Lt. Gov. Spencer Cox in recent months receded to the background of the state’s coronavirus response, stepping away from the limelight as his political opponents accused him of using the moment to boost his gubernatorial campaign.

Yet, as Cox describes it, he remained embedded behind the scenes as a trusted adviser to Gov. Gary Herbert and a participant in ongoing conversations about how the state should proceed. He took part in decisions over TestUtah, day-to-day emergency management and smoothing out differences between legislative leaders and the governor’s office.

And now, he’s reemerging as a more public part of the state’s fight against COVID-19, helping unite a multifaceted — and sometimes disjointed — crisis response as Utah heads into the fall and winter flu season.

“Over the past several weeks, I have continued to be involved … even more so involved than before,” he said, describing his current and past roles in combating the coronavirus in an interview with The Salt Lake Tribune.

Early on in the pandemic, Herbert assigned Cox a role akin to the one Vice President Mike Pence has taken on nationally. Cox said he was primarily responsible for bringing together disparate groups of people affected by the pandemic to help advise the governor.

From there, the state’s coronavirus task force was born, with Cox appointed as its leader.

According to Cox, the task force was most critical in the first stages of the pandemic as Herbert began formulating the state’s approach to the virus. But after the first month, Cox said, the response outgrew any one panel of experts, shifting to include a range of subgroups and a unified command structure that now handles daily operations.

Cox’s once high-profile position at the helm of the task force made him a target for his political opponents, who blamed him for state spending on no-bid contracts during the pandemic and the fraught multimillion-dollar TestUtah initiative. Cox, on the other hand, has played up the fact that Utah has among the lowest COVID-19 death rates in the nation and has a brighter jobs outlook than any other state.

However, some task force members say their group played a relatively minor role in major decisions during the pandemic.

State Rep. Paul Ray, who sat on the task force, said it gave input but largely received briefings on decisions that had already been made. Asked in June who was setting the course, the Clearfield Republican said: “The honest answer is, I can’t tell you. I think a lot of that went on behind the scenes.”

“It’s difficult to disentangle who is making what decisions, but as chair of the coronavirus task force, the lieutenant governor has taken a leadership position,” Peterson said. “And, ultimately, he bears some of the responsibility for the successes and the failures of our coronavirus response.”

While there has been confusion about the shifting role of the task force, Anna Lehnardt, a spokeswoman with the governor’s office, said it served only an advisory role to the governor’s office and has never had decision-making power. Its benefit, she said, was primarily uniting groups that had never worked together before in order to respond to the pandemic.

The role of the task force is now filled by unified command, which is led by Public Safety Commissioner Jess Anderson, who is reporting to Cox and Herbert. Several task force members say that while their group is no longer meeting, they continue to act in an advisory role to the executive branch.

(Trent Nelson | Tribune file photo) Gov. Gary Herbert at a news conference in Salt Lake City, May 28, 2020. At right is Gary Harter, executive director of Utah's Department of Veterans and Military Affairs.

TestUtah

Cox says he’s had barely any involvement with some aspects of the COVID-19 response — for instance, he says he didn’t know about the state’s much-criticized purchase of the malaria drug hydroxychloroquine until after the $800,000 no-bid contract was signed. Utah officials later canceled the order for the unproven COVID-19 treatment and received a full refund.

The lieutenant governor also said he had little to do with Healthy Together, the multimillion-dollar mobile app that was unveiled as a potential contact-tracing tool but has never been used that way except in a handful of cases.

He said he has had a larger role in decisions related to COVID-19 testing, as he’s pushed to increase access.

“Testing is the bridge to therapeutics and to a vaccine,” Cox said.

The state’s efforts to expand testing capacity led it into the TestUtah partnership, an initiative that has been dogged by controversy over cost and the accuracy of its results. Initially pitched as a philanthropic project, TestUtah ended up funneling millions in taxpayer dollars toward Utah tech companies that inked no-bid contracts with the state.

Cox explained that this partnership unfolded as the state tried to pattern its handling of the pandemic after South Korea’s example.

“Very early on, we sat down, and we were looking at responses across the country and across the globe,” he said. “We weren’t impressed with any of the responses here in the country, to be perfectly honest. South Korea became the model that we based everything on.”

Toward the start of the pandemic, Utah leaders established the goal of reaching about 7,000 coronavirus tests each day, but Cox said the state’s capacity was nowhere near that figure at first. Kristen Cox, the state’s executive director of management and budget, suggested looking beyond Utah’s health care giants, such as University of Utah Health and Intermountain Healthcare.

(Rick Egan | Tribune file photo) TestUtah Covid-19 testing at the 800 North location in Orem, June 9, 2020.
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Around that time, the lieutenant governor said, a group of tech entrepreneurs approached Kristen Cox with the idea of launching their own testing initiative. They told her they had contacts in Asia and access to the testing materials that others were struggling to find.

Their idea was to establish a site to test their own employees and open it to the public, and they were looking to partner with the state.

Spencer Cox said he was initially dubious that the tech companies could lead the public health project, but he was encouraged when he learned that they were working with an established lab at Timpanogos Regional Hospital. He even spoke with the hospital’s CEO, who assured him that the lab was capable of processing the coronavirus tests.

That’s when Kristen Cox suggested enlarging the initiative from one site to multiple locations, where people could receive free tests regardless of their insurance status, he said. The state could pay for the expanded vision with federal Coronavirus Aid, Relief, and Economic Security (CARES) Act funds allotted for testing activity.

“We presented that to the governor, and he agreed with that, was very favorable with it,” Spencer Cox said. “And so we signed off.”

In the months that followed, medical experts would question the accuracy of the initiative’s test results, and federal regulators would cite the Timpanogos lab for multiple violations.

The state has been reevaluating many of the no-bid contracts it made during the early days of the pandemic, and the TestUtah deal was among them, according to Lehnardt. After a procurement process to “carefully identify the best testing solutions for the state,” she added, officials have renewed the contract with the tech company behind TestUtah.

“Thanks to this unique partnership and the work of Intermountain Healthcare and University of Utah Health, our state has the ability to test anyone for COVID-19 who needs to be tested,” she wrote in a text message.

A ’complex’ response

The organizational chart defining the structure of the unified command COVID-19 response spans five pages, with groups assigned to manage vulnerable populations and the economy and subcommittees devoted to child care and education.

Overall, Lehnardt said there are roughly 200 people involved in the unified command structure.

As the state convened myriad task forces in the early days of the pandemic to manage different impacts of the virus, the Legislature created another. The primary role of that commission, authorized during the April special session, was to craft and present a framework for reopening the economy to Herbert and was prompted by lawmakers’ frustration over a lack of involvement in the coronavirus response.

But Cox said the Legislature’s advisory group complicated things, “because we had Unified Command that was making recommendations” on the one hand “and then you had this other group that was making recommendations to the governor” on the other.

Recently, Cox said he sat down with House Speaker Brad Wilson, R-Kaysville, and Senate President Stuart Adams, R-Layton, with the goal of streamlining the efforts of the legislative and executive branches.

“As our response has gotten more complicated and complex, which is natural, we wanted to try to find a way to get to what I like to say [is] the simplicity on the other side of complexity,” he said, referencing a quote from early 20th-century U.S. Supreme Court Justice Oliver Wendell Holmes.

That process has focused on defining new metrics for the state’s success on public health and economic outcomes and putting specific people in charge of those items, he said.

Wilson said he and Cox have been working “shoulder to shoulder” on this framework.

“The one thing we know is that this [pandemic] will continue to change,” Wilson said. “But I think there’s a more nimble and focused group now that, under the lieutenant governor’s leadership, can continue to respond to what’s happening.”

Leaders in the effort include Anderson, director of public safety; Dr. Joseph Miner, former head of the state’s health department; state epidemiologist Dr. Angela Dunn; and Richard Saunders, interim director of the Utah Department of Health. Kristen Cox, leader of the Governor’s Office of Management and Budget, also played an outsized role before her departure this month.

As state officials work to combat the spread of the coronavirus in the coming months, Spencer Cox said the state plans to continue working with local health departments to increase their capacity for contact tracing.

He doesn’t see the need, though, to close down the economy “in any major way.” Those shutdowns, he argues, have been detrimental to the economy “without delivering as much of a benefit.”

“We have found [health] measures that are cheaper and much less costly to allow us to keep the economy open,” he said.

For his part, Cox said he plans to continue taking the lead on testing efforts, with hopes of bringing rapid result technology to the state.

“That is absolutely what is going to save us in the fall and winter when we can’t be outside as much,” he said. “That will allow people to visit. I [can] go visit my grandma in a long-term care facility where she lives right now because I can say ‘Hey, I’ve had a test today and it costs $5 and I can show you I’ve tested negative.’ And so I can do some of the things I wouldn’t be able to do before.”