
Cities have enacted even tougher restrictions. Hoboken, New Jersey, Mayor Ravi Bhalla announced a citywide curfew that began Monday. San Francisco Bay Area in leaders asked residents to "shelter in place" until April 7, though the move is not a complete lockdown as residents don't need to obtain government permission before leaving their homes for necessary tasks.
The moves come in an attempt to "flatten the curve" of the coronavirus outbreak as experts suggest letting the outbreak occur over a longer period of time will avoid overwhelming the healthcare system. Leaders in Italy and Spain - the countries hit hardest by COVID-19 in Europe - have placed people on lockdown in order to stop the spread.
Experts say a window for taking action to flatten the curve in the US is shrinking.
Across the US, more than 5,200 cases of COVID-19 have been reported, and at least 94 people have died.
So far, Texas has confirmed 85 cases, Nebraska has 18, Missouri has six, and Idaho has five. The four states haven't reported any deaths relating to the novel coronavirus yet, according to data from Johns Hopkins University.
Part of the lowered response from these four states may be because COVID-19 hasn't infected as many people there, and aren't currently experiencing what experts call community transmission. But because it has taken so long to test high volumes of people nationwide, health officials expect there are many more cases than have been reported.
On Monday, US Surgeon General Jerome Adams warned the US could follow in Italy's path without "aggressive" measures like social distancing. Italy has reported the second-largest outbreak outside of China, with more than 27,000 cases and at least 2,158 deaths.
Texas is leaving things up to cities
Texas, which has a population of nearly 29 million and is the second-largest state in the country, hasn't yet closed schools, bars, or restaurants in the state, or forcibly limited the size of gatherings and groups.
Texas Gov. Greg Abbot has instituted policies that allow for the fast-tracking of out-of-state medical professionals, allowed for the allotment of medical supplies from a national stockpile, and waived trucking laws to more easily allow for food deliveries. He also banned non-essential guests at state nursing homes.
At a press conference over the weekend, Abbot said he believed individual city governments would make the best decisions for their communities on decisions like closing schools and limiting bar and restaurant services.
But as the Texas Tribune reported, some experts have warned that such "patchwork" policies that allow various practices across the state can lead to confusion.
It "makes people feel that they don't really know what's going on and that the people who are in charge don't really know what's going on," Mary Bassett, director of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University, told the Texas Tribune.
Some states have less strict requirements than the Trump administration's recommendations
Justin Pinkerman, a spokesman for Nebraska Gov. Pete Ricketts, directed Business Insider to state recommendations that schools move to online learning by March 23 and a press release where Ricketts reminded Idahoans of the CDC recommendations on crowd sizes. Neither, though, are mandated policies like the paths chosen by other states.
In a tweet, Ricketts said his recommendations were not enforceable by law. "It's going to take individual action from all of us to make this work," he said.
Missouri Gov. Michael Parson also recommended that localities within his state follow CDC guidance on social distancing and limiting gatherings, though he did not mandate them. Schools in Missouri have also not been told to close.
Idaho Gov. Brad Little has allocated funds to keep essential government services functioning amid the outbreak, though has likewise not demanded schools, bars, or restaurants close.
At least 26 states had closed schools as of Monday, affecting nearly 30 million children, according to the Wall Street Journal.
The offices of the Missouri, Idaho, and Texas governors didn't immediately respond to Business Insider's requests for comment.
At a White House press conference discussing the pandemic on Monday, President Donald Trump asked the American people to stay home if they can. Public health officials are emphasizing that the next two weeks are critical for curbing the spread of the virus.
"My administration is recommending that all Americans, including the young and healthy, work to engage in schooling from home when possible. Avoid gathering in groups of more than 10 people. Avoid discretionary travel. And avoid eating and drinking at bars, restaurants, and public food courts."
He continued: "If everyone makes this change or these critical changes and sacrifices now, we will rally together as one nation and we will defeat the virus."
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