State “Pandemic Pods”: US regional coalitions and their responses to the COVID-19 pandemic

As the COVID-19 pandemic began to unfold in the late winter and early spring of 2020, US states began to work collaboratively in regional coalitions to manage a rapidly developing public health crisis. These coalitions were made up of states that were geographically contiguous and, more importantly, built upon previous working relationships. We explore two regional coalitions—the Multistate Council and the Western States Pact in the northeast and western United States, respectively. We find that these regional coalitions each drew from institutional memory-previous collaborative policies—to craft their collective COVID-19 responses and that this approach produced two different outcomes. While these regional coalitions urgently provided critical resources (including institutional knowledge) to respond to the spreading pandemic, it may have also reflected a limit of institutional memory—path dependency which limited the regional coalitions' abilities to learn from each other and experience the benefits of other coalition approaches.