Around the time on Friday that President Donald Trump was shaking hands with business leaders at the White House and denying responsibility for the spread of COVID-19, more than 100 mayors of America’s largest cities gathered on a phone call to compare notes on how to fight the virus in the absence of federal help.

The mayors traded ideas about ending utility cutoffs and stopping evictions; they discussed who was banning gatherings and for how many people. One mayor on the call said the group had set up a Slack channel to see what other cities were doing to stop the spread of the virus. Another said that the leaders whose cities had already been affected had an urgent message for those still bracing for the impact of the novel coronavirus: “You must act now.”

Trump finally declared a national emergency on Friday, but state and local officials have been fighting outbreaks in their communities for weeks. Without help from Washington, many say, it has fallen to them to figure out how to respond to a pandemic that is disrupting everything from weddings to basketball games to businesses and Broadway shows. “There’s just no guidance,” says Los Angeles Mayor Eric Garcetti, a Democrat who says the lack of federal leadership has left mayors to instruct each other on what to do.

The result has been a patchwork of significant but disjointed local efforts to combat COVID-19. California prohibited gatherings of more than 250 people and issued sweeping guidelines allowing the state to commandeer hotels to treat coronavirus patients. In New York, only gatherings over 500 people are banned. New York City has resisted calls to close public schools but asked restaurants to reduce their occupancy by half. Washington state, which was hit particularly hard and early, has announced schools will be closed for the next six weeks.

Local leaders say the federal government’s sluggish response has cost them critical time. “Our city, our county and our state have been significantly hampered by the early failures, systemic failures, at the federal level regarding testing,” says Jenny Durkan, the Democratic mayor of Seattle, who notes there were too few tests available and that the testing guidelines were initially drawn too narrowly. “We have been doing everything we can to both protect people on the health care front and protect people on the economic front, but this event is more significant than any city or state can deal with alone.”

In Colorado, which suffered its first coronavirus-related death on Friday, Democratic Governor Jared Polis has used executive authority to screen visitors to nursing homes. “We’re very much focused on the day-to-day in our state,” Polis says, “and in making sure that we can bend the curve of the spread so that our health system isn’t overwhelmed.”

“When we first saw this thing coming, we put together a group of about 14 doctors from Ohio,” that state’s Republican Governor, Mike DeWine, tells TIME. “The advice that we got was: if you wait two more weeks, it’s too late.” Some 70% of Ohioans could become infected, health experts estimated.

DeWine announced Thursday that all Ohio schools would close for at least three weeks. “The odds are that we are going to continue to keep them closed for a long time after that,” he adds, noting it’s possible that the state seeks permission to scrap annual standardized tests. On Saturday, he held separate calls with veterinarians and dentists in the state, asking them to delay appointments. “They use some of the same personal protection gear that doctors use,” DeWine says. “Save the equipment. If you’ve got extra masks and other things, make those available. We’re going to need them before this thing is over.” Ohio simply doesn’t have enough hospital capacity should too many people get sick at once.

In fact, that’s the case across the country, which is the point of many of the new rules: to slow the spread of illness enough so that the health care system isn’t overrun. As of Saturday, there are more than 2,700 confirmed cases in the U.S., according to a tally compiled by Johns Hopkins University’s Coronavirus Resource Center. If the virus spreads too fast and the system is flooded, hospitals will be forced further into triage mode, without enough beds or ventilators to treat sick patients or gloves and masks for health workers. Delaying the spread of the pandemic by banning gatherings, closing schools, and encouraging “social distancing” could make the difference between life and death.

States and cities have also been asking for additional resources. New York City Mayor Bill de Blasio announced Friday a request for massive quantities of protective medical equipment, including 800,000 face shields, 95,000 surgical gowns, and 600,000 pairs of surgical gloves—and said the federal government hasn’t yet provided them. Fighting COVID-19 requires a bunker mentality, added de Blasio, a Democrat. “This is not a popularity contest,” he said. “This is war.”

But cobbling together new rules on the state and local level may be little help against a virus that knows no limits. “Viruses don’t care about border walls any more than they care about city boundaries. So trying to solve this problem city by city and state by state is the wrong way to do it,” says Democratic strategist Jesse Ferguson. “It’s the only way to do it because the Trump Administration has been more focused on his ego than on combatting the pandemic.”

As the public deals with constant uncertainty—how much toilet paper to buy, whether to go to restaurants, what to do about plummeting 401ks—the response from Washington has done little to reassure the public.

“A lot of people just feel adrift or abandoned at the national level, especially by the moral leadership,” says Garcetti. There was one point, he says, on which all the mayors could agree: “We’re still flying so blindly.”

With reporting by Philip Elliott

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Write to Charlotte Alter at charlotte.alter@time.com and Lissandra Villa at lissandra.villa@time.com.