Georgia’s response to the pandemic ranked among the nation’s worst, according to an analysis released Thursday by the New-York-based Commonwealth Fund.
The state ranked 44th among all states and the District of Columbia for its overall health performance according to the report, which looked at dozens of measures of health and health care access. Within that, the state ranked 47th for its response to the pandemic, which measured rates of death and COVID-19 hospitalization as well as staffing shortages and overflow in hospital intensive care units.
The message, said the authors: The pandemic has been bad, but being ill prepared made it worse for citizens.
“COVID-19 has pushed all states and their health systems to their limit,” Commonwealth Fund president David Blumenthal told reporters in announcing the results. However, he said, “States that entered the pandemic with stronger healthcare systems fared better.”
A spokeswoman for Georgia Gov. Brian Kemp, Katie Byrd, said that Kemp had “prioritized the lives and livelihoods of Georgians throughout the pandemic,” noting Kemp’s deployment of the National Guard and other resources to hospitals and pandemic health sites.
“Because of his measured approach, our economy is thriving, and Georgians are enjoying a safe, appropriate return to normalcy,” Byrd said in an email. “The loss of life we suffered throughout the pandemic is tragic, and Governor Kemp and the First Lady hold those families in their prayers daily. It would be inexcusable to suggest that the state didn’t do everything it could to mitigate loss of life from the outset.”
As of Wednesday, 31,952 confirmed COVID-19 patients have died in Georgia, in addition to 6,408 probable COVID-19 patients, according to the state Department of Public Health. The state has confirmed more than 2 million cases of COVID, and efforts are underway to understand the scope of long-term side effects from infection.
Pandemic measures favored by some public health experts that Kemp did not endorse included mask mandates, vaccination mandates and longer restrictions on gatherings. Some also criticized the state for not putting enough resources into mobile vaccination teams. Kemp did a publicity tour to encourage masking, publicly backed vaccinations and spoke in favor of science.
Kemp has now signed a law forbidding school districts from enforcing locally designed mask mandates unless the governor gives permission in a state of emergency.
At the top of the Commonwealth Fund ranking for overall pandemic performance were Hawaii, Maine and Vermont, states that have traditionally ranked high for strong health systems, according to the study authors. Georgia was at the bottom for its pandemic response, followed by only Mississippi, Kentucky, Oklahoma and Alabama.
The Commonwealth Fund is a nonprofit based in New York City that funds public health analysis and research. Its work has focused on health equity and system performance, and its studies have previously made the case for Medicaid expansion.
Georgia ranked 48th in the nation for the rate of adults fully vaccinated and boosted, and 47th for its high number of hospital admissions of confirmed COVID cases per 100,000 population.
Those higher rates of severe COVID cases led to poorer performance by Georgia’s hospitals. The state ranked 48th for hospital staffing shortages.
Credit: Ariel Hart
Credit: Ariel Hart
That hospital stress was associated with poor outcomes for everyone. The scorecard also measured “excess deaths,” and found that people were dying in Georgia at higher rates than average from conditions besides COVID.
Harry Heiman, a clinical associate professor of public health policy at Georgia State University, said the poor outcome for Georgia was predictable.
“Our lack of investment in public health infrastructure and workforce and failure to implement common sense policies like Medicaid expansion...put us at a disadvantage from the beginning of the pandemic,” Heiman said.
Georgia is one of nine states that have not expanded Medicaid insurance to all its poor. Heiman and others argue that leaves hundreds of thousands of Georgians without existing connections to primary care and health providers able to give vaccinations when the pandemic emergency hit.
Most of the lowest-ranking states also did not expand Medicaid. An exception is Kentucky, which ranked low in spite of its expansion of Medicaid to all very poor Kentuckians.
Georgia did better in some measures. The state ranked better than average for the rate of COVID deaths among nursing home residents. In Georgia 89 residents died with COVID for every 1,000 nursing home beds, the study said, compared to 94 nationwide.
In Georgia, Kemp has often focused his comments on Georgia’s economic response to the pandemic, touting his early decision to lift Georgia’s pandemic lockdown compared to other states. AJC reporting in 2021 found that Kemp disregarded the advice of public health experts in reopening as quickly as he did.
Kemp and other Georgia leaders said they moved to lift restrictions partly to prevent “deaths of despair,” people who might die or take their lives following isolation or business failure in the pandemic. The Commonwealth Fund analysis found that Georgia’s rate of overdose deaths rose 16th fastest in the nation in 2020. But its authors cautioned against drawing broad conclusions from that, because other variables were changing rapidly and disrupting the data.
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