This is the first in a two-part series about what Massachusetts is doing well during the coronavirus pandemic, and what the state could have done — and could still do — differently. Part one looks at what the state has done well. Read part two here.
To say COVID-19 has hit Massachusetts hard would be an understatement. To date, the disease taken the lives of more than 6,000 people statewide, a total surpassed only by New York and New Jersey.
Still, Massachusetts residents think highly of the state's response. Case in point: In a Suffolk University/WGBH News/Boston Globe poll taken before reopening began, 84 percent approved of Gov. Charlie Baker’s handling of the pandemic, and 69 percent said they had been “very strict” about social distancing.
Of course, those are subjective assessments — but there are concrete reasons to give Massachusetts high marks.
“Massachusetts is one of the best examples of how to handle this,” said John Brownstein, an epidemiologist at Harvard Medical School and Boston Children’s Hospital. “Nothing’s perfect, but I’d say it’s one of the best examples across the country.”
Brownstein credits leaders like Baker and Boston Mayor Marty Walsh for telling people to stay home and stay away from each other, emphatically and repeatedly, at a time when the federal government’s guidance was often muddled. And he praises the public for doing exactly that.
“We saw the impact of social distancing immediately — people stopped going out,” Brownstein said. “It’s one thing to make these recommendations, and it’s another thing for people to actually begin this way of life. … This has happened in a way that I actually find pretty unbelievable."
Brownstein’s assessment is quantifiable. A University of Maryland analysis, for example, shows that Massachusetts residents significantly increased social distancing starting in mid-March, more than a week before Baker issued a stay-at-home advisory. The analysis also puts us toward the top of the list in its ranking of states’ current social distancing practices.
Another strong point of Massachusetts’ response? At the height of the COVID-19 surge, the health care system had the resources to weather the storm.
“At the peak of demand,” said Paul Biddinger, director of Mass. General Hospital’s Center for Disaster Medicine, “there were emergency department beds, hospital beds, ICU beds and all of the clinical resources that come with it for the patients when they needed them.”
Biddinger cites widespread willingness to social distance as one reason hospitals were able to keep up. But he adds that another factor was crucial: an unprecedented willingness, across the medical establishment, to share data and resources.
“We had competitive health care systems sitting down virtually at the table, every single day, to talk about ICU admissions and [emergency department] admissions, to make sure that there was capacity for admitting new patients with COVID,” Biddinger said. “And it was a level of collaboration across the health care system that we just never see.”
Massachusetts hospitals also were able to keep pace because they shifted to a war footing proactively, before things got really bad.
“That’s not easy, right?” said Helen Boucher, the chief of infectious diseases at Tufts Medical Center. “The economic implications of doing that are not trivial. When everything’s kind of fine, and you hear about one or two cases in travelers, it’s kind of hard to get in front of people and say, ‘No more orthopedic surgery.’”
“That happened at a much higher pay grade than mine, but I’m very glad it did,” Boucher added. “Not only did we have enough ventilators and enough doctors and enough environmental services people to keep our hospital clean through all this, but we never got into that crisis mode that they did in Italy and these other places. And I believe that made us better able to care for the patients.”
Boucher also praises the Baker administration for building a new COVID-testing infrastructure from scratch by working with local partners like MIT and Harvard’s Broad Institute, which became a testing hub.
“The Broad Institute basically shifted their whole work stream from doing all the important science that they do to fighting COVID, and then ramped up their testing,” Boucher said. “There’s still a lot of work to be done. I don’t want to minimize that. But that partnership, I think, made a huge difference getting us to where we are today."
So far, Massachusetts has conducted more than half a million tests, according to the state's website, which points to another Massachusetts strong point: regular reporting of lots of data, from testing totals to hospital capacity to fatalities.
Alexis Madrigal runs the Atlantic’s COVID Tracking Project, which monitors data from around the country and gives Massachusetts an “A” for the information it shares.
“Some states took a long time to get up certain types of data,” Madrigal said. “Some states have never reported certain kinds of things. … From the beginning, Massachusetts’ reporting about what was happening in the epidemic was pretty solid and has remained so throughout.”
In retrospect, that candor from the highest levels of government may have been one reason so many of us were willing to disrupt our lives and hunker down starting in March.
Still, despite these successes, the toll from COVID-19 in Massachusetts is grim and growing, with nearly 600 deaths just last week.