As parts of the Kansas City metro begin to re-open, mayors from different jurisdictions are worried the varying approaches have created confusion that could lead to noncompliance and diminished trust in their ability to lead.
Recent reports on such meetings between mayors, including a transcript of a late April call between the mayors published by The New York Times, have shown a breakdown in the united front elected officials presented when the Kansas City metro region went into lockdown in late March.
The phone calls between leaders, organized by the Mid-America Regional Council, provide a rare window into the thought process of elected officials and the politics of managing a massive public health crisis.
On Tuesday, leaders discussed whether the metro would have to tighten restrictions if easing regulations results in increased cases, and what that would mean for public confidence and mental health. The conversation recounted here (with leaders comments edited for length and clarity) focused on whether the metro should adopt the same “gating” criteria, which are guidelines used to decide if a city or county is ready to move to the next step of reopening.
Kansas City Health Department Director Dr. Rex Archer expressed concern about “too early of an opening,” and said local governmental bodies should wait at least 28 days between phases of reopening to make sure easing restrictions didn’t cause an outbreak.
“I think it's going to be even more difficult to tighten up, but many of us are believing nationally, as well as I locally, that we will have to tighten up before the end of June — that this is not going to be working," Archer said. "And so I agree, we need to get that criteria out there. Hopefully, develop a consensus so that we understand why we're having to tighten back up.”
Unified Government of Wyandotte County and Kansas City, Kansas Mayor David Alvey said he worried about easing restrictions only to come back later and put them back in place. Alvey stressed that the guiding concern should be health care system capacity, especially because the region shares resources.
“I'm very concerned that no matter how we move forward, it doesn't make any sense to me, honestly, to open so much that we would then increase the infection rate and increase the mortality and then have to step back to another level, one of the previous levels," Alvey said. "I think that would really erode public confidence in not just the public health directors — even if the public health directors recommend that we be much more stringent and keep the controls on. If we as elected (officials) continue to open it up, perhaps prematurely, if we don't follow and we start getting a surge, we're back to the point where we have to prevent overload to our system. That's going to erode public confidence.”
Gladstone Mayor Carol Suter said even if local governments use the same criteria for moving through phases of reopening, each jurisdiction would meet the requirements at different times. And easing restrictions only to come back later and put them back in place would create “chaos,” she said.
“I mean, frankly, you look at these charts and you say, again, we look like chickens running around with our heads cut off. Because how can it be safe to have a wedding on this side of the street but it's not safe to have a wedding across the street? I mean, there are just some differences in here that boggle the mind to say that we're all using the very best, the very finest medical advice. Everybody's claiming that. And yet our advice is all different and we're really doing things differently," Suter said. "I feel for folks in most of our region who are multi-jurisdictional in our daily lives, we have created an almost impossible situation for people to be able to comply with. And so what we're seeing across the country, and right here in our region, is just lack of compliance. So while we kind of gnash our teeth over some of the fine details of this stuff, the public has no appetite for that.”
Kansas City Mayor Quinton Lucas pushed back, saying what happens in one city in the metro affects the entire region so it makes sense to have the same metrics for phased reopenings. Lucas pointed to an outbreak at a St. Joseph meat processing plant that led to a surge of cases in Kansas City.
“The thing that this group, and maybe we will never get to this, but the place that we actually need to get is all of us recognizing we're one place. And I say this as someone who sometimes probably doesn't act that way. But I mean if, yes, if Gladstone does open across the street from me, as is the experience, then that, I think, creates a challenge.”
Independence Mayor Eileen Weir jumped in to point out that the group had created six criteria for reopening: reduction in cases, access to protective equipment for frontline workers, health system’s having the ability to manage a surge in cases, robust contact tracing and public health funding.
“So now here we are on May 5 saying we need to create this gating criteria. Well, we have done that. We have had this criteria placed before us by our health directors collectively. And I think that continues to be our baseline. So as I've said, and if you didn't hear me say it you could have read it in the New York Times, this was presented to us, and I still feel strongly that this group should take some action on this.”
Lucas said he agreed with Weir’s point of using this as a baseline but wanted to stress that with the interwoven nature of the metro, it might not be safe for one city or county with low cases right now to reopen. Lucas also took issue with Missouri Gov. Mike Parson touring businesses without wearing a mask.
“We have to continue to express how this is an important crisis. My governor, God bless him, was out in Joplin yesterday without a mask on. He was talking about Missouri being open, and that's a message that is on television screens to a lot of people. And even if you don't agree politically with him, that's a sign to some that, ‘Oh yeah, this is fine.’”
Blue Springs Mayor Carson Ross pointed to the effect of stay-at-home orders on mental health. Ross said the group needs to consider the risk of domestic abuse and suicides increasing.
“I think there is a reality check for us elected officials. For those people that have not already lost confidence in our leadership, they're losing confidence in our leadership because we're not on the same page. And I don't expect everybody to be on the same page, but there need to be some similarities. I appreciate the health care professionals, they give us good information. But I'm also concerned about the other comments that I'm getting from people that's not in the healthcare industry. I'm very concerned about our business owners. Some have closed the doors that will never reopen. Some of them are struggling and will close the doors.”
Wyandotte County's Alvey said he’s also concerned about business owners, but he thinks the economic effects of a second wave of coronavirus cases could take an even greater toll.
“People trust us to make sure that we're protecting them. And as elected (officials), we follow the recommendations of public health, what they need to do in order to get things done and to protect us. And so I just can't imagine what the effect on the economy will be if we get a surge that does take over and spread like wildfire, overwhelms our capacity to provide healthcare. The demoralization that would occur from that, I just can't imagine what that would be like after what we've all been through," he said.
"And I would suggest that the real approach to this is a regional intervention strategy. We understand that this virus does not respect any kind of boundaries, other than social distancing, and we have to attack it regionally, wherever there's a hotspot, we need to know where it is. We need to be able to do the testing, the contact tracing, to isolate those individuals, whatever that place might be. So we can really get on top of this.”
The group decided to have local public health departments work together to create regional criteria for reopening phases as well as a framework that “provides options from which each jurisdiction can work” if a unified approach isn’t achievable. Those will be discussed next Tuesday.
