Letter to the Governor Baker RE: COVID-19 Surge Sent by Co-Chairs Rep. Driscoll & Sen. Comerford
December 21, 2021
Dear Governor Baker,
On December 16, the Joint Committee on COVID-19 and Emergency Preparedness and Management conducted an oversight hearing on the emergent Omicron variant and the evolving status of the COVID-19 pandemic. The hearing was of significant benefit as it provided insight on current issues facing hospitals, local public health officials, and the Commonwealth.
The experts and practitioners that joined the Committee expressed concerns about the alarming surge in COVID-19 trends and other challenging circumstances facing the Commonwealth. There is potential for the situation to further deteriorate in the coming weeks, despite having a highly vaccinated population. It is therefore our view that the administration needs to urgently and more clearly define the details of a surge-related plan with specific goals regarding tests, vaccinations, boosters, and hospital capacity thresholds. The plan could include additional anticipatory guidance for both practitioners and the public as January approaches. We acknowledge that the shifting ground with the Delta and Omicron variants create added unknowns but there are temporary and durable steps with clarifications that can be made now.
We urge your consideration of the following:
Reinstating a mask mandate for all indoor public spaces was the most urgent recommendation we heard, with broad support among public health, hospitals, and medical experts. Right now, there is a patchwork of mask advisories vs. requirements dotting the Commonwealth and the inconsistency from one town to the next, in the context of surge related public health messaging, is confusing for the public and inadequate in terms of utilizing coordinated tools that can slow transmission and hospitalizations. While mask wearing itself cannot end a surge, it, along with other measures, can help to prevent and slow COVID-19 transmission. Masking, particularly with well-fitting high-performance masks, was referenced as being a crucial tool in slowing transmission which may slow hospitalizations and ease the stress on the essential health care workforce. A clear off-ramp, provided at the start, with trigger(s) for the data/trend conditions under which a mask mandate would be discontinued could help to quell concerns and channel coordinated collective action toward driving transmission trends down again.
Vaccines and equity
Continue to work to close the race/ethnicity gap currently evident with pediatric vaccinations. We have heard repeatedly that locally-grounded efforts are most successful. Please focus and increase efforts, driven by publicly-stated goals, within communities of color that use best practices that are known to be effective at breaking down barriers to vaccine acceptance including universal translation and interpretation, deploying trusted messengers, and other proven strategies, including door-to-door outreach to reduce vaccine hesitancy. We heard from
local public health officials across the Commonwealth: the complexities associated with secondary and tertiary forms of communication contribute to communities becoming disproportionately impacted by COVID-19. Our local boards of health and community health centers know what works best for their community members and should be leveraged as a part of any effort to increase vaccine acceptance in their communities. They have expressed a need for improved translation and explicit outreach efforts, as well as work to decrease the spread of misinformation. We urge the Administration to re-energize the work with local communities to diagnose and address the barriers or shortfalls in an effort toward closing persistent gaps and meeting goals.
Additionally, set public targets and timelines for booster shots, again with an eye toward racial equity. The administration should state goals for the added testing and vaccination sites being stood up or extended. Greater clarity is needed regarding how many booster shots or tests the state hopes to achieve daily or by other parameters. For example, the committee understands there are likely valid reasons for the lag in meeting the goal set of the 5–11-year-old vaccinations. We and the public should understand what the challenges are, particularly related to vaccinations and testing, and how they are going to be addressed in an effort to highlight how the public can be part of achieving those goals. Test access and distribution should be matched with an aggressive education campaign on how to best use each test option.
State support for local communities has and will continue to be vital throughout the next weeks and months of the pandemic. In addition to the longer-term investments like those made via $200 million in ARPA funding to public health, today, the local boards of health and public health departments must be provided with the necessary knowledge and resources to effectively care for those in their catchment areas. This includes completing a contact tracing knowledge transfer to ensure that local health officials have access to the enormous resources and information amassed by the Community Tracing Collaborative before the program was ended.
Expanding in-school testing
The Commonwealth’s work to advance in-school testing is critical. We ask that you strengthen the “test and stay” program by including vaccinated students and also allowing those who have been exposed to COVID outside of a school context to qualify and participate.
We heard testimony from Massachusetts Health & Hospital Association (MHA) president and CEO, Steve Walsh, “Hospital capacity is stretched more than it has ever been since the beginning of the healthcare emergency...after two years of fighting this virus our caregivers are simply exhausted.” He also acknowledged that, "some of these pressures we feel are not COVID related and may have also been mounting for several months.” These hardships are growing, and this already strained workforce must maintain operations, handling the brunt of this ordeal. We support your action today to deploy the National Guard for non-medical transportation, patient monitoring and other support to hospitals where appropriate.
Additionally, to further safeguard our children and educators as COVID-19 trends surge or plateau at high levels, granting mask mandate exemptions for schools that have reached the vaccinated goal should be paused until after January or a period when transmission and trends are dropping precipitously week-over-week and greater hospital capacity exists.
We have found ourselves in the mid-holiday season with increasingly high COVID transmission rates, along with at or near capacity hospitals throughout the state. We are still learning about the Delta variant and navigating its surge, and now the emerging Omicron variant could have monumental impacts given its potential increased transmissibility. Dr. Nahid Bhadelia reminded us that even if those who have been vaccinated generally become less ill with the virus, with exponential growth driven by Omicron, we could see real system destabilization due to surging numbers of critical patients, among them the unvaccinated and others in the minority of vaccinated patients who have comorbidities.
Additionally, given the spike in COVID cases within congregate care settings, it is imperative that the administration open quarantine and isolation shelters across the Commonwealth. It is our understanding that there are critical, emergent capacity issues which threaten public health.
The expertise we heard at the December 16 oversight hearing, coupled with the Committee’s ongoing COVID-19 due diligence has combined to help us understand the reality of the current stage of the pandemic, but it has left us with questions about what specific plans the administration has established to combat the known and evolving challenges presented by COVID-19 in Massachusetts. We look forward to hearing more specifics from the administration.
Bill Driscoll, Jr., House Chair
Joint Committee on COVID-19 and Emergency Preparedness and Management
Jo Comerford, Senate Chair
Joint Committee on COVID-19 and Emergency Preparedness and Management