Legislative panel reviews state’s COVID response, issues proposals for change

  • Lisa White administers doses of the Johnson & Johnson COVID-19 vaccine at the Charlemont Fairgrounds in this file photo. White is a regional public health nurse with the Franklin Regional Council of Governments. FOR THE RECORDER/ELLA ADAMS

  • COMERFORD

Staff Writer
Published: 7/6/2022 11:10:13 AM
Modified: 7/6/2022 11:07:35 AM

NORTHAMPTON — Massachusetts should rethink its systems for managing major emergencies, fortify its personal protective equipment stockpile, improve air quality in all schools and pump funding into local health departments, the legislative committee tasked with overseeing the state’s COVID-19 response has said.

After 18 months of study and public hearings, the Legislature’s Joint Committee on COVID-19 and Emergency Preparedness and Management issued a report this week, making 16 key proposals for policy and regulatory changes to make future crisis response more effective and equitable.

Sen. Jo Comerford, D-Northampton, the co-chair of the committee, said the report will help ensure that the state will be “more prepared, more resilient” during catastrophes, and as the COVID-19 pandemic continues.

“Coming out of a tragedy like COVID, it is our responsibility to learn the lessons so that we are stronger together,” Comerford said Thursday. “This is not so much an indictment as it is a humble document” to help the Legislature study the strengths and weaknesses of the response.

The report found that the state’s communication and data transparency need to improve in the case of COVID-19 and future crises; vaccination efforts should ensure access by communities of color and other populations that are typically hardest hit; local health departments require more robust state support; and there should be a way to report at-home tests like the antigen tests for COVID-19.

A bill titled “An Act for a Better Prepared Massachusetts” contains many of the committee’s recommendations and is now before the Senate Ways & Means Committee.

Response hierarchy

One recommendation is that Massachusetts adopt an emergency response hierarchy that puts a single incident commander in charge of four divisions: operations, planning, logistics and finance. The Baker “administration deviated from standard incident management practices” in establishing the COVID-19 Command Center, which has used “a more amorphous, less-defined structure” and created frustration for local public health agencies, the report concluded.

Committee members also flagged the “the stark differences and long-standing inequities” among local health departments, some of which are well-funded and staffed by professionals while others are run by volunteers and propped up by overworked regional departments. The report recommends that the state establish a funding mechanism and quality standards that would eliminate those discrepancies.

“If we don’t get public health right coming out of the COVID-19 pandemic, then shame on us,” Comerford said. Lawmakers approved $200 million in federal American Rescue Plan Act funding for local health departments last year, which Comerford called a “generational investment” that began to lift some of the burden from cities and towns.

Still a threat

The first case of the novel coronavirus in Massachusetts was recorded on Feb. 1, 2020, and in less than 2½ years, more than 1.75 million people in the state have been infected, the report found, leading to the deaths of 19,651 people. More than one million have died nationwide, and the committee wrote that more highly transmissible or even “vaccine-evading” variants could still emerge.

“Currently, COVID-19 remains a major threat; among children, COVID-19 is nearly six times more deadly than the seasonal flu, and across the whole of the country, the current weekly death projections remain far higher than recent flu seasons,” the report reads. “The availability of vaccines for children from 6 months old to age 5, which began on June 21, 2022, is a welcome development that will provide them with substantial protection against severe disease.”

While local boards of health had identified hundreds of potential vaccine distribution sites before the pandemic, the Baker administration initially chose to launch eight regional locations, meaning “that western Massachusetts, an area roughly the size of Rhode Island, had just one mass vaccination site” during the early days of vaccinations.

The report recommends establishing a special assistant to the governor who will ensure equitable vaccine rollout during public health emergencies.

“This is not a moment for blame. This is a moment for learning lessons,” Comerford said. “It is very difficult terrain on which to operate. That’s why we have to legislate funding and data” and other elements of the response for the next emergency.

Committee’s approach

In crafting its report, the committee held nine oversight hearings and conducted a statewide listening tour of the six Health and Medical Coordinating Coalitions (HMCCs) that are overseen by the Department of Public Health’s emergency preparedness arm. Nearly all of the communities in the four western counties are in the Western MA HMCC.

“In 2013, DPH introduced HMCCs to promote cross-disciplinary planning and support public health and medical response across the Commonwealth during emergencies and disasters,” the report reads, with the goal of bolstering the efforts of local health departments.

But the state’s strict budget rules for HMCCs, which are the agencies that Comerford said are “perfectly situated” for pandemic response, and ever-changing public health guidance made their work less efficient.

“The Commonwealth’s COVID-19 guidance, which HMCC members were expected to either enforce or follow themselves, often changed suddenly and without explanation,” the report reads. “Several stakeholders reported being unable to learn what supplies were available at stockpiles established by the Commonwealth.”

The committee recommended that the state develop and maintain a long-term stockpile of personal protective equipment, including high-quality masks, for all adults and children. To shield Massachusetts against any supply chain disruptions, “the Commonwealth should make a concentrated effort to stockpile” testing swabs and kits, ventilators, all materials necessary to distribute vaccinations “and other medical and non-medical supplies needed to respond in the event of a major respiratory illness emergency.”

The report includes recommendations for test production, contact tracing and data gathering.

Schools should get an influx of funding for air quality improvements, the committee said, and although the state has committed $100 million in federal pandemic relief funds to school ventilation, more money and a multi-agency implementation plan will be needed.

“All of these things are smart public health imperatives that haven’t been on the front burner before,” Comerford said.

The 17-member committee includes several western Massachusetts lawmakers.


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