A temperate governor, an unbridled virus: Health crisis tests Baker’s technocratic approach

Governor Charlie Baker. “In the end, I think we will all be judged on the long game,” he said.Jessica Rinaldi/Globe Staff

Two days after the World Health Organization declared the COVID-19 outbreak a pandemic, Governor Charlie Baker stood before reporters on March 13, and, citing the advice of his public health officials, said closing schools statewide to combat the spread did “not appear to be the appropriate thing to do at this time."

But roughly 48 hours later, he reversed course: Schools shuttered for weeks. Restaurant and bar service sharply curtailed. Gatherings of more than 25 people banned. Even as the virus has upended daily life, this was a sea change — one Baker attributed to the changing “facts on the ground,” specifically growing evidence of community spread.

Amid the rapid escalation of an all-encompassing crisis, Baker is hardly unique among the 50 US governors constantly pivoting to reshape their citizens’ daily lives before a deadly infection does.

But the unprecedented threat of COVID-19 is challenging not just the bandwidth of Baker’s administration at a time when help from the federal government has been sorely lacking. It’s testing the very way the methodical state executive — who’s long embraced details and incremental progress over sweeping action — approaches solving problems.

Baker has always leaned on the “facts on the ground." But that ground is constantly shifting into invisible, unprecedented, and dangerous territory.

“Every decision I’ve made since I got into this was either too much or too little,” Baker said in a moment of retrospection Saturday during at a news conference at the State House.

“The economic consequences of these decisions for regular people who no longer have a job . . . through no fault of their own are profound," he said. "And if you make decisions to deal with one piece of this puzzle, you better be absolutely sure, especially if it has huge consequences over here, that you’re making the right one.”

Such is Baker’s rapid-fire reality. In 12 days, he’s issued more than 20 executive orders, many specifically designed to restructure routine life in order to corral what is still a rapidly growing numbers of cases in Massachusetts. Those decisions have had enormous consequences, helping drive people into unemployment, businesses to temporarily close, and families into crisis as schools and day care facilities close.

And through it all, Baker has made an oft-repeated statement at news conferences that each step was a stab at combating the illness “at this time.” But critics say it’s time itself that has become crucial.

“The governor and I approach things similarly: We are both analytical. We are both deliberate. We both think of unintended consequences before we act. That is a sign of a good person in government,” said state Senator Rebecca Rausch, a Needham Democrat and one of nearly three dozen elected officials who has urged Baker to declare a shelter-in-place order.

“But there are times you have to speed up the clock. You have to do it faster," Rausch said. "And this is one of those times.”

Since cutting short a vacation in Utah and declaring a state of emergency on March 10, Baker has layered in a series of escalating restrictions: banning travel for executive branch employees, prohibiting gatherings of 250 people (then narrowing it to 25 people), closing schools, and ordering restaurants and bars to stop in-person service.

On Thursday, he activated up to 2,000 members of the National Guard, and by Friday, the number of daily tests administered in the state grew to nearly 1,000.

Most moves have been applauded by public health advocates or lawmakers — even if they had for days been pushing Baker to take them. And, Baker advisers say, his approach is consistent with how the Republican has navigated his five-plus years in office: digging into data, seeking out experts, and moving when there’s evidence he should.

“We’re dealing with something that’s completely unprecedented. And the complication around that is separating what’s speculative from what’s anecdotal from what’s believable from what’s real,” Baker said in an interview Saturday.

Watch Baker give an emotional explanation of the human toll of social distancing

Gov. Baker talks about how he has heard about people who are unable to attend funerals during the coronavirus outbreak.

The information is “fluid to begin with,” he added. A former head of a health insurer, Baker has also leaned on his connections in the industry to guide his thinking.

“You have to be willing to reconsider the decisions you make and the way you’re making them based on the data," Baker said. "You have to be willing to be flexible.”

The consequences of his decisions can weigh heavily. Baker recalled attending a ceremony at an empty Temple Emanuel in Newton on Friday, speaking through a live stream at what would have otherwise been a packed temple.

The backlash he got from limiting crowds to 25 people to encourage social distancing was immediate, he said, especially within the funeral industry.

“What do people do at a funeral? They hug and they cry and they kiss. And they do it again,” Baker said in the interview.

“And when somebody tells you that you’re stealing those last moments to say thank you to their family member,” he said, his voice lowering, “it’s pretty brutal."

He also doesn’t regret that decision. “I think it was the right one," he said.

Yet, he’s also faced criticism that he hasn’t been aggressive enough, including when compared to Andrew Cuomo of New York or Mike DeWine of Ohio, governors who have drawn attention not just for the forceful ways they sounded the alarm but when.

Cuomo quickly dedicated $40 million to coronavirus efforts even before the state’s first case, holding press conferences since early February about the threat. Then, facing one of the country’s first and largest clusters of cases in New Rochelle, he deployed the National Guard and set up a containment zone there on March 10, when there were still just 173 confirmed cases statewide.

DeWine closed the state’s polling locations for the March 17 presidential primary — despite a court rejecting his request to do so.

“If you look at what has already played out over the last week and will continue to play out, this is an existential threat to our society. That is something we needed to be hearing from our leaders for some time,” said Regina LaRocque, who works in the division of infectious diseases at Mass. General Hospital.

“It’s a leadership issue," she said, "of communicating the nature of the threat and the need to prepare.”

Baker has moved before other states, including in limiting restaurant and bar service and reducing the size of gatherings. But the fast spread of the illness has meant other states have since leap-frogged Massachusetts with restrictions, and Baker is repeatedly asked if he will follow suit.

The enduring question is whether Baker will pull the most dramatic lever yet: ordering the nearly 7 million people in Massachusetts to shelter in place. California’s 40 million residents, the 19 million in New York, and 12 million more in Illinois are all under stay-at-home orders.

“I think it’s a hard, hard situation. And I think the governor’s caution does serve us well,” said Sandro Galea, dean of Boston University’s School of Public Health. “Are there are other things that could be done? Absolutely. But tomorrow is more of a test than today.”

There’s simmering frustration within public health circles that Baker should also more aggressively tap one of Boston’s greatest resources — the deep bench of experts and brain power who could help inform these life-altering decisions.

Marylou Sudders, a former social worker and Baker’s health and human services secretary, is leading the state’s coronavirus command center, and Monica Bharel, a general internal medicine doctor by trade and the state’s public health commissioner, is playing a key role, regularly appearing at Baker’s daily briefings.

Neither, however, has a deep background in epidemiology. The command center has gathered an advisory panel of experts, including former FDA commissioner Scott Gottlieb; Dr. Paul Biddinger, director of Mass. General Hospital’s Center for Disaster Medicine; and Eric Lander of the Broad Institute. But they only met formally for the first time Thursday.

“Massachusetts needs a Tony Fauci,” said Dr. Philip J. Landrigan, director of Boston College’s Global Public Health Program, in reference to the infectious disease expert who sits on the White House coronavirus task force and has often been an assured but sober presence in updating the nation on the status of the government’s response.

“When a medical situation arises like this that’s outside the norm, it’s wise to bring in at least one person, maybe several people, with specialized knowledge," he said. “And we have people in the greater Boston area who have those skills.”

Sudders said she understands the idea, but stressed that the administration, and Baker himself, have been speaking with experts “since the beginning," even if not always in formal settings.

“I want to make sure our thinking is as fresh as possible,” she said.

Doctors and public health experts say Baker, like every governor, has been severely hampered by failures at the federal level outside their control. President Trump was quick to downplay the virus, saying in January that was it was “totally under control.” The federal government has lagged in making test kits and protective equipment available, and Baker and other governors have publicly urged the Trump administration to move more quickly.

Baker hasn’t always taken that tone. On March 2, eight days before his emergency declaration, he praised the Trump administration’s decision to route flights from China to select airports, saying it had “absolutely made a big difference." He also expressed confidence the federal government would deliver on masks and other medical supplies.

“I believe they will play a big role in ensuring that people have access to the supplies when they need them,” Baker said.

Come Thursday, Baker was challenging Trump in a conference call of governors, saying days after the president urged states to seek out emergency protection equipment — crucial items such as masks and gowns — the state lost “on three big orders," each time to the federal government.

Sudders said that included an order for 3 million so-called N95 respirators that had been sitting in a New Jersey port for days, but became out of reach when the federal government impounded them.

“The state has been flat-footed. It’s because of the failure of federal leadership by and large, but they are behind," said Margaret Bourdeaux, research director at the Security and Global Health Project at Harvard Kennedy School’s Belfer Center. "By the same token, the virus doesn’t care.”

That reality of the crisis has left Baker moving from day to day, his time dominated by meetings, phone calls with other governors, and finding ways to get the best “possible health care results — and the least amount of economic damage,” he said.

“In the end, I think we will all be judged on the long game,” Baker said. “We are in the early stages of something that we’ll be working on and working through for months. And I think it’s really important we treat it that way.”

Victoria McGrane and Felice Freyer of the Globe staff contributed to this report.

CORRECTION: This story has been updated to correct the description of those who signed a letter urging Governor Charlie Baker to order residents to shelter in place. They’re all elected officials.