The letters of protest come from public health leaders in some of the state’s most densely populated regions, including Boston, Springfield, the Merrimack Valley, the Metro West area, and Plymouth County. The state health department is required to seek and include the local letters in its application for emergency preparedness funding from the CDC.
“The Commonwealth continues to operate under a constrained federal supply and has 170 public vaccine sites statewide, including several local boards of health who support several of our hardest hit communities and receive vaccines every week,” a spokeswoman for the state’s COVID-19 Response Command Center said in a statement. “Local Boards of Health partner with the state to develop plans for the vaccination of residents who are housebound, live in senior low income or affordable housing and populations more difficult to reach, and will continue to be a critical part of the pandemic response.”
After a slow start, Massachusetts has risen in state rankings for vaccinations, with more than 2.3 million total doses administered as of Wednesday, according to the CDC’s COVID Data Tracker. Massachusetts ranked 9th overall nationwide for total doses administered, based on population.
The state’s application to the CDC seeks $13 million in federal funding, and local health leaders say their letters detailing the significant problems in Massachusetts’ pandemic response are not intended to derail the funding. Nor is the protest likely to do that, they said. Their sharply worded letters, they said, are to highlight the failings and implore the state to move forward in a manner that better serves communities, especially those hardest hit by the virus.
“There seems to be a complete disconnect from the well-known and established plans that communities have built since 2001,” states the letter from Jeffrey Stephens, Westford’s health director, who also leads the Upper Merrimack Valley Public Health Coalition.
After the terrorist attacks in September 2001, Massachusetts spent millions of dollars planning how it would mobilize its vast network of local public health departments to respond in an emergency situation, including setting up and running mass vaccination sites. Many of the letters say the state threw out that blueprint during the pandemic.
“We feel the development of plans almost seems futile for future responses,” Stephens’ letter said. “The non-use and dismissal of current plans damaged relationships within our region and aids to the deteriorating confidence in Public Health by residents.”
The widespread show of disapproval from the state’s local health coalitions is unusual. The last time occurred in 2006, when many felt communications were lacking between Governor Mitt Romney’s health department and local health leaders.
Disjointed communication was cited in a number of the letters.
“Local boards of health were left out of the statewide planning and were instead faced with reacting to guidance as it came out from the state, which often was different than the plans we have built together,” stated Stacey Kokaram, director of the Boston Public Health Commission’s Office of Public Health Preparedness, in her letter.
In late December, local health leaders were sprinting to set up vaccine clinics for first responders after the state health department gave them only about two weeks to secure ultra-cold storage units for vaccines, as well as find adequate protective gear and staff to administer the shots. But, around the same time, the Baker administration was quietly setting up privately run mass vaccination centers at Gillette Stadium, Fenway Park, and other large venues, while moving away from local clinics.
Local health leaders have chided the state for a lack of communication during the pandemic, which led to widespread confusion in communities.
In one instance in the fall, the COVID Command Center abruptly changed how it measured the number of COVID-19 infections, which determines the risk levels in communities and affects business closures and more.
The change directly contradicted decisions about business closures and other guidance to residents many public health departments had issued earlier that same day, local health leaders said.
Shortly after, the command center relaxed quarantine rules, again with no notice to local health departments. Public health nurses were on the phone ordering residents into quarantine and explaining the rules at the very same moment the governor was on television introducing different rules, local leaders said.
Indifference by the state toward local expertise, as well as poor and sporadic communications “resulted in confusion and frustration between us and the communities we represent,” said Christopher Goshea in his letter from the Hampden County Health Coalition, which includes Springfield and Holyoke.
“We are open to thoughtful discussion, so this critical work can continue and be pertinent to the responses of the future,” he said.