2020 changed us. We have all been impacted by the COVID-19 pandemic: many have lost loved ones, lost their jobs, and worried like never before about how they will make ends meet. The toll on our healthcare workers has been unimaginable. Teachers, parents, and students alike have struggled with remote learning. Hotels, restaurants, and stores have closed, and small businesses and large employers alike have furloughed and fired employees. The pandemic has laid bare long-standing health inequities as we have all experienced unprecedented illness and death, prolonged shutdown, and a decimated economy.
To fully recover and rebuild a healthier, more resilient Boston, we must control COVID-19 across all 23 neighborhoods, from East Boston to Hyde Park. Andrea envisions a Roadmap for Recovery that addresses the immediate health impacts of the pandemic, the widespread economic decline in its wake, and the deep racial inequities it exposed.
Recovery begins with equitable, widespread vaccination to ensure Bostonians can get back to work and school. To make this a reality, we must track progress and use data, communicate and build trust between communities, and make smart, intentional investments to support working families.
We must also reflect and learn from this experience and invest in our public health infrastructure to lay the foundation for a future of health equity and resilience. Building on her experiences, driven by her vision for Boston, and grounded in her belief in healing communities, Andrea is uniquely positioned to lead this work.
To recover in 2021, the City of Boston should:
Ensure Vaccine Equity
All Bostonians must be able to access and trust in the safety and efficacy of the COVID-19 vaccine. Andrea deeply and personally understands the complicated history of medical mistreatment within communities of color in our city and our country. Our City’s leaders must recognize this complexity, build trust and confidence in communities across Boston, and deploy evidence-based policy grounded in science and best practice to ensure we all recover and maintain our health.
- Engage in Community Outreach to Build Trust. Widespread adoption of any vaccination program will depend on successful communication about the vaccine, building on trusted voices as lead communicators, particularly in our immigrant communities and communities of color. A culturally competent, multilingual communications program is critical to achieve near universal vaccine uptake. Andrea issued a City Council hearing order regarding vaccine distribution and implementation in December 2020 and will continue to build and support effective outreach efforts in every neighborhood, in partnership with local healthcare experts, including from the Boston Public Health Commission (BPHC) and the Health and Human Services Department, neighborhood health centers, public health advocates including the Black Boston COVID-19 Coalition, and faith-based, cultural, and community leaders.
- Oversee Equitable and Efficient Distribution of the Vaccine. The City of Boston has a responsibility to equitably distribute the vaccine and develop strategies to engage the community so that all Bostonians are safely and efficiently vaccinated as soon as possible. The City must partner with State and Federal leaders to prioritize residents who are at highest risk of COVID-19, including health care workers, the elderly, those who have received an essential worker designation as well as teachers, families with low incomes, and people who are in long-term care facilities, incarcerated, or experiencing homelessness.
- Ensure Ongoing Access. Vaccine distribution will be both an immediate priority and an ongoing activity. Now and in the future, City Hall needs to utilize high quality, timely data on vaccine distribution and rates of uptake in all neighborhoods, to ensure widespread availability, access, and adoption — all while maintaining confidentiality for residents. This will require close coordination with federal and state authorities to streamline resources and funding, particularly for families who utilize Medicare/Medicaid and MassHealth. Community health centers and smaller providers operating in neighborhoods across Boston must not be left behind. These neighborhood centers of health are critical and need funding and resources including for potentially retrofitting their facilities for cold storage to maintain vaccine stores onsite if needed.
Improve Transparency, Testing, and Surveillance
City Hall must consistently communicate data and a clear strategy around COVID-19. To recover and rebuild, we must use data within the Boston Public Health Commission and partner with our City’s unique healthcare community, including community health centers, to deploy a robust testing and surveillance program.
- Implement Transparent Surveillance. BPHC needs ongoing surveillance programs for COVID-19 just as it maintains for other infectious diseases like tuberculosis, meningitis, and HIV. High-quality surveillance demands robust data: BPHC should publish a weekly dashboard modeled off of the Commonwealth’s state-level report to provide real-time transparency about availability and utilization of testing, vaccinations, and rates of COVID-19 with neighborhood, race/ethnicity, occupation and age integrated throughout.
- Deploy Diagnostic and Screening Testing. Diagnostic testing must be the backbone of how we safely operate schools, workplaces, community health centers, and hospitals. The City must partner with community health centers and the largest local health care providers to ensure testing will continue to be available free of charge to residents, including those who are vulnerable, unhoused, and in high-risk settings such as nursing homes and correctional facilities. This work would be done in collaboration with state and regional leaders to ensure the necessary resources and training are deployed for a scalable and sustainable program.
Get Kids Back To School Safely
Andrea would prioritize safely re-opening schools through vaccinating and testing — which are essential tools to control community transmission. We now know more about how to keep students and staff safe once they arrive in school, and can deploy these approaches to ensure less disruption to learning going forward. Prioritizing teachers in vaccination efforts is paramount to creating a safe environment for a swift return to in-person learning.
- Deploy Pooled Testing. Boston biotech firms have developed best-in-class protocols for conducting pooled testing, and should be engaged to provide screening and surveillance testing across the whole of BPS. In December, Andrea called on the City to develop a weekly COVID-19 testing program for all students and staff, in partnership with BPS families, local research institutions, philanthropic partners, and Boston’s leading biotech firms.
- Keep Our Classrooms Safe. We know what we need to do to keep students, staff, and teachers safe: air filtration and ventilation, universal masking, hand washing, contact tracing, and social distancing. Now we must make sure it gets done – every day in every classroom – through transparent communication and strong execution in partnership with families and staff. This should include, for example, an online tracker that displays classroom level readiness including air quality measures. Many of our older school buildings do not feel safe, so the City should invest in short term solutions, like portable air filters, window repairs or alternative spaces for our students to learn, while accelerating longer term school building plans.
- Make Up for Lost Time. Regardless of how soon we bring students back, we know our students are suffering tremendous learning loss. We need to make tutoring, either one-on-one or in very small groups, available to BPS students so that they can catch up on critical learning. Andrea believes college students and recent graduates who need employment opportunities are ideal candidates to support the highest need students through a district-wide paid tutoring program.
Get Boston Back To Work
As long as our residents are sick or fear getting sick, our economy will struggle. The first step in the path to economic recovery is health recovery. With that foundation, Andrea believes the City can drive strong, inclusive and innovative economic growth across Boston. That will require us to:
- Create the conditions for businesses to bounce back. Boston’s businesses create the majority of Boston’s jobs, so helping businesses recover helps residents get back to work. The City can actively support small businesses, particularly those led by historically under-represented groups, through direct relief programs, funding partners, and easing licensing and permitting.
- Innovate childcare solutions. Job losses during the pandemic have fallen disproportionately on working women, front line service workers, and communities of color. To get residents back to work, we must recognize that childcare is foundational to the economy. Andrea would partner with both child care providers and Boston’s largest employers to increase access to a larger range of childcare options, build greater capacity at providers including through rental assistance, PPE, and support for testing and vaccination, and develop funding models to facilitate a more robust child care sector. In partnership with local employers and community leaders, Andrea would work to build Boston into a model for affordable childcare.
- Prioritize Housing, Transportation, and Food Security. Families cannot maintain their health, job performance, and wellbeing without a roof over their heads, a way to get to work, and the food they need to survive. To support working families, Andrea will continue to fight to protect renters from evictions, building on her resolution early in the pandemic to extend the eviction moratorium. Andrea has and will continue to lead voices in opposition to reductions in service on the MBTA, and the City must fight for investments in our public transit infrastructure and partner with local employers so Bostonians can get back to work and sustain their jobs. The City must harness Boston’s unique cadre of food policy leaders to build a resilient food system so that families are able to regularly source healthy meals. To connect families with sustainable support systems and reduce the burden on the charitable food system, one of the most effective tools we have as public servants in this urgent moment is to ensure that families are maximizing their participation in federally funded nutrition programs, such as SNAP, WIC, and School Meals.
As Mayor, Andrea will:
Invest in Resilient Public Health Infrastructure
Andrea will prioritize disease surveillance efforts to mitigate future pandemic risk and preventive services to build more resilient public health. We must invest in our network of service provision to ensure that the entire city has a robust infrastructure, and tackle the fundamental social, environmental, and economic drivers of health in every “02” zip code.
- Modernize BPHC. Public health leaders have gone above and beyond before, during and after the COVID-19 pandemic and they deserve the tools and resources they need to best serve all Bostonians. The pandemic has demonstrated how vital a modern, 21st Century health commission is to Boston’s future. Andrea will elevate and focus the mission and leadership of BPHC to be able to do the work we all know matters so much to the health of our City — and build a commission that will be available to every neighborhood as the critical engine of health it can be, and will work to partner with our City’s incredibly strong healthcare community to ensure everyone in Boston can access the City’s unique, world-class medical resources.
- Prioritize Preventive Care. COVID-19 disrupted the delivery of routine primary care. Andrea will work to help not just restore but also strengthen preventive services, including integrating mental health services into primary care. Mental health needs are great across Boston, even more so in the wake of the pandemic. COVID-19 also increased utilization of telehealth, but this approach can be scaled further to ensure access for all Bostonians as we work to achieve equitable healthcare more broadly. Andrea will partner with the State to close the digital divide, including advocating for the Commonwealth to require insurers to provide coverage and ensure equitable access for individuals with disabilities and limited English proficiency through standardized procedures and accommodation services.
- Fight for healthier neighborhoods. Andrea knows that a thriving city that works for everyone is built on the foundation of safe, affordable housing, good schools, access to healthy food, quality health care, and jobs that pay a living wage. As Mayor, she will deploy a comprehensive strategy to drive health in every zip code by investing in the social, economic, and environmental factors that influence health outcomes and help to build a more resilient Boston.
Learn From This Crisis
COVID-19 has forced our country to reckon with deep racial inequities, including those in health, which have existed for generations. While it is not the first or the last pandemic we will face, it has served as a call to action to address the systemic racism it laid bare. As we move forward, we can learn specific lessons about our public health infrastructure, collect meaningful data on disparities, and prepare for a more equitable future based on a stronger foundation of communication and trust.
- Execute an After-Event Review. At the conclusion of the 2009 H1N1 pandemic, the Massachusetts Department of Public Health held an after-action conference and developed a formal After Action Report/Improvement Plan (AAR/IP) which detailed potential areas for improvement. While that plan included some effort to attend to the use of data for identifying the experience of different population groups, it did not adequately address questions of equity. As Mayor, Andrea will conduct a formal After-Event Review to rigorously measure disparities and their underlying causes, and develop comprehensive plans to address them.
- Build Trust beyond COVID-19. Our shared experience of COVID-19’s devastation provides an opportunity to build new partnerships between the healthcare community and communities of color. Under Andrea’s leadership, a robust public communication strategy around the vaccine would be operated beyond January 2022, and as the need to support vaccine distribution declines, could be pivoted to reinforce other forms of public education in support of broader community health. Ongoing community engagement is central to building trust and stronger relationships going forward, and Andrea will drive this as she has throughout her service.
As we move beyond the COVID-19 pandemic, we must learn from both our collective failures and successes so that Boston can build a strong and equitable foundation of public health resilience for all its residents in the future.