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Failing federalism? US dualist federalism and the 2020–22 pandemic
John Agnew
2022, Regional Studies, Regional Science
October 11, 2025
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Abstract
Some accounts focus on the role of governmental systems in the management of the 2020-22 Coronavirus/Covid-19 pandemic. But studies with such an emphasis have typically taken second place to interpretations of outcomes in terms of cases and deaths based on cultural and demographic differences. In theory, federal systems would seem to have certain advantages in managing pandemics given the presumed ability to co-manage national challenges at the federal level (testing, vaccines, resources, etc.) with local differences in demography and behaviour at the state level. This paper argues that, in the case of the United States, its federal system was central to its failure in managing the pandemic. But rather than an indictment of federalism broadly construed, this was the result of a vision of federalism put into practice since the 1980s reflecting a strict division of powers between the states and the federal government. Rather than partners or collaborators with the federal government, the states became competitors with one another and with the federal government. This was the recipe for failure more than was federalism as such.
Key takeaways
AI
The US federal system's dualist federalism exacerbated pandemic management failures between 2020-22.
Federalism in the US has devolved into competition among states rather than collaboration.
The US experienced the highest COVID-19 death rate among high-income countries, with over 863,000 deaths.
62.9% of the US population over age 12 was fully vaccinated by January 20, 2022, lagging behind other nations.
The paper critiques the effectiveness of US federalism in crisis management, arguing for a more coordinative approach.
Figures (3)
Daily Trends in Number of COVID-19 Cases in The United States Reported to the CDC
Percent of People Fully Vaccinated Reported to the CDC by State/Territory and for Select Federal Entities for the Population 12 Years of Age and Older
In theory one might expect all federal systems to do better than unitary ones at managing < yandemic: at the same time, you can combine national leadership and economies of scale ir ucquiring needed resources and leadership with local measures reflecting the needs of differen sopulations (rural/urban, attitudes to disease, health care facilities, etc.) As Figure 3 (coverings he first year of the pandemic) shows, this is not how it turned out, although some did bette: han others (De Biase & Dougherty, 2021). The US performance was among the direst acros: he first nine months. By and large, the federal and the other more decentralized if still officially initary countries (measured in terms of total subnational and subnational health expenditures ended to do relatively worse across the first nine months of the pandemic in caseloads than dic nany of the more centralized countries with clearer central direction and less political grand- standing by regional and local politicians. Belgium did poorly early on (as shown here), partly yecause of regional animosities, but it later bounced back with a very successful vaccination pro- xramme (Vanham, 2021). Many other federal systems in large countries, such as Canada, Aus- ralia and Germany, though, managed to maintain a more collaborative or ‘polyphonic’ rathe: han a competitive/dualist approach to governance from the outset (e.g., Fenna, 2022; Kropy & Schnabel, 2022; Lecours et al., 2022). This involves formal channels for negotiating acros:
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Regional Studies, Regional Science

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/rsrs20

Failing federalism? US dualist federalism and the
2020–22 pandemic

John Agnew

To cite this article: John Agnew (2022) Failing federalism? US dualist federalism
and the 2020–22 pandemic, Regional Studies, Regional Science, 9:1, 149-171, DOI:
10.1080/21681376.2022.2045214

To link to this article: https://doi.org/10.1080/21681376.2022.2045214

UK Limited, trading as Taylor & Francis
Group

Published online: 24 Mar 2022.

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REGIONAL STUDIES, REGIONAL SCIENCE
2022, VOL. 9, NO. 1, 149–171

ANNUAL LECTURE

Failing federalism? US dualist federalism and the
2020–22 pandemic
John Agnewa

ABSTRACT
Some accounts focus on the role of governmental systems in the management of the 2020–22
Coronavirus/Covid-19 pandemic. But studies with such an emphasis have typically taken second place
to interpretations of outcomes in terms of cases and deaths based on cultural and demographic
differences. In theory, federal systems would seem to have certain advantages in managing pandemics
given the presumed ability to co-manage national challenges at the federal level (testing, vaccines,
resources, etc.) with local differences in demography and behaviour at the state level. This paper argues
that, in the case of the United States, its federal system was central to its failure in managing the
pandemic. But rather than an indictment of federalism broadly construed, this was the result of a vision
of federalism put into practice since the 1980s reﬂecting a strict division of powers between the states
and the federal government. Rather than partners or collaborators with the federal government, the
states became competitors with one another and with the federal government. This was the recipe for
failure more than was federalism as such.
ARTICLE HISTORY
Received 20 October 2021; Accepted 28 January 2022
KEYWORDS
dualist federalism; unitary and federal regimes; United States; 2020–22 pandemic

INTRODUCTION

With few exceptions, mainly in Asia, most national governments worldwide have been seen by a
host of commentators as largely ‘failing’ the test of their organization and competence posed by
the 2020–22 Coronavirus/Covid-19 pandemic. This has been put down to a wide range of fail-
ures both cultural and governmental. In one case, for example, the ‘failure of the Enlightenment
project’ is indicted in which the central state lauded by the main ﬁgures in European political
philosophy such as Thomas Hobbes, John Locke and Montesquieu – particularly in the UK
and the USA – is judged to have failed compared with its East Asian counterparts based in a
more collectivist political–intellectual tradition (Murphy, 2020). The available empirical evi-
dence for this is hardly convincing as of January 2022. Alternatively, some have noted the revolt
of peripheral local populations against an overweening central state (Tuccille, 2020) that pun-
ishes rather than celebrates a diversity of ‘values.’ Seeing restrictions as worse than the disease,
the Italian philosopher Giorgio Agamben suggested that the pandemic was ‘invented’ as a

CONTACT
(Corresponding author)
[email protected]
a Department of Geography, University of California, Los Angeles, CA, USA.

© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/
licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

150 John Agnew

pretext for disciplining populations (Agamben, 2021, p. 13). This celebration of ‘liberty’ against
mask and vaccination mandates seems evidently ideological and self-destructive in terms of lives
lost and damaged. Finally, and similarly, is the claim that central governments, particularly in
the United States, based on a ‘vision of neutral administration’ (Howard, 2021) emerging
since the 1960s, spawned a crisis in public trust and subsequent public paralysis in the face of
failure to address ‘political trade-offs’ between health and economy. The failures of the US fed-
eral government here seem to reﬂect the ideological polarization between the two main political
parties during the pandemic rather than any longstanding nationwide bureaucratic inertia.
Somewhat less hyperbolically, and more contingently, other authors have identiﬁed the geo-
graphical tensions inherent in certain systems of governance as central to understanding what
happened in the face of the pandemic. The uneven geographical distribution of different
socio-demographic groups (age, race, ethnicity) as well as the differential distribution of differ-
ent local–regional political regimes with distinctive vulnerabilities to the pandemic in terms of,
respectively, health conditions and management capacities, are seen as keys to understanding.
Thus, Gaskell and Stoker (2020), Delaney (2020) and Ford (2020), just to name a few, identify
the crucial role of multilevel governance and the barriers to achieving coordinated management
and emergency response, in some cases more than others, as crucial to the outcomes in terms of
testing/tracing, lockdowns, deaths, hospitalizations and vaccinations. As the pandemic has per-
sisted it is in fact the last two of these that offer the most interesting evidence relative to the
quality of management (e.g., Samuel, 2021).
Some governmental systems, therefore, appear to have failed more than others (Baldwin,
2021). Of course, the geographical scope of pandemics and emerging challenges such as climate
change make governance on a strictly state–territorial basis increasingly difﬁcult. Little events
somewhere distant now cause rapid and signiﬁcant effects elsewhere. Pragmatism rather than
adherence to old maxims may be the only solution in such circumstance. Most governmental
systems are ill-prepared for this. The utter failure to cooperate very well globally in providing
vaccines worldwide in order to prevent dangerous mutations from evolving is exhibit A for
the mismatch between problem scope and management reach (Brilliant, 2021; The Economist,
2021a; Gostin et al., 2021; Haseltine, 2021; Wang et al., 2020). But even at the national scale in
the United States the tragedy has been evident in the failure to learn from other subnational
governments even within the same country as well as from abroad (e.g., The Economist,
2022b; Morrow, 2022; Stone, 2022; Taranto, 2022). Most states locked into public health pol-
icies that, even while failing, were not abandoned because of ideological attachments and pol-
itical resentments based in historic inequalities and scientiﬁc ignorance (e.g., Gordon et al.,
2020; Witt, 2020; Wright, 2021). Among other things, blame-shifting across levels of govern-
ment and an unwillingness to show political weakness by reversing course have long been noted
by students of political crisis management (e.g., Weible et al., 2020).
But a more mundane and, it turned out, lethal attachment to initial decisions, made in the
face of totally inadequate information, also informed the relative failure in many cases. Different
units – states and localities – locked into testing/quarantine, mitigation (distancing, closing
public spaces, etc.), suppression (wholesale lockdowns) or doing little or nothing, without
much later adjustment to account for changing circumstances and better knowledge (Baldwin,
2021, p. 4; The Economist, 2022a). Local governments, as largely creatures of state governments
under US federalism, had limited autonomy to follow their own practices during the pandemic.
At the same time, much more pragmatism was evident in economic policies such as income sup-
port and loose monetary measures on the part of central banks (e.g., Ip, 2021; Tooze, 2021).
Effective policymaking may have been more difﬁcult in a pandemic, but it was not impossible.
Whatever the metric, the outcome in the United States has been relatively dire. In terms of
excess deaths, the US performance in the pandemic was the worst among all the world’s high-
income countries: eight times higher than the average (Achenbach, 2022; The Economist, 2021e;

REGIONAL STUDIES, REGIONAL SCIENCE

Failing federalism? US dualist federalism and the 2020–22 pandemic 151

Mueller & Lutz, 2022). As of 20 January 2022, a total of 863,334 deaths in the United States
were attributed directly to Covid-19. A total of 1 in 500 Americans had ofﬁcially died as a direct
result of infection by the virus by 8 September 2020, 1 in 463 by the same date in October 2021,
and 1 in 259 by 20 January 2022 (Bump, 2021; Holcombe, 2021; The New York Times, 2022).
US deaths from Covid-19 doubled in 2021, even with the arrival of effective vaccines early in the
year (Chappell, 2021). The daily case count in September 2021 was up 316% since early Sep-
tember 2020, and the hospitalization numbers were up 158% from the same date (Beer, 2021).
These metrics then exploded again in November–December 2021 with the arrival of the Omi-
cron variant. This time, however, the death rate was much lower due to increased immunity and
the apparently lower virulence of the strain. The pandemic seemed to be never-ending after
hopeful signs in June 2021. Indeed, speculation about further waves of infection in the United
States in late 2021 did not seem widely off the mark (e.g., Wilson, 2021).
Many other countries at similar levels of economic development had much better numbers in
terms of fewer cases and hospitalizations by September 2021, even in the face of the more viru-
lent Delta variant, reﬂecting in large part the failure of vaccination to reach sufﬁcient people (as
a consequence of both limited access in some poorer communities as well as anti-vaccination
sentiment more generally) and the hostility to restrictive behaviour (masking, lockdowns,
etc.) campaigns in numerous US states (Levitt & Keating, 2021). New variants spread as a
result. Hospitals were swamped in states such as Mississippi, Arkansas, Texas, Florida and
Idaho in late summer 2021. These rates were higher than in early impacted states such as
New Jersey and New York in winter 2020 and across a broader swath of states in winter
2020–21 (Evans, 2021). A similar geographical pattern was repeated with the more transmis-
sible but less virulent Omicron variant in late 2021 and early 2022 (e.g., Narea, 2022; Smyth
& Gilbert, 2021; Steinhauser et al., 2021).
Of declared federal countries, ones with constitutionally deﬁned divisions of political func-
tions between federal and state- or provincial-level governments (covering about 40% of the
world’s population), as opposed to ones with multi-tiered governments in which ultimate auth-
ority rests in centralized unitary states (such as Spain, Italy and the UK), only Brazil had an
overall higher ofﬁcial Covid-19 death rate than the United States as of 20 January 2022 and
the United States ranked a very high 19th in death rates out of 223 reporting territories. The
deﬁciencies in the quality of the data available worldwide including in the United States (on
the numbers, see, e.g., Worldometer, 2022; on data, see, e.g., Tufekci, 2021a) should be kept
in mind. Reports suggest that the numbers of deaths in India and Mexico (both federal
countries) have been signiﬁcantly higher than ofﬁcial ﬁgures suggest (e.g., The Economist,
2022c; Jha et al., 2022). In terms of vaccination against Covid-19, as of 20 January 2022,
62.9% of the US population over age 12 was fully vaccinated (deﬁned as two shots of the Mod-
erna and Pﬁzer vaccines and one of the J&J) compared with 70.4% of over-16s in the UK, and
70.6% of all adults in the European Union. The US vaccination rate tailed off over the summer
of 2021 to one of the lowest overall rates among the world’s wealthiest countries (Lukpat, 2021).
Although 60.3% of the world’s over-12 population had received at least one dose of the vaccines
as of 20 January 2022, only 9.4% of people in low-income countries had received one dose
(Ellyatt, 2021; Our World in Data, 2022). In September 2021, the pandemic had still seemed
far from over in light of the surge associated with the spread of the Delta variant. The appear-
ance of new variants (such as Omicron) and continuing low vaccination rates even in countries
with relatively easy access did not inspire conﬁdence that the pandemic would soon pass (e.g.,
Kupferschmidt, 2021). The longer the pandemic lasted, the more tenuous the immunity offered
by the original vaccines would become (e.g., Cortez, 2021).
The present focus, then, is on the governance of the pandemic we have all been experiencing
over the past two years or more and, more speciﬁcally, the relative merits of the actual decen-
tralized versus a prospectively more centralized response in the United States as a diagnostic

REGIONAL STUDIES, REGIONAL SCIENCE

152 John Agnew

case. So, as the world slowly begins to recover from the pandemic in 2022, how will different
regions and localities cope and respond in terms of what they have learned given the different
institutional settings in which they are located? More speciﬁcally, I am interested in the role of
US federalism in what has been widely seen by many commentators in the country as a chaotic
response to the pandemic from the outset. Much of this has been laid at the door of the Donald
Trump administration from February 2020 to January 2021 and the so-called transactional fed-
eralism (or reward some and punish others) that was used to try to ﬁnd a role for the federal
government in the face of a myriad of approaches adopted by the governors of the different
states (Agnew, 2021). But until September 2021, when he ﬁnally proposed a national vacci-
nation mandate, President Joe Biden had also essentially deferred to the states, suggesting
how much it has been institutional bias against federal action since the 1980s more than the
individual activity or not of the occupant of the White House that has been at issue (e.g.,
Healy et al., 2021). Of course, much of the pandemic response was already in place when
Biden came to ofﬁce and the potential ire and mobilization of Trump supporters, in the
wake of electoral defeat, also limited what was possible in many states (Shear et al., 2022).
My claim here is that the very recourse to the patronage method under Trump is indicative
of the great difﬁculty that the current federal system has faced in managing a nationwide crisis
such as a pandemic. Of course, over the period January 2020–January 2022, different countries
have been seen as having had the ‘best’ management only to subsequently disappoint. Thus,
both the US and the UK were lambasted early on, but over the course of the summer of
2021 with their successful vaccine rollouts, they had risen up the charts in numbers of vacci-
nations. At the same time, of course, the pandemic certainly is not yet over, so any conclusions
must be based on incomplete data. Over the next months, interpretations may shift to account
for a longer timeframe. It looks very much that in terms of deaths, this pandemic has been much
worse worldwide than we were thinking it was in early summer 2021 when vaccination rates in
the United States, Europe and other scattered parts of the world were on the upswing and the
highly transmissible Delta and Omicron variants had not yet spread widely. That said, it seems
clear that the current range of governance arrangements worldwide have been subjected to a
common test. This is the context in which I am hoping to make a contribution to discussion
about how well different types of governance have responded to the pandemic and consequently
what can be learned from this for future challenges such as other pandemics, climate change and
other disastrous crises.
Some caveats and limitations on what follows bear emphasis at the outset. First, the agenda
of centralization–decentralization obviously must include so-called unitary states as well as ones
labelled as federal in order to reach even tentative conclusions about the relative merits of federal
systems in the management of the pandemic. Second, much of the readily available data come
from the Organisation for Economic Co-operation and Development (OECD), so much of the
world (including large countries such as Brazil and India) is still missing from the discussion
here. Third, the United States is something of an outlier globally in relation to the pandemic
in respects other than the nature of its federal system. Critically, for example, only Russia has
had a higher and as persistent a level of so-called vaccine hesitancy as the United States across
a wide range of countries (The Economist, 2021b). Much of this hostility to active measures in
managing the pandemic may be attributed to their politicization by Trump while president and
his clear dismissal of expert knowledge as the pandemic developed. Public health expertise has
been explicitly pilloried across states controlled by the Republican Party (Baker & Ivory, 2021).
In addition, however, an overall pre-existing low level of trust in the federal government by seg-
ments of the population persisted, particularly, but not entirely, among white people in the
South and West worried about their status within an ethnically changing country (Packer,
2021). More generally, the failure of US armed interventions in Iraq and Afghanistan after
9/11 based in either fabricated or poor intelligence and on subsequent managerial incompetence

REGIONAL STUDIES, REGIONAL SCIENCE

Failing federalism? US dualist federalism and the 2020–22 pandemic 153

has not helped the reputation of the federal government at home (e.g., Luce, 2021). The United
States is also an increasingly unequal country in terms of income and access to public goods and
services (and relative to other developed countries), including public health services. Therefore,
it is not too surprising that it has been older and poorer people (particularly among minority
groups such as Latinos and African Americans) that have had the highest rates of hospitaliz-
ation and death (Abedi et al., 2021; Brownson et al., 2020; Islam et al., 2021). Fourth, and
reﬂecting these social realities, to the extent that is possible, it is best to focus on pandemic man-
agement indicators such as vaccination rates, rates of hospitalization and so on rather than just
on outcomes such as death rates and caseloads, that can reﬂect demographic and economic
characteristics (age distributions, numbers of people in care homes, ethnic indices, etc.) more
than management per se, so as to identify the more speciﬁc role of governance in the pandemic.
The paper emphasizes an empirical overview of the course of the pandemic in the United
States with a focus ﬁrst on the overall number of cases nationally between January 2020 and Jan-
uary 2022 and a description of how different states and regions experienced this onslaught. This
sets the scene for a subsequent analysis of the state-by-state course of vaccination rates between
January 2021 and January 2022 as a key indicator of management of the pandemic. This is then
developed further in an exploration of the geography of vaccination–Delta variant complex (how
low vaccination rates led to the spread of the variant and fuelled hospitalizations and deaths) in
late summer 2021 as illustrative of the costs of state governments not learning from one another
and seeing the federal government as an opponent more than a collaborator in managing the
pandemic. The second section brieﬂy addresses a number of the putative explanations offered
for the spatial variation in the management of the pandemic at the state level that do accept
an overall diagnosis of failure in terms of the national response but do not typically deal with
the federal–territorial nature of the pandemic. Third, therefore, if these are inadequate or pro-
blematic as complete interpretations of what has happened, what is it about US federalism that
has produced the distribution of managerial outcomes noted in the ﬁrst section? In theory, fed-
eral systems could be expected to perform better in a pandemic than unitary ones by combining
national economies of scale and leadership in many respects (such as developing and deploying
vaccines) with sensitivity to local and regional demographic and attitudinal differences. So how
well, particularly early in the pandemic, did a range of federal systems perform relative to unitary
ones? Asking this question, given the overall focus of this paper on the US, also requires a brief
discussion of how US federalism has mutated since the 1980s towards the dualist vision of an
absolute division of labour between federal and state governments. This had prevailed before the
Civil War but had been in abeyance particularly from the 1930s to the 1980s as a result of the
Great Depression and the New Deal, the Second World War and the Cold War empowering
the federal level. Since the 1980s and in line with the increased party polarization of US national
politics, the dualist vision has made a stunning comeback (e.g., Bulman-Pozen, 2014; Schapiro,
2020).
It is this vision of federalism and its current practice, I allege, rather than federalism tout
court that lies behind the US national failure. This leads into a discussion of what it was
about this vision that produced the problematic national outcome in the pandemic. In plugging
the gaps in the dualist system, the Trump administration developed a patronage-based model of
transactional federalism that failed to compensate for the limits of the existing system. A con-
cluding section claims that the balance within the system could shift back towards a more coor-
dinative and less dualist vision. This is the main lesson from the pandemic experience. But this
seems unlikely currently given the extreme polarization of US electoral politics between an
extremely anti-federalist Republican Party deeply ensconced in the southern and western
regions of the country and a more federalist-friendly Democratic Party that is disadvantaged
within the federal system of government (particularly in the US Senate and in presidential poli-
tics because of the Electoral College and the courts). The United States may not be too big to

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154 John Agnew

govern, but it will require fundamental political–institutional change in the federal system to
overcome the real limitations revealed by the pattern of mismanagement of the 2020–22
pandemic.

TERRITORIAL ASPECTS OF THE 2020–22 PANDEMIC IN THE UNITED
STATES

The 2020–22 pandemic has gone through ﬁve phases in the United States (similarly elsewhere)
in terms of overall caseloads (daily cases) and the geography of the peaks of infection (Figure 1).
In terms of cases of people testing positive for the coronavirus, the ﬁrst peak was in April 2020,
with most cases concentrated in the Northeast, Washington State and hotspots nationwide.
The second peak was in August 2020 with community spread leading the way with concen-
tration in Florida, the prairie states such as North and South Dakota, and continuing onslaught
in the Northeast and to a lesser extent on the West Coast. The third and highest peak of
December 2020–January 2021 drew in much of the country with the highest rates in California,
the Midwest and the Northwest. The onset of vaccination programmes in January 2021 saw an
attenuation of the pandemic (with a brief upswing in states with low vaccination rates and an
absence of regulation of public spaces in March–early April 2021). The fourth peak, associated
with the spread of the Delta variant, had its major impact in those states with the lowest vac-
cination rates, poorest enforcement of anti-virus protocols and limited hospitalization facilities,
expanding rapidly between 1 June and 24 July 2021 (going from 20% to 90% of all cases): Flor-
ida, Texas, Mississippi, Alabama, Arkansas, Idaho and rural Oregon (e.g., del Rio et al., 2021;
Jain et al., 2021). On 7 September 2021, ofﬁcials in Idaho were forced to ration hospital beds for
the ﬁrst time in the state’s history (Hawkins et al., 2021). Alaska, an early leader in vaccination,
followed suit later in September as the vaccination rate slumped and the Delta variant arrived in
force (Slotnik, 2021). The ﬁfth phase associated with the Omicron variant led to a dramatic
increase in cases nationwide, if initially concentrated in the Northeast in late November–late
December 2021. It hit hardest in states and localities with the lowest vaccination rates. Its
high degree of transmissibility was fortunately not matched by its virulence in producing serious

Figure 1. Daily positive cases for Covid-19 in the United States, 23 January 2020–20 January 2022.
Source: Author from Centers for Disease Control and Prevention (CDC) data, https://data.cdc.gov/
Case-Surveillance/United-States-COVID-19-Cases-and-Deaths-by-State-o/9mfq-cb36/data

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Failing federalism? US dualist federalism and the 2020–22 pandemic 155

disease, particularly in the vaccinated. So, the dramatic increases in cases were not matched,
except in places with large pools of the unvaccinated (such as Florida, Georgia, Louisiana
and Mississippi), with proportionate increases in hospitalizations and deaths as in earlier phases
or waves of the pandemic (Muller, 2022; Nirappil, 2022; The New York Times, 2022; Walsh,
2022). Nevertheless, the number of deaths in late January 2022 reached the highest level nation-
ally since February 2021 reﬂecting both the dramatically increased volume of cases (Figure 1)
and persisting pockets of the unvaccinated (Kamp, 2022). No clear ‘end’ was in sight even if
the Omicron variant seemed less devastating than earlier ones (Lin & Money, 2022; Murray,
2022).
Therefore, the pandemic had a deﬁnite geographical imprint over its ﬁrst two years.
Through the ﬁrst three peaks this had much to do with, in the ﬁrst instance cases coming
into the country from outside, and then community spread depending on such factors as the
distribution of vulnerable populations (people in care homes, the aged, etc.) as well as the dis-
tribution of mitigation measures such as masking and lockdowns. In 2021, however, it was the
rate of uptake of vaccines that seems to have driven down the incidence of cases, hospitalizations
and deaths (e.g., Pierson et al., 2021). At least latterly, then, it was the onset and delivery of
vaccinations that was the main driver of the variegated geography of the pandemic. Despite
the existence of so-called breakthrough infections of the vaccinated with new variants (the
Delta variant in particular), the overwhelmingly majorities of hospitalizations and deaths by
summer 2021 were down to infections of the unvaccinated including increasing numbers of
younger people, among them children under 12 with no availability of vaccines. These were
overwhelmingly in states with low vaccination rates and lax or missing protocols to limit com-
munity spread (Avila et al., 2021; Pierson et al., 2021). It is important to note that during the
fourth peak and subsequently hospitalizations did tend to include more people with milder
symptoms relative to earlier waves. These patients were younger on average than those in earlier
rounds (Zweig, 2021). But death rates nevertheless trended higher in places with higher rates of
hospitalization (Pierson et al., 2021). If through the ﬁrst two waves the elderly (and ethnic min-
orities) were the primary victims of the pandemic, latterly the impact was more widely spread
across age groups and ethnicities.
The federal government in January 2020 had mobilized with a number of pharmaceutical
companies to produce vaccines (under Operation Warp Speed) that were not only rapidly pro-
duced and tested but also manufactured on a massive scale by December of the same year. All
the vaccines, but particularly those associated with Moderna and Pﬁzer, turned out to give excel-
lent immunity against the early variants of the virus if with much less success in preventing
transmission. Crucial, then, was how the vaccines would be distributed and the pandemic
brought under control. This is when the federal system was given its most severe test. If during
the ﬁrst three peaks, mitigation measures of various sorts had been the métier of managing the
pandemic, the future now depended on the rapid distribution of the vaccines. This and the con-
tinuation of associated measures to keep mitigation in place until herd immunity could be estab-
lished on a local basis by means of vaccination determined the outcome of the fourth phase in
the summer of 2021.
As can be seen very clearly on a map of vaccination rates of the age 12+ populations by state
as of 20 January 2022 (Figure 2), the effective distribution of vaccines into the population has
been very uneven. It ranges from very high in states in the Northeast and on the West Coast
(plus Minnesota, Colorado and New Mexico) to much lower in the South and in the western
states of Idaho and Wyoming. The low vaccination states also happen to be those where there
has been most anti-vaccine sentiment relative to population size and where the pandemic has
been most politicized as effecting federal overreach by local elected ofﬁcials (e.g., Fernandes
et al., 2022; Levitt & Keating, 2021; Nirappil, 2022). Consistently since the start of the pan-
demic these are the states (along with Texas and Florida) that have most questioned the

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156 John Agnew

Figure 2. Vaccination rates (percentage of 12+ population) by state (and other units) across the Uni-
ted States as of 20 January 2022.
Source: Author from Centers for Disease Control and Prevention (CDC) data, https://www.cdc.gov/
coronavirus/2019-ncov/vaccines/reporting-vaccinations.html

messages emanating from federal agencies (such as the US Food and Drug Administration –
FDA, and the Centers for Disease Control and Prevention – CDC) and challenged the
trade-offs between better health outcomes and temporary economic setbacks that have mainly
prevailed elsewhere. So, much of this can be ascribed to cultural/attitudinal differences relative
to questioning the reliability of medical expertise and overall distrust of the federal government
as well as overinvesting in Trump’s early dismissals of the dangers associated with the virus (e.g.,
Gonsalves, 2021; Kaufman, 2021; Morris, 2021).
But a signiﬁcant element in it has been the refusal of state and local ofﬁcials to learn from
elsewhere by adopting a pragmatic outlook about the novel challenges to government raised by
the pandemic. Instead, they have tended to portray the federal government and its experts as
interlopers or outsiders rather than potential collaborators in ending the pandemic. Evidence
for this contention ranges from the very different state–government positions on vaccine man-
dates and masking ordinances to school closures and lockdowns without much change in pos-
tures over time (e.g., Grifﬁn, 2020; Ivory et al., 2021; Leavitt, 2022; Mazzei, 2022; Wood &

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Failing federalism? US dualist federalism and the 2020–22 pandemic 157

Brumﬁel, 2021). In turn this has undoubtedly extended the pandemic. This extension is clear
when counties in the United States as of late July 2021, with major outbreaks and hospitaliz-
ations associated with the Delta variant, are mapped with respect to their relative status in
terms of vaccination (Cuadros et al., 2022; WSTB TV, 2021). The overwhelming majority
of counties with high rates of outbreak were in very low vaccination states in which state leaders
obstructed or discouraged masking, social distancing and vaccination measures. Local govern-
ments challenging state rules were often disciplined or sued in court. Hospitals overloaded as a
consequence, death rates soared (e.g., Santiago, 2021; Williams, 2021). Deaths were not just
from Covid-19 but also resulted from the collapse in capacity to treat other ailments (Evans,
2021). So, the spatial correlation illustrated here strongly supports a causal linkage between
the deepening of the pandemic and failure to provide appropriate management equivalently
across the country. The end result has been the dire overall performance of the United States,
even if much of it seems to be down to a set of the states unwilling to learn from others or coor-
dinate with the federal government.

PLAUSIBLE ALTERNATIVE INTERPRETATIONS OF THE AMERICAN
FARRAGO

Before indicting contemporary US federalism, what might be some plausible alternative
interpretations? These do not all address the territorial nature of the pandemic, only the overall
perception of a failed national response. In brief compass, the predominant ones are as follows.
The ﬁrst is the relatively inefﬁcient and ineffective US healthcare system (Emanuel, 2020;
Oshinsky, 2020). Relying heavily on private insurance provided overwhelmingly by employers
plus the federal Medicare programme for the elderly and the state-administered Medicaid pro-
grammes for the poor, the number of hospital beds and healthcare facilities have been dramati-
cally reduced in recent years as provision for healthcare has become as corporate in organization
as has its ﬁnancing (OECD, 2020). The typical way of representing this in its entirety is to show
how much the United States spends per capita with very poor outcomes (such as life expectancy
at birth) compared with countries that spend signiﬁcantly less (e.g., Scott, 2021; Thompson,
2021). Although this helps to explain some of the problems with hospital access during the pan-
demic it is difﬁcult to see how this accounts for all the consequences of the pandemic and their
geographical patterning tout court. It also should be noted that it is the western states of the US
that hospital capacity has been most reduced (OECD, 2020). These are generally not the states
with the worst outcomes in the pandemic. Early in the pandemic private insurers also waived
deductibles and co-pays so these features of insurance were not a barrier to treatment. As
they were restored in late 2020 and 2021, however, this imposed an added burden on the mainly
unvaccinated pool of the infected in low-vaccination states looking for hospital based ‘cures’
(Rowland, 2021). Perhaps most importantly, the absence of reliable health insurance for per-
haps 25% of the population seems to have reduced trust in the overall healthcare system and
in the pronouncements of medical experts on matters such as masks and vaccines (Tufekci,
2021b). Finally, the public health system across the country has been systematically under-
funded for years and has serious deﬁciencies in coordination and personnel at all levels: local,
state, and federal (e.g., Sharfstein, 2022; Stacey, 2022; Wallace & Sharfstein, 2022).
The second interpretation isolates the idea of ‘democracy’ as somehow critical to the man-
agement of pandemics, claiming that across a number of pandemics down the years (from 1960
to 2020) the death rates were lower for relatively afﬂuent democracies than other types of polity
of whatever gross domestic product (GDP) per capita (The Economist, 2020). In this pandemic,
however, the correlation does not seem to have that much validity. Indeed, China and a number
of other non-democratic regimes seem to have done as well or better than those conforming to a
typical deﬁnition as ‘democratic’ (periodic multiparty elections, transparent legal systems, etc.)

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158 John Agnew

Yet, the corollary does not hold. The variance in performance among all sorts of political system
suggests that neither democracies nor dictatorships can claim a singular advantage (e.g., Esarey,
2021). Perhaps the most important factor in overall outcomes has been relative trust in govern-
ment, with countries such as the US doing particularly poorly on this score (Bollyky et al., 2022;
Taylor, 2022).
Third on the list is the more clearly plausible idea from what we know about the course of
the pandemic is that the spread of the virus and the relative vulnerability of different population
groups (on account of co-morbidities such as obesity and age) account for the outcome (e.g.,
Goldhill, 2021; Lane, 2022; Mendenhall & Gravlee, 2021). Given the host of socio-spatial
inequalities that plague the United States, as noted previously, this is not that surprising.
This interpretation acknowledges, therefore, the geography of the pandemic but typically
exempts the ways in which management of the pandemic has varied regionally and locally
from the equation. Much of the mainstream media coverage in the United States has tended
to take this tack. By the summer of 2021, however, this approach was increasingly supplemented
by reference to the role of the different state governments in the prolongation of the pandemic.
The problematic nature of the federal compact was rarely invoked. Some analyses, while empha-
sizing the deﬁciencies of the US healthcare system and the deep-rooted character of social and
ethnic inequalities across the country, do manage to show that federalism as practiced failed to
live up to its promise notwithstanding the efforts of some states and their governors to effec-
tively manage the pandemic (e.g., Singer et al., 2021).
Finally, relatively rarely but with some publicity in ‘conservative’ outlets, such as the editorial
pages of Rupert Murdoch’s The Wall Street Journal, have been accounts that lament the declin-
ing ‘resiliency’ of US populations compared with times past, presumably when ‘America was
Great’, and the overriding need to limit restrictions and declare the pandemic over ad seriatim
(e.g., Freeman, 2022; Halperin, 2022; Henninger, 2022; Taranto, 2022). In this ideological
‘bubble’ the pandemic was only ever a discursive construction whose main negative effect was
invariably economic rather than human. In this vein, the historian Niall Ferguson argued
that during past pandemics in the 1950s Americans were both less fearful and more measured
in addressing the risks attached to catching any disease in question than they were in 2020–22
(Ferguson, 2021). Of course, in those simpler times there was also much less of the misinfor-
mation spread by social media and the population was much less polarized politically than it is
today. The early claims by Trump and others that the coronavirus was just a new ﬂu that would
be over soon also confused many people as to its seriousness. This paralysed many people’s con-
sciousness of the relative risk attached to it (compared with, say, crossing a street or smoking)
and probably aided in the extension of the pandemic.

US ANTI-FEDERALIST FEDERALISM AND OTHER FEDERAL SYSTEMS
DURING THE 2020–22 PANDEMIC

So, if none of these is adequate in its entirety in explaining the geographical course of cases, hos-
pitalizations, deaths and vaccinations, what is it about US federalism that made the outcomes
we have seen likely?
In my view, the story begins in the 1980s (Agnew, 2002, 2021). During that decade both the
US federal government executive branch and the federal judiciary began to question and under-
mine the stronger role for the federal government in regulation and direct delivery of services to
states and localities that had become common from the New Deal of the 1930s to the 1970s.
This role has been seen as expressing a ‘polyphonic’ model of federalism in order to stress the
complexities of overlapping rather than mutually exclusive jurisdiction between the state and
federal governments in various functional areas. So, during the Ronald Reagan presidency
the United States began to return to what had been the model of federalism before the US

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Failing federalism? US dualist federalism and the 2020–22 pandemic 159

Civil War: one with a rigid division of labour between the states and the federal government in
which there should be no overlap and all other powers, other than those speciﬁcally given to the
federal government in the US Constitution, should be reserved to the states. Partly this reﬂected
the increased reliance of the Republican Party on the votes of those southern whites who viewed
the federal government in a dim light as a result of the civil rights and other legislation of the
1960s that potentially undermined their local political dominance. But it was also the result of
the turn away from an activist federal government toward the victory of so-called neo-liberal
capitalism in which government was seen as the enemy of economic growth and slashing income
taxes should be the centrepiece of economic policy. This ‘dualist’ view has been reinforced in the
years since by the increasingly conservative cast of the federal judiciary and the popular redeﬁni-
tion of federalism more broadly towards a restricted conception of the role of the federal gov-
ernment outside of narrowly deﬁned parameters (Bulman-Pozen, 2014; Schapiro, 2005–06).
Amazingly, the main conservative legal organization (created interestingly in 1982), actually
called the Federalist Society, has taken up the task of championing what the framers of the US
Constitution would undoubtedly have seen as anti-federalism. Its view is of a rigid division of
functions between federal and state levels and the sense of the two levels as competitors rather
than as co-actors (e.g., Gibson & Nelson, 2021). In efforts at shrinking the role of the federal
government, therefore, the clock was turned back to a conception of federalism that arguably
prevailed before the Civil War, but which might also be seen as embodying the very premises
of government based on loose confederation that the US Constitution, at least in the eyes of
James Madison and Alexander Hamilton, was designed to overcome.
Americans have long fought over the meaning of the US Constitution and what it entails for
the balance between the states and the ‘general’ or federal government. The boundary between
the two has always been fuzzy but advocates of ‘states’ rights’ (even though this term nowhere
appears in the US Constitution) have turned state autonomy into the highest feature of US fed-
eralism rather than emphasizing the need to balance the states’ right to experiment in policy
against the need for collective learning and coordination, particularly in emergencies. Much
of the controversy concerning the federal government is about the so-called supremacy clause
and the extent to which historical change (the coming of the welfare state, total wars, macro-
economic management and so on) mandate revisiting the balance between the tiers of govern-
ment (e.g., O’Neill, 2005; Terbeek, 2021). More recently, the entire question of the delegation
of powers to federal executive agencies from the US Congress has also been raised to undermine
the federal role in managing a wide range of issues from gun control, free school meals, climate
change, and water pollution to abortion rights and vaccine mandates (e.g., Greenhouse, 2022;
Mortenson & Bagley, 2021; Sokol, 2022).
What seems clear, however, is that the dualist vision of a strict division between the tiers has
made a major comeback over the past forty years. Yet a strong argument can be made that this
effectively undermines the nationwide pursuit of the very goals of ‘life, liberty, and happiness’
represented by the US Declaration of Independence and enshrined in the US Constitution
that the whole is somehow greater than the sum of the parts. In this context, Robert Schapiro
has reminded us that the glaring inequalities in income and welfare among the states in the Uni-
ted States are not intrinsic to federalism but a by-product of its present-day malfunction (Scha-
piro, 2020; also see, e.g., Gibson & Nelson, 2021). The former FDA Commissioner, Scott
Gottlieb, points out that the main federal agency charged with managing pandemics, the
CDC, had been hollowed out over the years and left the country without an effective operational
national centre once Covid-19 arrived on US shores (Gottlieb, 2021). The geographical course
of the pandemic further illustrates two distinctive aspects to these features of US governance.
One, clearly, is the relative retreat of the federal or general government from coordinating across
the states, and the other is the absence of much coordination and learning among the states.
Other federal systems, such as Germany, Canada and Australia, seem to have done much better

REGIONAL STUDIES, REGIONAL SCIENCE

160 John Agnew

on both counts because of clear institutional channels for collaboration even in the presence of
different political parties controlling different levels of government (e.g., Bohrn, 2021; Rozell &
Wilcox, 2020). More speciﬁcally, ‘executive power’ across states and provinces in coordination
with federal ofﬁcials trumped partisanship and anti-federal inﬂuences in both Canada and Aus-
tralia relative to the United States (Brown & Latulippe, 2021). Even if in Canada anti-federal
government protests, such as the ‘Freedom Truck Convoy’ to Ottawa and the blocking US–
Canada border crossings in February 2022, suggested weary displeasure with vaccine mandates,
they were not widely supported and were ﬁnanced as much by right-wing Americans as by
Canadians of any political stripe (e.g., Mahdawi, 2022; Porter, 2022). Evidence from across
Latin America underlines the vital importance in better outcomes of consultation and coordi-
nation across tiers of government irrespective of whether systems are unitary or federal (Cyr
et al., 2021).
In theory one might expect all federal systems to do better than unitary ones at managing a
pandemic: at the same time, you can combine national leadership and economies of scale in
acquiring needed resources and leadership with local measures reﬂecting the needs of different
populations (rural/urban, attitudes to disease, health care facilities, etc.) As Figure 3 (covering
the ﬁrst year of the pandemic) shows, this is not how it turned out, although some did better
than others (De Biase & Dougherty, 2021). The US performance was among the direst across
the ﬁrst nine months. By and large, the federal and the other more decentralized if still ofﬁcially
unitary countries (measured in terms of total subnational and subnational health expenditures)
tended to do relatively worse across the ﬁrst nine months of the pandemic in caseloads than did
many of the more centralized countries with clearer central direction and less political grand-
standing by regional and local politicians. Belgium did poorly early on (as shown here), partly
because of regional animosities, but it later bounced back with a very successful vaccination pro-
gramme (Vanham, 2021). Many other federal systems in large countries, such as Canada, Aus-
tralia and Germany, though, managed to maintain a more collaborative or ‘polyphonic’ rather
than a competitive/dualist approach to governance from the outset (e.g., Fenna, 2022; Kropp
& Schnabel, 2022; Lecours et al., 2022). This involves formal channels for negotiating across

Figure 3. Federal versus unitary systems in expenditure patterns and Covid-19 cumulative cases
(OECD member countries), January–December 2020: (a) cumulative cases versus total subnational
expenditures; and (b) cumulative cases versus subnational health expenditures.
Source: Redrawn from De Biase and Dougherty (2021).

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Failing federalism? US dualist federalism and the 2020–22 pandemic 161

tiers of government and recognizing that in the contemporary world all sorts of public problems
cannot be addressed just at one scale of governance. Overlaps are understood as inevitable and
should be managed as such. By and large, outcomes turned out to be considerably better (e.g.,
Bohrn, 2021: Cox Downey & Meyers, 2020; Rozell & Wilcox, 2020; Steytler, 2022). Whatever
the precise parameters of the governmental system, clearly deﬁned authority structures across
tiers with incentives for ‘collegial endeavor among autonomous actors’ (Cameron, 2022, p.
274), such as in Australia and New Zealand, to name just two countries, tended to be signiﬁcant
in overall managerial success across the course of the pandemic.
Australia makes for a particularly good comparison with the United States as another set-
tler–colonial country, if one with a much smaller population and relative geographical isolation
in the context of a global pandemic (e.g., Jackman et al., 2020). Not all went well. In particular,
in focusing on trying to remain ‘Covid free’, the Australian federal government neglected the
introduction of vaccines and thus extended the pandemic unnecessarily given the other advan-
tages the country enjoyed. As of late summer 2021, only around 33% of Australian adults were
fully vaccinated. But there was clear collaboration between the states and federal government
and there was nothing like the politicization of public health measures such as happened in
the United States, partly because US governors opted for such utterly different strategies and
seemed to deliberately eschew learning from the experience of other states. By January 2022,
the Australian fully vaccinated population had risen to 77.8%, well above that of the United
States. Even as the Australian states sometimes deﬁed the federal government on closing
their borders and other quarantine measures, they nevertheless collaborated with it and one
another to an extent unheard of in the United States (e.g., The Economist, 2021d; Fenna, 2022).

DUALIST FEDERALISM IN PRACTICE

What about US dualist federalism was most responsible for the problematic national outcome?
Several aspects deserve mention. One of the most important is that since the 1980s, state
governors’ executive powers have expanded relative to both their own legislatures and the federal
government. Governors are no longer the ﬁgureheads they often once were (The Economist,
2021c). This put them front and centre as the pandemic arrived. Federal governments have
long shifted implementation of national policies to the states (e.g., Kettl, 2020). In the absence
of federal leadership, state governments can pick up the slack (e.g., Wines, 2021). They then
innovate on all sorts of policies, including those that contradict longstanding federal ones on
voting rights, restricting abortion, immigration, legalizing drugs, etc. (e.g., Agnew, 2021;
Waldman, 2021). The road to the White House has also long led through governors’ mansions,
but in the context of an increasingly polarized electorate this means that governors are often
engaged in national political campaigning as much as they are in governing their own states.
During the 2020–22 pandemic, Florida Governor Ron DeSantis was a clear example of this ten-
dency. In many respects, both privatizing federal powers and devolving powers to the states have
also hollowed out the federal government. As a result, state ofﬁcials have also turned challenging
federal policies into a central tenet of their power (Adolph et al., 2021; Dinan, 2020). Attempts
at providing government-sponsored health insurance through the states (the Affordable Care
Act, or so-called Obamacare) would be a good example. Finally, accountability for managing
the pandemic was completely unclear from the outset. The president, governors and various
public health ofﬁcials all vied for attention, but it was never clear if the buck stopped anywhere.
They were all working from different scripts.
Cerny (1989) has dubbed the overall trend in the relative diminution of and increased con-
fusion about the role of the federal executive in the United States ‘Madisonian entropy’, com-
bining the framer of the US Constitution James Madison with the idea of dissipated energy.
Cerny argues that in the 1930s, following the Great Depression and encouraged by the

REGIONAL STUDIES, REGIONAL SCIENCE

162 John Agnew

mobilization for the Second World War and then the Cold War, the US popular sense of com-
mon foreign enemies, limited party divisions and the management of the national economy by
the federal government jointly led to federal empowerment. This has disintegrated with the end
of the Cold War, the shift to neo-liberal economics and the increased ideological division
between the two main political parties, one of which, the Republican Party, has become expli-
citly anti-federalist. The clash of state and federal sovereignty claims has now left even the possi-
bility of federal direction or coordination across levels of government fatally damaged, even for
programmes that are widely popular (Allain-Dupree et al., 2020; Reiley, 2022; Stacey, 2022).
Several examples of this clash from the course of the pandemic have received much attention
latterly. The failure of a national testing policy for Covid-19 and the lack of a centralized system
for tracing variants are good examples of policy areas in which the federal government should
have had a net advantage relative to the states. But in neither case did this happen (e.g., Abbasi,
2021; Becker et al., 2021; Khazan, 2020; Koons, 2021; Maxmen, 2021; Nuzzo & Gostin, 2022).
A laissez-faire approach prevailed in each of these functional areas, to the extent that with
respect to testing, states themselves began to form consortia in the absence of the federal gov-
ernment. With the rollout of vaccines, the pattern of states shooting off in multiple directions
without showing evidence of either learning from one another or making the most of federal
resources, until circumstances are utterly dire, has continued, as attested to by Figure 2. The
lack of a basic and consistent federal messaging strategy about behavioural norms, such as avoid-
ing closed spaces, crowded places and close-contact settings, was particularly evident early in the
pandemic compared with some other countries, such as Japan, which as a result have seen lower
death rates and overall socio-economic disruption (e.g., Oshitani, 2022).
A ﬁnal problem area has been the ad hoc way in which data about the course of the pandemic
have been collected by the states and then compiled by federal agencies, particularly the CDC.
Early in the pandemic, in particular, before the CDC passed under new leadership in January
2021, the ‘optics’ of the numbers were more important to the federal government (and many
governors) than understanding the reality of what was afoot. This led to various scandals,
such as keeping cruise ships out of port so numbers of cases could be deﬂated and manipulating
numbers or ﬁring ofﬁcials at the state level whose numbers went against the ideological postures
of their governors (e.g., Beason, 2020; Gold & Shanahan, 2021; Schultz, 2020). As the pan-
demic evolved, there was also limited attention given nationally and state by state to whether
metrics such as cases or hospitalizations made more sense as primary measures for determining
strategies (Samuel, 2021), particularly when with the late 2021 onset Omicron variant, for
example, testing positive (if vaccinated) was not typically life threatening and hospitalization
was often not caused by the variant but by some other condition, but the variant was present
once admitted to the hospital (Khullar, 2022).

TRANSACTIONAL FEDERALISM

Arguably, therefore, the federal government was largely missing in action, particularly early on
in the pandemic, save for the vaccine ﬁnancing and various agencies’ efforts at helping with ﬁeld
hospitals. What the country experienced instead was what a number of people have called ‘trans-
actional’ federalism in which the federal government singled out governors for punishment or
reward depending on their partisan afﬁliations and premature decisions to open up their econ-
omies rather than actually managing the pandemic (Bowling et al., 2020; Williamson & Morris,
2021). In this regard, the United States exhibited what has been called a commitment to ‘medi-
cal populism’ (Lasco, 2020) in which the president and many ofﬁcials staged the pandemic as a
performance opportunity in pursuing their rhetorical demonization of experts and bureaucrats
who remained more the enemies of ‘the people’ than the pandemic itself. Rather than establish-
ing and then adjusting a national plan, they engaged in daily routines (such as press conferences)

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Failing federalism? US dualist federalism and the 2020–22 pandemic 163

mainly directed at criticizing their political enemies more than mobilizing and organizing
against the spread of the virus. The outcome was the poor pandemic management and coordi-
nation alleged at the beginning of this article.
Arguably, in pursuing a transactional strategy in the absence of mechanisms for coordinating
with other tiers of government in a concerted and organized manner, the Trump administration
was adhering to an approach to governance that Trump himself had championed in his business
and television careers. Transactional leadership is the use of rewards and punishments to encou-
rage highly valued behaviours, particularly loyalty. It is by deﬁnition more attuned to ascription
than to achievement in the sense that maintaining the afﬁliations and status of those in a
relationship matter almost to the exclusion of achieving some wider goal. Thus, negotiating
over some common protocols for managing the pandemic took a back seat to rewarding the pre-
sident’s overt supporters in the states and punishing his partisan enemies.
Bowling et al. (2020, p. 515) present a series of examples of how this worked across the ﬁrst
seven months of the pandemic in 2020, quoting from a series of news articles to make the argu-
ment. States that ‘go too far’ in social distancing and stay-at-home rules were threatened with
legal action by Attorney General Barr; governors calling on the federal government for help in
acquiring medical equipment were admonished by Trump as follows: ‘The federal government
is not supposed to be out there buying vast amounts of items and then shipping [them]’; Gov-
ernor Larry Hogan of Maryland (a ‘disloyal Republican’) was chastised for ordering masks from
South Korea because he ‘could have called [Vice-President] Mike Pence … I don’t think he
needed to go to South Korea. He needed to get a little knowledge’; and Governor Andrew
Cuomo of New York was instructed after asking for more ventilators (cue a scene in The God-
father where supplicants are kissing the ring of the padrone):

It’s a two-way street, they have to treat us well also. They can’t say, ‘Oh gee we should get this, we should
get that.’ We’re doing a great job … they could have had 15 or 16,000, all they had to do was order them
two years ago but they decided not to do it, they can’t blame us for that.

At the same time, other states were rewarded rhetorically and materially. So, Governor Kemp of
Georgia, after heaping praise on the president, was suitably rewarded by a positive reference at a
press conference and told that his reopening of businesses was the right decision. Governor Ron
DeSantis of Florida was similarly rewarded for not imposing a stay-at-home order with the pub-
lic statement that he was ‘A great governor. Knows exactly what he’s doing.’
All this added up to a ‘chaotic’ type of transactional federalism (Bowling et al., 2020, p. 517).
In this context, any pretence of planning disappeared in a miasma of complaint, resentment and
lack of focus on the matter at hand. Systematic coordination between the federal government
and the states as a whole was non-existent. Trump’s transactional and populist impulses then sub-
stituted in the absence of any system for coordination in producing the outcomes we have all
seen. As federal experts cautioned early on that such minimal measures as distancing and mask-
ing were prudent actions to limit viral spread, transactional federalism locked into punishing
states that pursued such strategies and rewarding states that ploughed on, out of fealty to the
leader, in pretending for many months that the risks attached to the spread of the virus were
no different from the annual ﬂu outbreaks. ‘Prudence’ was not in Trump’s vocabulary. The con-
clusion to Bowling et al. (2020, p. 517) is worth quoting to make clear the costs of this ‘gap ﬁll-
ing’ approach to federalism:

Crises understandably place great stress on systems; when the system itself is chaotic, it is almost a fore-
gone conclusion that the response of that system will be suboptimal. In addition, when states are forced
into competition or when the federal government fails to act on issues with known externality concerns,

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164 John Agnew

coordination becomes nonexistent and, in this case, produces inefﬁciencies and the lack of provision of
public goods that are evident today.

LOOK A LITTLE ON THE BRIGHT SIDE?

After this relatively poor overall performance, it is difﬁcult to look on the bright side. But the
actual experience of the 2020–22 pandemic may well encourage a rethinking and reworking of
the current US federal system. The balance could shift back. All but the most ideological fol-
lowers of Trump can see that the transactional federalism he proffered did little or nothing
to compensate for the practical weaknesses of a dualist federal system mismatched to the pro-
blems of the 21st century. The fact that Trump’s federal government did manage to procure and
manufacture vaccines that would have been beyond the capacity of any speciﬁc state might even
persuade a few of his followers that the federal government does in fact have its domestic uses
within the United States. That said, the extreme polarization of US electoral politics is now the
major barrier. The Republican Party, ensconced in power now at the state level in many more
states than the Democrats, and with signiﬁcant advantages in senatorial and presidential elec-
tions, is now profoundly anti-federalist in the sense of pro-states’ rights and against the federal
government doing much of anything except in national defence. Its populist war with govern-
ment is speciﬁcally directed at the federal level, but is based in an overall hostility to the very idea
of collective action for the common good (Fried & Harris, 2021; Mason, 2018).
As survey data from the United States and Australia suggest, a lack of commitment to collec-
tive action based on expert knowledge is now the biggest blockage in preventing a swing back to a
more polyphonic federalism in the United States (Jackman et al., 2020). In this regard, responses
to a question about trust in medical experts (a surrogate for attitudes towards experts and bureau-
crats more generally) shows that US opinion on average is not that different from that in Australia,
but the Trump supporters in the United States are the big exception. Across a range of policy areas
and popular attitudes, including that of disdaining experts associated with the federal government
such as the top US federal infectious disease expert Dr Tony Fauci and the CDC, such voters are
likely to be openly opposed to a more involved and collaborative federalism (Durkee, 2022). State-
level partisanship based largely in hostility to the US federal government is the current major bul-
wark of US dualist federalism (Birkland et al., 2021; Kincaid & Leckrone, 2022).
In conclusion, federal systems in general have not had a good pandemic, so to speak (e.g.,
Figure 3). That much seems clear. But neither have many putatively unitary states (e.g., Sharma,
2022). There was no simple magic such as that initially widely believed about authoritarian zero-
covid solutions such as that mandated in China. That would have never been implementable in
the United States. Centralization is not in itself a solution to managing pandemics, even if the
United States could have done with much better integrated and coherent federal–state relations
(e.g., Bourne, 2021). China’s highly centralized response seems to have built up a number of
serious middle-term problems, not least the need to lockdown signiﬁcant economic sectors,
when in fact suppression to this extent has turned out to be less effective than milder mitigation
plus mass vaccination in putting countries on the path to normalcy (e.g., Bloomberg, 2022;
Emanuel & Osterholm, 2022; Qin & Chien, 2022; White & Olcott, 2022).
For its part, however, the United States could have done much better than it did, notwith-
standing all its social–spatial inequalities. The geographical course of the pandemic illustrates
not just systematic differences in demographic and health-related characteristics, but more
strongly (Figure 2) the impacts of different state policies and the failures of both federal and
state-to-state learning and coordination in reducing the impact of what would regardless
have been a devastating crisis. Was this just a one-off misfortune or something indicative of dee-
per societal and institutional ﬂaws (Bufacchi, 2021)? What then will be learned from this

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Failing federalism? US dualist federalism and the 2020–22 pandemic 165

experience? One can hope, if somewhat forlornly, that a return to business as usual will not be
the lesson (e.g., Brownson et al., 2020; Chyba et al., 2021). A revitalized cross-linking in public
health and economic development policies across the states could capture both the beneﬁts in
many respects of centralization and the positive effects of local knowledge and values of decen-
tralization. The dynamic is currently wildly out of balance, as the outcomes of the pandemic
have shown. Coordination and collaboration collapsed. We have seen the result.

ACKNOWLEDGEMENTS

The original version of this paper was given as a presentation to the RSA Festival on Regions in
Recovery on 18 June 2021. I have revised it in numerous respects to account for changes in the
nature of the pandemic since the original version was written in May 2021. I thank Felicity
Nussbaum, Scott Stephenson, Matt Zebrowski and two reviewers for helpful comments and
suggestions that improved this article.

DISCLOSURE STATEMENT

No potential conﬂict of interest was reported by the author.

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FAQs
AI
What were the death rates associated with the US pandemic response?
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The US had the highest excess deaths among high-income countries, with 863,334 Covid-19 deaths by January 2022, translating to 1 in 500 Americans.
How did local vaccination rates impact pandemic severity in the US?
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States with low vaccination rates, such as Florida and Texas, experienced significant Covid-19 outbreaks, emphasizing the correlation between vaccination hesitancy and higher hospitalizations.
What role did partisan politics play in the US pandemic management?
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Partisan polarization contributed to ineffective federal coordination, as seen with Trump's punitive transactional federalism towards states that opposed his policies.
When did the vaccination crisis peak in the US, and what were the results?
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By January 20, 2022, only 62.9% of Americans over age 12 were fully vaccinated, contributing to prolonging the pandemic's impact.
How did geographical differences affect health outcomes during the pandemic?
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The pandemic revealed stark geographical disparities, with poorer health outcomes in states like Mississippi, linked to local policies and socio-demographic vulnerabilities.
John Agnew
University of California, Los Angeles, Faculty Member
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Federalism in a Time of Plague: How Federal Systems Cope With Pandemic
Mark J . Rozell
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This article compares and contrasts the responses of Australia, Canada, Germany, and the United States to the COVID-19 outbreak and spread. The pandemic has posed special challenges to these federal systems. Although federal systems typically have many advantages—they can adapt policies to local conditions, for example, and experiment with different solutions to problems—pandemics and people cross regional borders, and controlling contagion requires a great deal of national coordination and intergovernmental cooperation. The four federal systems vary in their relative distribution of powers between regional and national governments, in the way that health care is administered, and in the variation in policies across regions. We focus on the early responses to COVID-19, from January through early May 2020. Three of these countries—Australia, Canada, and Germany—have done well in the crisis. They have acted quickly, done extensive testing and contact tracing, and had a relatively unif...
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Governing in a Polarized Era: Federalism and the Response of U.S. State and Federal Governments to the COVID-19 Pandemic
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Publius: The Journal of Federalism, 2021
How does the state of American federalism explain responses to COVID-19? State-by-state variations to the COVID-19 pandemic illustrate the political dynamics of “kaleidoscopic federalism,” under which there is no single prevailing principle of federalism. In the COVID-19 pandemic, features of kaleidoscopic federalism combined with shortcomings in the public health system under the Trump administration, leading to fragmented responses to the pandemic among the states. Federalism alone does not explain the shortcomings of the United States’ response to the pandemic. Rather, the fragmented response was driven by state partisanship, which shaped state public health interventions and resulted in differences in public health outcomes. This has sobering implications for American federalism because state-level partisan differences yield different and unequal responses to the pandemic.
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Federalism and the Response to COVID-19
Felix Knüpling
2021
'COVID-19 has triggered an avalanche of books and articles examining the public policy responses to the pandemic. However, Federalism and the Response to COVID-19 is one of the very few books that examines and compares the effectiveness of these responses in federal and quasi-federal countries. As the authors show, the pandemic challenged federal structures and processes everywhere but in this crisis was also an opportunity. This volume showed me which federal countries used the pandemic to make innovations in both the practices and structures of federalism and which were incapable of rising to the challenge.
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Impact of COVID-19 on the comparative practice of federalism: Some preliminary observations
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The COVID-19 pandemic is an unprecedented international event. The spread of the coronavirus – the biggest public health crisis in a century and the first of this scale in the globalized modern world – has prompted unparalleled responses by national governments. The proliferation of 24-hours news coverage and social media has allowed people across the world to follow, in real time, the unfolding and visible impacts of the pandemic. In 2020, as governments grappled with fluctuating waves of the COVID-19 pandemic, the effectiveness of public policy varied among federal nations (the paper focuses on countries that are explicitly and constitutionally federal, and countries with governance systems in which governance powers and responsibilities are devolved from the central level to the subnational level). Federal countries such as Australia and Canada managed to keep mortality low, whereas others such as Brazil, Spain and the United States suffered some of the highest numbers of fatalit...
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Anti-Federalist Federalism: American “Populism” and the Spatial Contradictions of Us Government in the Time of COVID-19
John Agnew
Geographical Review, 2021
The US federal government has been widely criticized for its response to the Coronavirus/Covid-19 pandemic. Much of the poor response and outcome has been ascribed to President Trump's personal failure. Yet more importantly this failure has been of the US governmental system. More specifically, the role of the federal government in fashioning nationwide policies across a range of areas, including public health, has been crippled by an anti-federalist ideology and the institutional inertia it has created. Ordinarily, one would think that the federal government would be empowered by a selfdefined "nationalist" or right-wing populist in the White House. But rather than command and coordination across tiers of government, the states have been left to cope as best they can without much of anything in terms of coherent and consistent national/ federal leadership. The recent efflorescence of anti-federalist ideology has roots going back to the 1980s. The pandemic has exposed the distortion of the once well-established polyphonic practices of historic US federalism by a now institutionalized dualist vision of federalism that has sadly become the leitmotif of failed US governance in the pandemic.
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Fumbling Through: The First Wave of COVID-19 Pandemic in the U.S.A.
Bob Travica
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We used a framework on pandemic containment strategizing to investigate how a sample of states in the U.S.A. responded in the early stage of the COVID-19 pandemic compared with the world and between themselves. Although limitations imposed on freedom of movement and business operations were in a mid-range, the U.S. underperformed on some medical and enforcement policies. There were significant differences among the states. Our analyses suggests that government intervention is the key to reducing mortality. We propose a D&4T strategy as a method of confronting this pandemic.
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Policy Error and Policy Rescue in COVID-19 Responses in the United States and United Kingdom
Ezgi Müftüoğlu
2020
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Rethinking 'Cooperative Federalism' during COVID
Shasanka Sekhar Pati
Third Concept, 2022
[The outbreak of COVID-19 has put India’s federal framework to test. Given the peculiar and distinctive features of Indian federalism and the sheer diversity, one can notice the fundamental and paradigmatic shift that it is going through to cope with the monstrous challenge posed by this healthcare crisis. The capability and effectiveness of India’s federal framework to deal with such a crisis is singularly dependent on the extent to which all the three layers of government- the central, the state, and the local levels are able to coordinate with one another.]
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American “Populism” and the Spatial Contradictions of US Govern-ment in the Time of COVID-19
John Agnew
Geopolítica(s). Revista de estudios sobre espacio y poder, 2020
President Donald Trump has been the public face of the blundering managerial response of the US federal government to the Coronavirus/COVID-19 pandemic. Yet, beyond Trump’s personal failure lies a failure of the US governmental system. More specifically, the role of the federal government in fashioning nationwide policies across a range of areas, including public health, that one think would be empowered by a self-defined “nationalist” or right-wing populist in the White House, has been crippled by an anti-federalist ideology and the institutional inertia it has created. These have roots going back to the 1980s and the distortion of historic US federalism that these have entailed.
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COVID-19, Federalism, and Health Care Financing in Canada, the United States, and Mexico
Gregory Marchildon
Journal of Comparative Policy Analysis: Research and Practice, 2021
National responses to COVID-19 depend in part on national health care financing arrangements. Yet the pandemic itself has not only strained system capacity, it has – through subsequent economic shocks – strained revenue sources that prop up these arrangements. In federal countries, fiscal pressures are particularly pronounced. As this paper argues, however, federal health financing regimes differ in ways that are shaping the agenda for post-pandemic reforms. The analysis, which focuses on health care financing in three federal countries (Canada, the United States, and Mexico), explores the current and potential future impact of COVID-19 on existing policy legacies.
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