Massachusetts began Phase III of its reopening plan this week. Reopening unquestionably involves disproportionate risks to the health of some residents relative to others, and the State’s push forward fails to adequately address these risks.
Phase III of Governor Baker’s Reopening Massachusetts Plan began on July 6, with the exception of Boston, which will begin Phase III on July 13. The first step of Phase III focuses on the reopening of recreational activities: gyms, movie theaters, museums, casinos, and professional sports teams, with specific rules for each type of operation.
In its May 2020 report, “Reopening Massachusetts,” the State’s Reopening Advisory Board asserts that “key public health metrics will determine if and when it is appropriate to proceed through reopening phases.” It references six indicators, including the COVID-19 positive test rate, deaths, hospitalizations, health care system readiness, testing capacity, and contact tracing capabilities.
But these state-wide metrics are inadequate, in both public health and ethics terms. Missing from these metrics in particular, and this Reopening Plan in general, is recognition of, not to mention accountability for, the predictably disproportionate negative impacts that reopening has on the lives of Black and Latinx residents, low-wage workers, and other groups already disparately harmed by COVID-19.
In early June, the Task Force on Coronavirus & Equity — comprised of nearly 100 public health, community, and labor organizations as well as academic institutions state-wide — set out four equity criteria for reopening. Designed to protect those most affected by the pandemic, these criteria include reduction in infection rates for all subgroups of the population, enforceable workplace safety protections and support for small businesses, expanded testing, and the inclusion of most impacted communities in reopening decision-making.
In late June, the Task Force issued a “report card” assessing the Governor’s progress on these measures and found that the Governor earned two D’s and two F’s according to a defined scoring rubric with associated descriptions and recommendations.
The Fs were granted for the State’s lack of engagement with the communities most affected by the reopening policies in the decision-making process, and for the lack of enforcement capacity for worker safety standards, which protect workers and the public from risks of COVID-19. The only slightly better Ds were earned for the State’s lack of implementation of the recent data collection law written to strengthen our understanding of health inequities, and for its limited COVID-19 testing rates, especially for asymptomatic, high-risk persons.
These health equity metrics seemingly have been disregarded as the State proceeds into Phase III. Yet virtually every page of the 29 page “Reopening Massachusetts” report makes this statement: “All public health criteria included in this document are subject to change. As research and data on this novel coronavirus continue to develop, this plan can and will be updated to reflect the latest science and data.” Notably, the State does not collect some data highly relevant to reopening, for example, the infection and death rates of essential workers or immigrants. But other State data are now available that show definitively the disproportionate COVID-19 case and death rates by race and ethnicity in Massachusetts.
When will the Reopening Plan be updated to reflect these latest public health data, as well as the health equity metrics?
The Task Force on Coronavirus & Equity was formed soon after Governor Baker declared a state of emergency in Massachusetts in March 2020 in order to assure that equity concerns — racial, economic, and more — are central to the State’s pandemic decision-making. In addition to an equitable reopening, the Task Force is supporting efforts on pro-equity policies in seven other COVID-19 related arenas: public health data collection, police accountability, decarceration, housing security, immigrant health and safety, worker rights, and State crisis standards of care.
Co-chaired by Sandro Galea, MD, Dean of the Boston University School of Public Health and Cheryl Bartlett, RN, CEO of the Greater New Bedford Community Health Center and former Commissioner of the Massachusetts Department of Public Health, the Task Force welcomes new organizational members.
For the most recent updates for the Task Force, see https://twitter.com/MAPublicHealth and https://www.facebook.com/ActionforAHealthyMass.
Charlene Galarneau, PhD, MAR, is Senior Lecturer, Department of Global Health and Social Medicine, Harvard Medical School, Center for Bioethics – an organizational member of The Task Force on Coronavirus & Equity; also Emerita faculty of Wellesley College.
