Mass. health leaders call for stepped-up COVID plans for fall and winter

Backpacks and school supplies were given away at the 11th Annual Back-to-School Distribution near the The Salvation Army Boston Kroc Center in Dorchester last week.David L. Ryan/Globe Staff

Health experts and community leaders on Monday urged state officials to step up COVID preparedness ahead of the fall and winter, when many expect a rise in COVID infections as well as a resurgence of the flu.

“We all want this pandemic to be over, but wishing it won’t make it so,” said Katie Murphy, president of the Massachusetts Nurses Association, at a virtual news conference. “Pretending that we’re doing all that needs to be done for the fall and winter seasons and what they may portend, isn’t acceptable on any level.”

At the briefing, hosted by the Massachusetts Coalition for Health Equity, a group of health care and community leaders advocating for more comprehensive COVID policies, public health experts said there were more weekly COVID cases and average weekly hospitalizations in Massachusetts for the period ending Aug. 18 than a year ago. Yet COVID precautions have fallen by the wayside.

Last week, officials from the Department of Elementary and Secondary Education announced there would be no statewide masking or testing mandates for schools this fall and that students and staff exposed to COVID do not have to isolate if they have no symptoms. The guidance was similar to what the state released at the end of the 2021-22 school year, and in line with new guidelines from the Centers for Disease Control and Prevention. (Children who test positive for COVID should isolate for five days and wear a mask around others for 10 days.)

Booster vaccinations have also lagged. Only 59 percent of fully vaccinated individuals have received a booster shot in Massachusetts, compared to a national average of 48 percent. Additionally, full vaccination has differed by age group, with 51 percent of 5- to 11-year-olds, 78 percent of 12- to 15-year-olds and 73 percent of 16- to 19-year-olds fully vaccinated.

Among the measures advocates called for were back-to-school vaccination “festivals,” a resumption of mask mandates in schools and all public buildings at the start of surges, plans and funds to resume surveillance testing during surges, and hours or areas in schools, workplaces, and public spaces where masks would be required. They also want policies that require those who test positive for COVID to isolate for 10 days or until students or workers test negative on rapid tests. Some also advocated for mandatory masking and testing at the start of the year, and for new standards for ventilation and air filtration.

“We have other goals beyond [maintaining] hospital capacity,” said Jonathan Levy, a professor of environmental health at Boston University School of Public Health. “Keeping our hospitals from getting slammed is incredibly important. But we need and want other things. We want in-person school with as much attendance as possible. We want our workplaces to be functional. We want to make sure our supply chains are not disrupted.”

The Baker administration did not immediately respond to requests for comment, however the Department of Health and Human Services noted throughout the summer and into September, DPH has coordinated more than 480 free family-friendly vaccine clinics for anyone 6 months and older. The Department of Public Health’s mobile provider was also offering clinics for family and pediatric practices too small to administer vaccines themselves, and the state was offering mobile pop-up vaccination clinics at places such as public K-12 schools and community colleges.

Such approaches weren’t enough for a number of the experts and advocates. Julia Raifman, an assistant professor at Boston University School of Public Health, said in the southeast part of the country, where the school year began without mitigation policies, there had already been increased hospital admissions among children.

“This is a tragedy to know that these children are being so severely affected. It’s a tragedy when children have long COVID, when their parents and educators have it, and when they miss work and suffer economic hardship. All of this we can help reduce with COVID mitigation strategies,” Raifman said.

A study posted online earlier this month but not yet published in a peer-reviewed journal suggested that mask mandates kept COVID transmission low in Boston-area schools. Researchers from the FXB Center for Health and Human Rights at Harvard’s School of Public Health and the Boston Public Health Commission compared COVID rates in schools that had lifted mask requirements in February with those that had continued masking through June. They estimated that schools that allowed students to go mask-free had an additional 45 cases per 1,000 students and staff over the 15 weeks following the lifting of the mandate, or approximately 12,000 cases.

That study was in addition to research published earlier this month in JAMA Network Open from researchers at Boston University, which found that in-class transmission of COVID was “negligible” when mandatory masking and vaccination were in place.

Advocates emphasized that without action, the consequences of the pandemic would continue to fall hardest on essential workers, Black and brown communities, and those with health issues. Suleika Soto, cofounder of Families for COVID Safety and an organizer with Boston Education Justice Alliance, said Boston Public School children came from families of essential workers, whose jobs were in jeopardy if they had to miss work. Many live in multi-generational households with vulnerable older relatives.

“It has been so important for our schools not to be sources of infection and transmission and for there to be the layers of protection that racial equity demands to shield students and families from this unrelenting ongoing pandemic,” she said.

Dr. Lara Jirmanus, a primary care physician and instructor at Harvard Medical School, pointed to a mother and daughter she saw in a video visit. Jirmanus suspected the daughter had COVID, yet the mother said there was no way the other members of the family could quarantine. They also didn’t live within walking distance of a test site, didn’t have tests at home, and only spoke Portuguese, and so struggled to navigate websites to find nearby testing locations.

“The tools have always been least accessible to the Black and brown communities most impacted by the pandemic,” Jirmanus said. “And furthermore, people who are elderly are less likely to have computers or easily navigate the really complicated online tools that you need to access vaccines, tests, and treatments. This is not giving people access to the tools. This is a show of tools that are easily accessible by white, wealthy people who are highly plugged in.”

Disability advocates also lamented that a lax attitude toward COVID had robbed them of access to public spaces. Ellen Leigh, a disability advocate and member of the Massachusetts Coalition for Health Equity, pressed for universal masking, as well as remote education options, during surges.

“This is public health. We can do better by being realistic, by planning for the future and imagining new ways forward to save our well being for all of us,” Leigh said. “Disabled and immunocompromised people should not have to sacrifice their lives for the convenience of everyone else.”