Charlie Baker ought to be just the right person to lead a state during a serious disease outbreak. As the former CEO of a major health insurance company and a onetime state secretary of health and human services, he has deep experience in the inner workings of the health system.
So why didn’t reports of an outbreak at a Biogen conference in Boston lead to swift action sooner? And why are governors in other states taking a more high-profile role in helping institutions respond to the coronavirus crisis and offering more information to the public?
Certainly many of the problems facing the state, including a shortage of tests lamented by doctors at Massachusetts hospitals, have their roots in Washington. But the ineptitude at the federal level is another reason why stronger leadership is needed at the state level.
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Baker is known for his cool, calm, and cerebral approach to crises and thorny problems. In ordinary times, that’s admirable. However, his response to the coronavirus pandemic in these extraordinary times seems lacking in boldness, clarity, and transparency, especially given his expertise and the state’s reputation as a national leader in health care.
On Friday, Baker announced a ban on events of over 250 people, including but not limited to, community, civic, public, and leisure gatherings, faith-based events, sporting events with spectators, concerts, conventions, fund-raisers, parades, fairs and festivals (and excluding workplaces and schools). That decision comes 10 days after state officials first learned about an outbreak of illness at a conference sponsored by Cambridge-based Biogen — and three days after Baker declared a state of emergency, which he said would give him the power to take whatever steps he deemed necessary to ensure public health, such as canceling large events.
As of Friday afternoon, the current tally of positive cases in Massachusetts had jumped to 123, but the actual number of cases is probably far greater. As reported by the Globe, Massachusetts doctors say a shortage of tests for Covid-19 is hurting efforts to control the local outbreak. They also say Massachusetts is testing fewer people and disclosing less information than other states. At a press conference Thursday in Pittsfield, however, Baker said the state now has the ability to test 5,000 more people and has what he called an “adequate supply” of test kits.
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But Massachusetts is not publicly disclosing how many people total have been tested so far for Covid-19 — and that won’t happen until March 18, state officials said on Friday. (Earlier this week, Massachusetts Public Health Commissioner Dr. Monica Bharel said that only 400 people had been tested since Feb. 28).
Public health experts, including those from our state’s esteemed institutions, argue that the state should be testing at least 1,000 people a day to have the same success fighting the epidemic that has been observed in South Korea. State officials say they can now test 200 people per day and that by next week that number will double.
Much of the blame for the lack and delay of testing nationwide can be placed on the Trump administration, which rejected the World Health Organization’s test for the virus and then botched the rollout of tests around the country. Still, some states have done more to make testing accessible than Massachusetts. Colorado, California, and New York are offering drive-through testing.
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Massachusetts officials also reported that Massachusetts General Hospital and several other hospitals are waiting to get FDA approval to run diagnostic tests. Concerning the message he has been getting from hospitals that they are “this close” to getting FDA approval, Baker said, “They have been this close for a while. It’s enormously frustrating for all of us.”
It’s unclear whether state officials responded quickly enough as the local outbreak emerged. The Biogen conference that is now recognized as the epicenter of the Massachusetts outbreak of Covid-19 took place on Feb. 26 and 27. Bharel said Tuesday that she wasn’t sure exactly when her department learned that people who attended the Biogen conference were ill with Covid-19 because all the days “are blurring together.” However, according to a Globe report, Biogen officials first reached out to state public health officials on March 3.
On March 6, Baker held a joint press conference with Boston Mayor Marty Walsh, at which he said there was a “low risk” for infection. He then left for a family ski vacation in Utah.
When the number of Massachusetts cases ticked up, Baker cut short his vacation, and on March 10 he declared a state of emergency. He barred executive branch employees from out-of-state work-related travel; canceled conferences, seminars, and other large discretionary gatherings; and banned private international trips.
At a State House press conference on Tuesday, Baker said the private sector should follow suit “when appropriate.” That instruction left the decision-making up to individual employers. Some employers have asked people to work from home if they can. Meanwhile, Boston-area college students have been sent home, museums have closed their doors, and state and federal jury trials have been postponed. The sports world has essentially shut down. On Friday, Baker and Walsh announced that the world-famous Boston Marathon would be postponed until Sept. 14.
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Other governors offered earlier and clearer guidance to private companies and municipalities on what to do about large events and closures — social distancing measures that scientists consider to be critical interventions at the early stages of an epidemic. Before Baker announced a statewide ban of gatherings larger than 250 people, Governor Jay Inslee of Washington had banned events with more than 250 people in three of the hardest-hit counties in that state. In New York, Governor Andrew Cuomo had called in the National Guard and ordered a one-mile containment zone in New Rochelle, which has at least 108 cases. In California, Governor Gavin Newsom had said all public gatherings should be postponed or canceled. After only three confirmed cases in Ohio, Governor Mike DeWine declared a state of emergency and then called off large gatherings before Massachusetts, which has far more confirmed cases.
With the leadership void at the federal level, governors have to take the lead in the coronavirus response. And a state with as many medical resources as Massachusetts should be setting the pace, not lagging behind. That means more transparency and more guidance for the public going forward.
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