On the last day of August 2021, 1,677 Utahns tested positive for the coronavirus.
Nearly 500 of Utah’s hospital beds were filled with COVID-19 patients, with about 50 new patients hospitalized each day. Lines at test sites were so long that patients were relieving themselves in bushes. Thirteen Utahns had died from the coronavirus one day earlier.
That was the day Gov. Spencer J. Cox stopped doing regular public updates focused on the pandemic.
Damon Cann, a political-science professor at Utah State University, said he connects that policy shift with the widespread availability of vaccines that gave people the chance to protect themselves — even if they chose not to.
“For me, it feels like the pivot point,” Cann said. “With that change, he has looked a lot more like conservative governors around the country.”
Since last August, Cox appears to have deviated from expectations that his reputation as a moderate would extend to his coronavirus response, as well as largely detaching from his office’s vague-but-lengthy agenda for combating COVID-19.
That agenda, drafted in Cox’s “One Utah Roadmap,” declared several of the administration’s pandemic response priorities “completed,” as cases were again rising and vaccinations had plateaued. Pandemic response priorities like implementing an aggressive vaccine strategy and hiring and training additional community health care workers were check-marked done in October.
A Cox spokeswoman said the administration’s fight against COVID-19 isn’t over but argued the state has made progress since the governor’s inauguration.
“We now have a much broader set of tools to fight the pandemic — vaccinations, booster shots, monoclonal antibodies, antiviral pills and other treatments — that we didn’t have at the beginning of the year,” senior adviser Jennifer Napier-Pearce said.
And more than 2.1 million Utahns have received at least one dose of the vaccine, “which is a remarkable achievement to celebrate,” she added.
But the pandemic isn’t over. Case counts in Utah increased rapidly during the final weeks of 2021 and the state’s intensive care units remain nearly full.
Governing the pandemic away
When Cox began his term a year ago, the new governor was hailed in national media as a rare, centrist Republican — one who looked to elevate civility and had consistently condemned former President Donald Trump’s attempt to overturn the 2020 election.
And during his first months as governor, Cox’s tone on COVID-19 was, accordingly, more moderate than much of the rhetoric coming from the right.
In a party where other Republican governors mocked mask use, supported rollbacks of childhood immunization outreach and dismissed COVID-19 as a media ploy, Cox has admonished anti-vax sentiment as misleading and deadly propaganda, promoted mask-wearing and openly scolded unvaccinated Utahns.
Cann notes that, unlike many other Republican governors, Cox has also raised concerns about access inequities to the COVID-19 vaccine and initially took a more aggressive policy stance on preventive measures.
“Some Republican governors have just kind of taken an absolute do-nothing attitude from fairly early days in the pandemic,” Cann said. “That certainly hasn’t been the case with Gov. Cox.”
When other red states were banning even private businesses from requiring proof of vaccination, Cox pledged to support private businesses’ choices.
The governor also distanced himself from legislation — bills he’d signed with veto-proof majorities — that restricted most public officials from enacting health restrictions like mask requirements.
And a week before his final weekly COVID-19 address, Cox was considering an executive order that would have allowed schools to require masks as cases spiked in the fall.
Then things changed.
In his last dedicated COVID-19 briefing on Aug. 31., Cox derided not only anti-maskers but also “extreme maskers,” telling them to “get over themselves.” He delivered the comments directly after a cancer-stricken health care executive at the event had begged Utahns to mask up to protect the immunocompromised.
Since, Cox has made few public remarks about the ongoing pandemic. In the latter part of his first year, he has objected to federal vaccine mandates and publicly accepted a donation of sanitizing wipes from multilevel marketing firm dōTERRA — about 18 months after federal regulators cited the company for falsely advertising its essential oil products as coronavirus remedies.
Gone were Cox’s frustrated reminders that it was the Legislature that had forbidden most paths to public prevention measures. And there was no more talk of executive workarounds to allow mask requirements in schools, even as the virus surged among children, contributing to delays in needed care for kids suffering from chronic illness.
And his early statewide tributes to those who died from COVID-19 have not resumed, even as the virus’ death count has hit new milestones.
Napier-Pearce, who was editor of The Tribune prior to joining Cox’s team, said the governor has been an unwavering proponent of COVID-19 vaccination and continues to drive the point home in the news media and in conversations with state lawmakers.
“Even though the need for the governor to host weekly news conferences has subsided, those working on the response continue to work day and night to ensure the health and safety of Utah residents,” she said.
April Mahon, a Taylorsville nurse who works in an intensive care unit, said she gets the sense that Cox is tired of talking about COVID-19 and wants to ignore it, despite the continued strain it puts on the state’s health system.
Lt. Gov. Deidre Henderson met with health care workers and visited a hospital this fall, but Cox’s attention seems to have shifted, Mahon said. When Cox recently scheduled a media appearance with snowplow drivers and urged Utahns to respect them as they work, she said, it was hard not to feel pushed aside.
“What about nurses? What about [respiratory therapists]? I’m glad you’re showing what snow-plowers have to do, but hello, this is still going on,” she said, adding that she had little hope of getting acknowledgment from the governor. “It is what it is. It’s not going to change.”
Cann points out that despite the tumultuous times, Cox’s approval ratings have held fairly even at around 60% over the first year of his term, perhaps a product of the governor’s affable presentation and emphasis on civility. Even if you disagree with Cox’s policies, his demeanor makes “it hard to be cranky” with him, the professor says.
But what Cann sees as civility, Mahon views as lack of leadership and unwillingness to stand up for public health measures.
“We’ve got a very loud … minority in the state of people that are like, ‘I’m not going to do this,’ and essentially throwing adult tantrums because they don’t want to keep their community safe,” she said. “And you’re going to pander to that?”
Rep. Suzanne Harrison, who works as a physician, says she’s worried the politicization of the pandemic will only continue. She’d like to see Cox push back more forcefully against the GOP-dominated Legislature.
“We have seen increasingly extreme bills coming out of the Utah Legislature that are anti-science and anti-business,” the Draper Democrat said. “I hope the governor will lead out against such extreme policies and advocate for common-sense solutions that help us get back to work and back to normal.”
Cox’s first year in the pandemic
Cox’s “One Utah Roadmap” initially promised: an “aggressive” vaccine strategy; more community health workers; the creation of an improved testing and messaging campaign to combat COVID-19 hot spots; a policy to guide health emergency planning and supplies; a council of public health and health care industry workers.
All of those agenda items were checked off as “completed” when the roadmap was updated in October.
Napier-Pearce said the administration placed 129 health workers — who collectively reach 30 languages and 60 cultures — in local health departments and community-based organizations across the state.
They’ve also started publishing information about school outbreaks on the state’s online COVID-19 dashboard to “help parents make the best choices for their child,” Cox’s spokeswoman said. And they have partnered with rural physicians and other trusted community leaders to combat vaccine hesitancy in communities with lower immunization rates.
But the roadmap document itself doesn’t always explain what actions reflect the completion of its goals.
For example, the vaccine strategy was marked “done,” even though the vaccine hadn’t been released yet to children younger than 12, and Utah’s vaccine coverage of eligible residents — a bit below the national average — had increased less than 3% during the previous month.
And Utah’s vaccination rate has fallen even further below the national average since October, according to CDC data.
Cox’s updated “Roadmap” kept testing and messaging improvements on its to-do list, along with the priority of being “judicious” stewards of federal relief funds and preparing for future public health emergencies.
Early last year the state ramped up its free testing sites through TestUtah and the Utah National Guard, a priority of the new governor.
But those sites became overwhelmed when the state transferred most of its locations to the private contractors who operate TestUtah, right as schools opened and cases surged in late August and early September — something health officials had been predicting for weeks.
Tests eventually became more available as the sites ramped up staffing and locations — but state officials warned that wait times were rising again amid the winter holidays.
One goal that hasn’t yet been checked off the roadmap to-do list is to complete a full review of the state’s COVID-19 response.
“The pandemic continues,” Napier-Pearce said, “We continue to update our response in real-time as new needs and challenges arise, so a full review isn’t possible at this time.”
Brian Shiozawa, a physician and former state legislator, was part of the team that advised Cox in the lead-up to his inauguration — offering public health guidance that the governor would incorporate into his roadmap. So far, Shiozawa is impressed by Cox’s handling of COVID-19, praising the governor’s collaboration with health systems and his efforts to educate Utahns about immunization.
There is room for more communication from the governor about aspects of the pandemic, Shiozawa said. But when it comes to vaccination, Cox likely has limited power to sway resistant Utahns.
“There is so much fatigue out there in the public about COVID,” he said. “And the people who are going to get vaccinated probably have been vaccinated, and those who aren’t are pretty set in their opinion about why they shouldn’t be.”
