2D ❚ MONDAY, APRIL 6, 2020 ❚ USA TODAY NEWS
ical supply chain despite pleas from
governors in both parties to take control
of procurement and distribution.
The step back is deliberate. Trump
says he wants to give the states “flexibil-
ity” on whether to issue stay-at-home
orders. Vice President Mike Pence, head
of the White House coronavirus task
force, has repeated a mantra that the
administration’s approach is “locally
executed, state managed and federally
supported.”
The result: Never in modern times
has any governor had to handle a bigger
or more deadly crisis, one that is also
stressing the global economy and
straining the nation’s health care sys-
tem. Nearly 10,000 Americans have
died, a number that doesn’t yet show
signs of leveling off, and a record 6.6
million Americans filed last week for
unemployment insurance.
“Ninety days after I became governor,
I was faced with the riots in Baltimore,
where we called up 4,000 members of
the National Guard and a thousand po-
lice officers,” Hogan, who is also chair of
the National Governors Association,
said in an interview with USA TODAY.
“This is like 10 times more than that ev-
ery single day. It’s like a hurricane hits
all 50 states that keeps coming and
keeps increasing intensity with each
and every day.”
He said some of the decisions being
made – to close schools, shut down
businesses, impose quarantines, erect
emergency hospitals and blow up state
budgets – would have been unimagina-
ble only a month ago.
Is there a cost to candor?
One of the decisions: whether to
criticize Trump.
Governors who have publicly faulted
the federal government for not deliver-
ing enough help or the right help have
found themselves the target of the
president’s bully pulpit. Gov. Jay Inslee
of Washington, the first state to record a
coronavirus outbreak and death, in an
early tweet thanked Pence for his help
but added that “our work would be more
successful if the Trump administra-
tion stuck to the science and told the
truth.”
Trump then labeled Inslee “a snake”
who was “not a good governor” and
someone he would refuse to talk to, al-
though Pence has continued to speak
with him. Those exchanges have fueled
fears in Washington state and else-
where that a rhetorical breach could
have a substantive impact – that is,
could prompt federal agencies to punish
a governor by sending less aid to his or
her state.
“I’m praying that it doesn’t,” Inslee’s
predecessor, Christine Gregoire, said in
an interview. The former two-term gov-
ernor provides training sessions for new
governors through the National Gover-
nors Association, a group she once
headed, but she says she’s never en-
countered this particular challenge be-
fore.
“I have to tell you,” she said, “I can’t
remember one where the stakes were
high, let alone a matter of life and death,
where there’s been public disagree-
ments of this nature.”
Governors have found themselves
trying walk a fine line between express-
ing candor and protecting their state’s
interests.
“Maybe some of them are a little more
critical than they probably should be, in
my opinion, and some of them maybe
don’t speak up as much as they should,”
Hogan, a Republican, said of his fellow
governors in an interview with USA TO-
DAY. “But I just try to strike that balance
of being respectful, not overly critical,
but really clearly stating what the needs
are.”
Hogan pushed back last week when
Trump said, inaccurately, that gover-
nors were no longer expressing con-
cerns about a shortage of testing kits.
When the federal government sent
170 ventilators to Los Angeles County,
none of them operational, Newsom said
he simply located a Silicon Valley firm
that could refurbish them. “I didn’t call a
press conference,” the California gover-
nor said, although he did relate the ex-
perience in an interview on CNN
Wednesday. “Not finger-pointing; not
nail-biting.”
Newsom said his state, which has
among the highest number of coronavi-
rus patients in the country, doesn’t ex-
pect to receive all the ventilators it
needs from the federal stockpile and in-
stead is competing with other states to
buy them, a situation that has encour-
aged price gouging. “It’s the wild, wild
West, no question about it.”Wrath against ‘a woman governor’Whitmer also has incurred Trump’s
wrath.“All she does is sit there and blame
the federal government,” the president
complained last month, referring to her
as the “young, a woman governor” in
Michigan, not mentioning her name.
Whitmer responded with a tweet
that included a hand-waving emoji. “Hi,
my name is Gretchen Whitmer, and that
governor is me.” In an appearance on
Comedy Central’s “The Daily Show with
Trevor Noah,” Whitmer sported a bright
blue T-shirt that said, “That Woman
from Michigan.”
The president and the governor did
finally speak on the phone Tuesday. “It
was an unscheduled call,” Whitmer said
in the interview. “I had reached out and
asked for a call and it didn’t happen im-
mediately, but ultimately it did.”
She said she thanked him for a feder-
al shipment of protective N95 masks
from the Strategic National Stockpile
but said much more were needed.
“When we have one hospital system
in Detroit that’ll go through 12,000
masks in a shift, it tells you that 112,000
is helpful, but it’s nowhere near solving
the problem,” she said.
She dismissed questions about the
political implications of the crisis: “We
all have to remember right now the ene-
my is COVID-19.”
That said, Whitmer’s political stock
has risen. Former Vice President Joe Bi-
den, the presumptive Democratic presi-
dential nominee, said last week that she
had already been on his list of possible
running mates.
New York Gov. Andrew Cuomo’s rep-
utation has grown, too. His daily brief-
ing from Albany has become a Demo-
cratic counterpoint to the White House
briefing later each day presided over by
Trump. The governor’s blunt, measured
updates have even prompted specula-
tion on social media that he would be a
stronger presidential nominee than
Biden, a notion the governor has reject-
ed.
The coronavirus crisis could have a
broader political impact as well. For one
thing, it could counter the public’s long-
standing appetite for outsiders in politi-
cal office.
At the moment, deep experience and
an ability to direct the bureaucracy are
seen as valued assets. Among the gover-
nors who have gotten the highest marks
are those with long – and sometimes fa-
milial – records in politics. Cuomo andHogan have not only been elected to
multiple gubernatorial terms but also
are both second-generation politicians.
(Cuomo’s father was a New York gover-
nor; Hogan’s father was a Maryland
congressman.) Ohio Gov. DeWine is a
former lieutenant governor, state attor-
ney general, U.S. representative and
senator.
The challenges for governors won’t
end when the coronavirus crisis eases.
At that point, they’ll be dealing with the
pandemic’s repercussions for the health
system, for the economy and for bud-
gets that in 49 states are mandated to be
balanced. (The exception: Vermont.)Spring break at the beachThe governors who have gotten the
most criticism are those who have been
slowest to act, calculating that the
threat to their citizens didn’t warrant or-
dering the most disruptive restrictions.
Only a dozen governors, all of them
Republicans, so far haven’t issued state-
wide stay-at-home orders, a step that
public health officials say is crucial to
“flatten the curve,” to reduce transmis-
sion of the virus to avoid overloading the
health system. Those states are Ala-
bama, Arkansas, Iowa, Missouri, Ne-
braska, North Dakota, Oklahoma, South
Carolina, South Dakota, Texas, Utah
and Wyoming. (Some of those gover-
nors have ordered less far-reaching re-
strictions.)
Florida Gov. Ron DeSantis, whose re-
tiree-heavy population makes his state
particularly susceptible to the disease,
has been hammered for resisting calls to
close down crowded beaches during
spring break celebrations that drew
thousands of young people. Trump had
praised him as a “great governor” who
“knows exactly what he’s doing.”
Once the president on Tuesday
adopted a more somber tone and issued
a sobering projected death toll, howev-
er, DeSantis did order a statewide shut-
down for 30 days. He acted after the U.S.
surgeon general, Dr. Jerome Adams,
said on NBC’s “Today” show that De-
Santis should view the federal guide-
lines urging social distancing as “a na-
tional stay-at-home order.”
Georgia Gov. Brian Kemp also issued
a statewide shelter-in-place order on
Wednesday. At a news conference, he
said he had just learned that people who
showed no symptoms could be infected
and pass on the virus. Public health ex-
perts had been warning about that fact
since January, the fundamental reason
they had been urging everyone to stay
home.
“Well, we didn’t know that until the
last 24 hours,” Kemp told reporters.
“This is a game-changer for us.”Governors
Continued from Page 1D
“When we have one hospital system in Detroit that’ll go
through 12,000 masks in a shift, it tells you that 112,000 is
helpful, but it’s nowhere near solving the problem.”
Michigan Gov. Gretchen Whitmer“Although recognizing that many pa-
tients are experiencing new concerns
because of the COVID-19 pandemic,
ACOG continues to recommend follow-
ing existing evidence-based guidance
regarding home birth,” the group’s
statement says. “Each woman has the
right to make a medically informed deci-
sion about delivery.”
ACOG notes planned home birth is
associated with fewer maternal inter-
ventions than planned hospital birth
but also is associated with a more than
twofold increased risk of infant death
immediately after birth and a threefold
increased risk of neonatal seizures or
serious neurologic dysfunction.
About 1% of births in the USA occur at
home, according to the National Insti-
tutes of Health and Science. It’s too
early to say whether COVID-19 will
change that statistic in any significant
way, but anecdotal evidence shows
more women exploring it.
In Takoma Park, Maryland, Kathy
Peacock, a certified nurse-midwife, has
seen a surge of interest at her practice,
M.A.M.A.S.
“It’s really blowing up,” she said. “No-
body wants to go to the hospital. And I
kind of think they shouldn’t if they have
a low-risk pregnancy.”
Peacock said four or five people typi-
cally take part in in-person information
sessions, but by mid-April, 20 people
joined a meeting, now held online. Her
practice has space for six to eight clients
a month, based on due date. The spaces
don’t always fill up, but they are at ca-
pacity through August. New clients are
being taken on only if everyone in the
practice agrees, Peacock said.
Layla Swisher, a licensed midwife in
Tallahassee, Florida, said she is seeing
an increase in late transfers, women
who change to midwifery care further
along in their pregnancies. She had five
women seek her out in one week, which
is more than usual.
“It’s the ‘I’m getting ready to deliver’
crew who are calling us,” said Swisher,
who screens potential clients to ensure
they are a good fit for a home birth.
In Hope, Rhode Island, nurse-mid-
wife Michelle Palmer said she is seeing
“an exponential increase” at her prac-
tice and is hearing from other midwives
in similar situations.
Palmer, chair of the Home and Birth
Center Committee of the American Col-
lege of Nurse-Midwives, said there is an
opportunity to bring home birth and
midwifery care more into the health
care system. Her association collected
updated resources for health care work-
ers and patients.
“There are all different kinds of mid-
wives in our country wanting to be part
of the solution and be of service to ourcommunities in any way we can,” Palm-
er said.
Midwives say they take additional
safety precautions to cut down on pos-
sible infections. Swisher changed office
procedures at her birth center, the Birth
Cottage, so clients don’t overlap and in-
tends to cut down on post-birth home
visits.
Peacock said her practice “had to re-
do our entire model of care.” She and her
midwife colleagues scrapped home vis-
its, as well as in-person group meetings
for pregnant women due around the
same time. Those are virtual now, as are
a good portion of regular checkups.
The women start their regular check-
up on video chat in their car outside the
midwife’s home office and come insideonly for a hands-on check. Peacock
opens all doors for her clients, minimiz-
ing exposure to surfaces, disinfects
scrupulously between visits and en-
sures she and her fellow midwives are
not together in person. That way, if one
gets COVID-19, it can’t be spread to the
others.
Peacock asked her patients to have
on hand blood-pressure cuffs, a ther-
mometer, a stethoscope to listen for
heart tones and a measuring tape to
check fetus growth. Clients also are
asked to designate a single room at
home for labor, so it can be fully disin-
fected.
“For the majority of women, you
don’t need really anything other than
someone telling you that you’re doing a
good job and to keep at it,” Peacock said.
“That’s the community that we try to
build – that they have the resources
they need.”
The changes have taken a toll on the
midwives, who miss the close physical
connections, and on their pregnant pa-
tients.
“There’s a lot of uncertainty for any
woman pregnant with her first baby but
especially in a pandemic,” said McBee, a
M.A.M.A.S. client.
Star Ulosevich, who lives in Wash-
ington, transferred to M.A.M.A.S. She’d
planned to have her second baby, due in
May, with a hospital-based midwife
practice. But as COVID-19 bore down,
she and her husband researched home
births, buoyed by the uncomplicated,
unmedicated labor for their first baby.
Ulosevich finds comfort in the “care
and thoughtfulness” Peacock’s group
shows. Born at home herself, Ulosevich
decided a home birth would offer more
control, both against disease spread
and in the overall experience. Despite
the natural fear about a potential emer-
gency during birth, she said the pros of
being home outweighed the cons.
“Bringing a baby into the world is
more than just a physical exercise, it’s
quite an emotional one, and we wanted
to feel like we had a bit more control over
what that experience would be,” Ulo-
sevich said. “We’re really grateful that
we have this option.”Births
Continued from Page 1D
Star Ulosevich speaks with midwife Kathy Peacock on video chat in her car
outside Peacock’s home in Takoma Park, Md. Peacock prepared her basement for
use as an office during the COVID-19 pandemic. JASPER COLT/USA TODAY