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Image via Shutterstock

U.S. Surgeon General Jerome Adams said this week would be the “hardest and the saddest” for “most Americans’ lives,” and went on to compare the upcoming period to the attacks on Pearl Harbor and 9/11.

More than 10,000 Americans have now died of the novel coronavirus, and more than 350,000 have been infected. Yet a handful of Republican-led states are still refusing to issue stay-at-home orders. 

In doing so, the seven GOP governors have gone against the advice of Dr. Anthony Fauci, the nation’s top infectious disease expert. “If you look at what’s going on in this country, I just don’t understand why we’re not doing that,” Fauci told CNN last week. 

These states are also ignoring new warnings from the U.S. Surgeon General Jerome Adams, who on Sunday said that this week would be the “hardest and the saddest” for “most Americans’ lives,” and went on to compare the upcoming period to the attacks on Pearl Harbor and 9/11.

“This is going to be our Pearl Harbor moment, our 9/11 moment, only it’s not going to be localized, it’s going to be happening all over the country and I want America to understand that,” Adams said on “Fox News Sunday.” 

About 300 million Americans—roughly 90% of the population—across 42 states and the District of Columbia were under stay-at-home orders as of Monday. South Carolina became the 43rd state on Monday afternoon to order residents stay at home; the order goes into effect starting Tuesday at 5 p.m. The state has reported 2,049 cases and 44 deaths.

Most developed countries are also under stay-at-home orders as well. So why are seven states—Arkansas, Iowa, Nebraska, North Dakota, South Dakota, Utah, and Wyoming—holding out?

It’s not for lack of the virus. All seven states have confirmed cases, with Utah documenting at least 1,600. The governors of these states have offered several explanations for why they have resisted, ranging from “states rights” and the preference for personal responsibility over collective action to an insistence that more rural areas don’t need to worry about the virus in the same way as urban and suburban centers.

Here’s a state-by-state breakdown:

Arkansas

In Arkansas, Gov. Asa Hutchinson has questioned the effectiveness of stay-at-home orders, noting that residents still leave the house to buy groceries, while some continue going to work. “The question is, ‘Are you accomplishing anything by doing that order?'” Hutchinson said April 2.

During a Monday press conference, Hutchison again resisted a stay-at-home order, arguing the state’s number of cases per capita was among the lowest in the nation and that the number of deaths, 16, was “pretty low.”

There are 854 confirmed cases of COVID-19 in Arkansas.

Iowa

Iowa’s Republican Gov. Kim Reynolds is still resisting calls for a shelter-in-place order, despite the fact that the Iowa Board of Medicine voted unanimously on Friday to recommend such an order. “A stronger commitment to isolation is in the best interest of the public and health care providers,” Kent Nebel, executive director of the Iowa Board of Medicine, told the Des Moines Register.

Reynolds has been relying on a 12-point scale to decide whether to issue a shelter-in-place or stay-at-home order. The scale considers elements such as the ages of infected individuals, the number of hospitalizations, and the rate of long-term care outbreaks.

Reynolds has said the data does not yet merit a stateside order, but announced on Monday that she would close additional businesses through April 30, including “malls, social and fraternal clubs, bingo halls, bowling alleys, pool halls, arcades, amusement parks, libraries, museums, zoos, skating rinks and parks, outdoor and indoor playgrounds, or children’s play centers, tobacco and vaping stores, racetracks, toy, gaming music instrument and movie stores, and campgrounds.”

Iowa has 946 confirmed cases and 25 deaths.

Nebraska

Gov. Pete Ricketts, a Republican, has shrugged off calls from doctors and local leaders to enact stricter measures, such as stay-at-home orders. Ricketts has said that his state is handling its response county-by-county based on where there are signs of community spread.  

All 93 counties are now under state Directed Health Measures (DHMs), which limit public gatherings to 10 people, limit restaurants and bars to takeout, delivery, and curbside service only, and prohibit elective medical and dental procedures. But Ricketts still refuses to impose a statewide stay-at-home order.

“The virus won’t be everywhere in our state all at once,” Ricketts said last week. “It will spread in different places at different rates.”

Nebraska has reported 409 cases and 8 deaths.

North Dakota

North Dakota’s Republican Gov. Doug Burgum has temporarily shut down bars, restaurants, movie theaters, and schools, and has acknowledged that some residents have not taken social distancing seriously. Thus far, however, he has refused to issue a statewide order.

“We’re a low population state and a large low population state. I will use every tool at my disposal as governor to protect the lives and safety of North Dakotans, but I’m only going to use those tools if it makes sense and when it makes sense,” Burgum said on Friday.

North Dakota has experienced 225 confirmed cases of COVID-19 and three deaths.

South Dakota

The South Dakota Medical Association has urged Gov. Kristi Noem to issue a statewide stay-at-home order, but Noem, a Republican, has thus far refused, arguing such an order would infringe on individuals’ rights. 

“South Dakota is not New York City,” she said in an April 1 press conference. “The calls to apply for a one-size-fits-all approach to this problem is herd mentality. It’s not leadership.”

Noem also suggested that following social distancing orders should be voluntary. “The people themselves are primarily responsible for their safety,” she said. “They are the ones that are entrusted with expansive freedoms. They’re free to exercise their rights to work, to worship, and to play. Or to even stay at home, or to conduct social distancing.”

Noem has admitted that as much as 70% of her state’s population might become infected with COVID-19, and that a statewide stay-at-home order would help slow the spread of the disease. She still refuses to issue such an order because she believes it’s not worth the disruption it would cause.

South Dakota has confirmed 288 cases and four deaths.

Utah

In Utah, Republican Gov. Gary Herbert continues to ignore pleas from Democratic officials and Salt Lake City leaders to issue a statewide directive. Herbert has instead issued the voluntary “stay home, stay safe” initiative, which he believes strikes a more positive tone. 

“We think we have enough fear about this without adding to it,” Herbert said last week, adding that the “shelter-in-place” terminology sounded like a World War II effort.

Utah has 1,675 confirmed cases of COVID-19 and 13 people have died from the disease.

Wyoming

Gov. Mark Gordon, a Republican, remains defiant about issuing a statewide order, going against advice from medical professionals. 

During a Friday press conference, Gordon grew angry as he defended his decision not to issue an order. The governor said his three existing statewide orders closing schools, some businesses, and banning gathering of more than 10 people was action enough and an example of “Wyoming values.”

“Our orders talk less and say more,” he said, adding that his call to “stay home, wash your hands, maintain social distancing, don’t mob the stores, or allow your kids to gather for playdates” achieves the same thing as an official order. “That’s essentially what a stay-at-home order is,” he said. “Are you waiting for ‘Mother may I? Or are you taking care of yourself and practicing the common sense we expect?”

Wyoming has reported 210 cases of COVID-19, but no deaths.

Editor’s Note: This story has been updated after South Carolina Gov. Henry McMaster issued a stay-at-home order on Monday.