Knowing virus doesn’t respect borders, states with stricter COVID-19 restrictions warily watch lax neighbors

Sarah Poe watched with rising alarm as coronavirus cases began to spiral last month in rural Malheur County, Ore., turning the remote region bright red on maps of hot spots. The county health director knew locals were ditching masks and isolation. But she also saw a threat directly across the Snake River: Idaho.

Half the workforce in Malheur, where the minimum wage is $4 higher than across the border, lives in Idaho. Other Idahoans come for Oregon's sales tax-free shopping and legal marijuana. But the intermingling looks more menacing to Poe and other Malheur officials these days - because unlike in Oregon, masks are not mandated across the border and the coronavirus metrics there are far bleaker. Now, the public health department in that Oregon county has traced cases to origins in Idaho.

"Part of our threat is being so close to Idaho," Poe said. "We are a border community up against a state that has much looser restrictions."

That concern simmers on other state lines where neighboring jurisdictions - just a bridge or short drive away - have different suppression measures and virus case numbers. To officials in these adjacent places, and to many experts, the tensions illustrate problems inherent with a highly fragmented national response to a virus that knows no boundaries.

"I've said from Day 1, it would have been a lot easier for the decision-makers if everyone would have been on the same page, and we'd have shut down this or that type of business in our county and state, and the bordering states would have done the same. That's the only sure way of doing it," said Herb Simmons, emergency management director in St. Clair County, Ill., which sits across the Mississippi River from Missouri, where restrictions are lower. "What we needed is a national-level plan."

Public health officials in Las Cruces, N.M., know from contact tracing and investigation that some cases had roots in El Paso, the Texas city about 45 miles south, said New Mexico health department spokesman David Morgan. As coronavirus weariness sets in, he said, it's hard to get people to refrain from crossing the border to engage in behavior allowed in Texas but not New Mexico. In May, New Mexico's human services secretary warned that such travel would "absolutely, unequivocally" lead to more COVID-19 cases and hospitalizations.

"We ask, 'Did you travel recently?' They'll say, 'No, but I went to El Paso to have my hair cut.' Well, that's travel and that counts," Morgan said. Hair salons opened a month earlier in Texas.

"If they can't get the service they want in one state, it's just natural that they seek it in the state where they can," Morgan said. "But the consequences are greater than a lot of people appreciate."

Leaders in many places have adopted strategies aimed at thwarting the virus's roving, borderless nature. In the United States, states including Connecticut and New York now require many travelers entering the state to quarantine, and some regions, including Native American reservations, have set up checkpoints or turned away visitors. In Europe, where residents are accustomed to traveling without passports between countries, many nations closed their borders to outsiders. Nationally, cellphone data indicates trips across state lines have tripled since the shutdowns of March.

As reopening began this spring, blocs of states in the West, Midwest and Northeast banded together to coordinate plans. In an announcement about its formation, the five-state Western States Pact - which was joined by Oregon but not Idaho - noted the "virus has preyed upon our interconnectedness" and "doesn't follow state or national boundaries." States in the South, where cases are surging, discussed forming a compact, but it never materialized.

The Midwestern group includes seven states, but not Missouri, which lifted all statewide restrictions in early June and now has a far higher rate of positive virus cases than its neighbor, Illinois, which opened more cautiously. Missouri was singled out this month by Illinois Gov. J.B. Pritzker, D, who pointed to alarming spread in counties of his state across the Mississippi River.

One Illinois county Pritzker mentioned was St. Clair, which Simmons said "is in full panic mode" after logging a daily record of 105 coronavirus cases July 18. St. Clair Public health officials say they haven't directly linked cases to Missouri, but Simmons said he did not doubt movement across the bridge was playing a role.

Missouri was "behind us in shutting down their bars and restaurants. It was nothing for people to get in their cars or get on mass transit and go to St. Louis and do their partying and come back here," Simmons said. St. Louis has strong restrictions, but other nearby counties in Missouri don't, he said.

Helena-West Helena, Ark., sits on the Mississippi River, a natural barrier to infection - except that a bridge connects the city to Mississippi, and Louisiana is close by. Both states have been virus hotbeds, and across the river from the Arkansas city are three counties labeled as red zones. Cases in Helena-West Helena are not rising at the alarming rate of those neighboring counties, but Mayor Kevin Smith said he sees the bridge as a "funnel" bringing the virus over.

"We have three state policies, and the president did not want a national strategy; he basically said, 'You're on your own' to the states and the cities. So we have a patchwork of things," Smith said. "All of us have been left to fend for ourselves."

Early in the pandemic, Smith unsuccessfully petitioned Gov. Asa Hutchinson, R, to allow screening of travelers crossing the bridge. He remembers when growing up that trucks carrying cotton across the bridge were inspected for boll weevils that could devastate crops. He called it "somewhat ridiculous" that the state would be "super vigilant about agricultural disease" but not "actually human diseases that could kill people."

Still, he credits Hutchinson with consistency compared with Mississippi Gov. Tate Reeves, R. Reeves has rolled back an aggressive reopening as cases rise. Arkansas now has a statewide mask mandate; Mississippi does not, although one is in place for the hardest-hit counties.

"We're doing better than most of the counties on the lower Mississippi River," Smith said. "But we are surrounded by it, and it's closing in."

Even as some states such as New Mexico trace cases to neighbors, the extent of cross-jurisdiction spread nationally remains unclear, because gleaning such trends depends on intense contact tracing that is not happening in most places, epidemiologists say. John Graves, a Vanderbilt University researcher who works on modeling for Tennessee, called it "a huge blind spot of a lot of modeling, which assumes a contained population. But given the amount of commuting that happens across state borders, it just stands to reason that we're not isolated in our own cocoon."

In the absence of clear evidence of viral creep across the state line, officials in Virginia say they're keeping a close watch on the border with Tennessee.

Bristol, Tenn., and Bristol, Va., share a historic downtown, with State Street running from one to the other and only plaques to mark state lines. But on the Virginia side, gatherings greater than 250 people are banned, and Gov. Ralph Northam, D, is again urging people to stay home. On the other side, NASCAR recently hosted one of the first major sporting events of the pandemic, with 20,000 spectators and the governor in attendance.

"I am concerned about that," Virginia Health Commissioner Norman Oliver said. "The important thing about the spread is that it's multifactorial. I would not say it's all because of porous borders, although that fact is one factor."

In eastern Oregon, officials see few ways to alleviate what they feel certain is a cross-border effect stoking a troubling caseload and positivity rate. As the poorest county in the state, Malheur depends on Idahoans who reside in the fast-growing greater Boise area. They shop at the busy Walmart. They fill 70% of the jobs at the 3,000-bed state prison. They drive regional marijuana sales that are quadruple the state average, according to the Oregon Office of Economic Analysis.

"The parking lots are full, Idaho license plates are throughout the entire facility, and there's lines going around the buildings," at marijuana dispensaries, state Sen. Lynn Findley, R, said.

To cope, officials are stressing wearing masks and engaging in social distancing, and exhorting people to avoid large gatherings - which they know have been happening in Malheur, Poe said, but even more so in Idaho's Canyon County, which has the state's second-highest caseload. Packed Fourth of July events there drew many Oregonians, she said.

"People are going to Idaho to do restricted activities," said Poe, echoing a concern officials on the Washington-Idaho border have also expressed. Such gatherings "are very concerning, because it absolutely impacts our population, too."

This month, commissioners in deeply conservative Malheur passed a resolution urging even more mask-wearing and smaller get-togethers than Oregon requires. It was "a very bold move for that community," state Rep. Mark Owens, R, said.

Across the Snake River, Idaho Gov. Brad Little, R, has declined hospital leaders' pleas for a statewide mask mandate, telling NPR he worries about "mask fatigue," particularly in areas with few cases.

And in the cluster of southwest Idaho counties east of Malheur, public health officials have struggled to hold meetings to discuss masks. On July 16, a virtual meeting live-streamed from the district health department office in Canyon County was canceled after unmasked protesters - including Ammon Bundy, who led a 2016 occupation of a National Wildlife Refuge in Oregon - disrupted it, trying to enter the building, where masks were required. The department canceled a rescheduled meeting days later, citing safety concerns.

The health department did not respond to requests for comment. But on Thursday, its board of health managed to meet in the county courthouse, where face coverings were not obligatory. The board decided to recommend mask-wearing throughout the region, but not mandate it.