Thinking Globally, Acting Locally

The U.S. Response to Covid-19

Published in: The New England Journal of Medicine (April 2020). doi: 10.1056/NEJMp2006740

Posted on RAND.org on April 07, 2020

by Rebecca Lee Haffajee, Michelle M. Mello

Read More

Access further information on this document at New England Journal of Medicine

This article was published outside of RAND. The full text of the article can be found at the link above.

Covid-19 has exposed major weaknesses in the United States' federalist system of public health governance, which divides powers among the federal, state, and local governments. SARS-CoV-2 is exactly the type of infectious disease for which federal public health powers and emergencies were conceived: it is highly transmissible, crosses borders efficiently, and threatens our national infrastructure and economy. Its prevalence varies around the country, with states such as Washington, California, and New York hit particularly hard, but cases are mounting nationwide with appalling velocity. Strong, decisive national action is therefore imperative.

Research conducted by

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.