Deb Ternove inhales information about the coronavirus, religiously looking to the state’s daily updates for clues about how to safely negotiate the changed world. How are Massachusetts residents most commonly getting infected? Which types of businesses or workplaces are linked to large numbers of COVID-19 cases?
But more than six months into the pandemic, those answers remain elusive for Ternove and others. While some states have been adding more concrete and easy-to-digest information about the most common places and ways in which their residents are getting infected, Massachusetts has yet to provide such accessible information.
“We’re not eating indoors [at restaurants] and going to the beach, but gradually you want some sort of sense of what the risks are,” said Ternove, a 64-year-old Upton resident and former human resources director who now runs a pet-sitting service, an occupation she deems relatively safe because of few people interactions.
“You’re always wondering what is safe, what is not safe, and where can I take a risk,” she added.
Weddings, large parties, and campus gatherings regularly burst into the news as super-spreader events, for example, yet every day, people are getting infected in mundane ways. But where and how?
Some state health departments, such as Louisiana, are sharing reports from their contact-tracing programs that specify the businesses, schools, or other facilities where outbreaks are occurring. Others, such as Vermont and Colorado, post the occupations, industries, or settings — such as bars, casinos, or food processing plants — with the highest number or percentages of infections in their states.
Massachusetts, which has teamed up with the Boston-based nonprofit Partners in Health to conduct contact tracing, is not publicly releasing information from that effort that would more clearly pinpoint where and how infections are spreading. A Partners in Health spokesman said the data they collect is turned over to the state health department.
When asked about such expansive data, the Baker administration said in a statement: “The Commonwealth’s contact tracing program has found that spread and clusters are typically formed when people let their guard down, as we are seeing transmission mostly in settings where people socialize and congregate, including households, informal gatherings, parties, and sporting events.”
The health department has significantly increased the amount of data it shares in daily and weekly online reports. It recently added charts and a color-coded map illustrating the hot spot communities, and those that have relatively lower rates of transmission, and the magnitude of local and state contact-tracing efforts.
The state also releases reams of raw data in dense spreadsheets that includes testing results across roughly 50 occupations, although about two-thirds of the results are missing from recent data and critics say the information is difficult to find on the state’s website and is hard to follow for the average person.
Ternove and other residents aren’t the only ones wishing for more accessible data. Local public health officials, who are on the front lines of the epidemic, say they, too, often lack a clear sense of where infections may be percolating.
“The governor keeps saying [infections are] coming from big social events, but . . . where are the numbers to show that,” said Sigalle Reiss, president of the Massachusetts Health Officers Association and Norwood’s health director. “I only see a small slice of the big picture. What are the trends statewide? Is it workplace? Is it social gatherings?”
Reiss recently had to briefly close one store and two fast-food restaurants in Norwood for cleaning after workers at the three businesses tested positive. Still, she said she’s finding it hard to know whether those cases signal a larger trend because “it’s hard to see the trends while you’re in the midst of it.”
Reiss said the state’s central database, which local health departments can access, does not allow the departments to easily run reports that might help them better pinpoint trends.
“It’s really hard [for residents] to have an accurate understanding of where the risk is,” said Carlene Pavlos, executive director of the Massachusetts Public Health Association.
Last Thursday, the Baker administration said it was targeting five communities with some of the highest infection rates — Chelsea, Everett, Lawrence, Lynn, and Revere — for additional services and would be meeting with local leaders “to understand residential and business activities contributing to trends.”
That, Pavlos said, is a “step in the right direction.”
If the epidemic has largely been fueled by partying and lax behavior, as Baker suggests, then the state’s data would not so often show some of the highest numbers of infections in communities that have dense housing and high concentrations of poverty, she said.
“If quality data can be collected, analyzed, and reported, we will learn something more about why these communities are experiencing higher rates,” and they can develop strategies to address it, Pavlos said.
By contrast, in Vermont, the state health department in August added a new section, “How are people getting COVID-19,” to its weekly online report. State epidemiologist Veronica Fialkowski said the department wanted to help residents understand what health officials there know about the source of infections, and also to help residents make informed choices. The section includes data culled from cases in which contact tracers could discern a known source of outbreaks, such as in nursing homes or workplaces, or from types of relationships, such as transmission through a family member, co-worker, or neighbor.
For cases in which the source of infection is unknown, the state shows the percentage of infections among each occupation. The highest percentages have been among workers in the hospitality, grocery, retail, and travel industries.
“We are all learning as we go,” Fialkowski said. “There is a lot of responsibility about how to share, for health privacy reasons. We are trying our best to provide data that is useful and interpretable.”
Crystal Watson, who specializes in risk assessment at Johns Hopkins Center for Health Security, said many states are collecting data on where residents are thought to have been infected but few are doing a good job sharing that information publicly.
“Health departments are running on fumes and people are exhausted,” Watson said. “They don’t have the resources to do the things they have to do and this may be a bonus in their minds.”
Watson said state-level data may not not be able to help residents know whether one specific restaurant, for instance, is more dangerous than another for coronavirus transmission, but it may illuminate whether certain types of businesses or places are linked to more infections.
Without more detailed information, Ternove, the Upton pet sitter, is analyzing every activity and measuring it against her own barometer for what seems safe. Going to the hairdresser still seems too risky, but given her aching joints, she has been to her massage therapist. She’s still trying to get food delivered as much as possible, because she’s unsure about grocery shopping.
“It’s these calculated risks that we are taking and you want that validation: Am I being overly cautious or am I being just about right,” Ternove said. “If you don’t have any information, you are settling into an adjective of being paranoid or nonchalant and you are doing it in a vacuum.”