Priorities for a Healthy and Equitable Boston in 2021 and beyond

COVID Recovery

A Roadmap for COVID-19 Recovery

The COVID-19 pandemic changed us — and continues to challenge us all, with the recent emergence of the Delta variant presenting a new threat to our City’s health and economy. Over the past two years, 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 have struggled with remote learning. Hotels, restaurants, and stores have closed, and small businesses and large employers had to furlough and fire employees. As we respond and prepare to safely return to work and school, we must come together to face a range of challenges, from vaccine inequities to learning disruption.  

To fully recover and rebuild a healthier, more resilient Boston, we must contain COVID-19 variants across all 23 neighborhoods, from East Boston to Hyde Park. Andrea has called for a roadmap for recovery that addresses the immediate and ongoing health impacts of the pandemic, the economic toll it has taken, and the deep racial inequities it exposed. 

Recovery requires equitable, ongoing access to reliable information, consistent testing, and accessible vaccination so that all Bostonians can stay at work and in school. To ensure a sustainable reopening and recovery, we must track progress and use data, communicate and build trust between communities, and make smart, intentional investments to support Boston’s workers and families.  In the coming months, Andrea is calling for the following actions in response to the Delta variant:

  1. Require vaccination for entrance to high transmission locations including restaurants, bars, concert venues, and gyms.
  2. Launch a vaccine verification system for Boston, in partnership with surrounding municipalities.
  3. Mandate vaccination for all city employees or require weekly testing, while ensuring city employees can return to hybrid and remote work.
  4. Reopen BPS with improved ventilation, adequate PPE and regular testing for students and staff

In the long term, 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. 

As Mayor, Andrea will: 

Reopen thriving, safe, supportive schools this fall. 

Our students lost a lot last year.  Thankfully, with the help of a surge in federal stimulus dollars, we have a once-in-a-lifetime opportunity to reopen schools that can meet the needs of our students in this moment.  We must:

  • Make up for lost time. Boston’s top priority must be to make up for the significant and inequitable gaps which have been exacerbated in the last year. Unfortunately, too many students missed out on opportunities for summer programming, but it’s not too late to ensure fall access to high-dosage tutoring, through staff stipends as well as tutoring by other community members and non-profit community partners. We also know that mental health has been a challenge for many of our students amidst the isolation and pain of the last year, so our recovery must also include an infusion of counseling and social emotional supports.
  • Plan for a seamless start to the school year. These funds give Boston the resources the City needs to stipend teachers, school leaders, and other staff to have real planning time, so that on the first day of school, we’re ready to welcome back students and address their individual needs — everything from health and safety protocols and on-time buses to the social and emotional supports we know our students will need.
  • Invest in curriculum and technology. The stimulus also provides a unique opportunity to make overdue updates in the materials and equipment our students and educators use every day.  That can include modernizing Madison Park’s vocation facilities, ensuring staff and students have the hardware and software they need across the district, and putting high-quality, culturally and linguistically sustaining curriculum in our schools.
  • Build the school buildings children and educators deserve — while freeing up money for the future. The pandemic highlighted what many of our families and educators already knew — our buildings are in dire need of repair. While we had our attention on windows that won’t open and non-existent HVAC systems, we also know that too many of our buildings lack the 21st century learning environments that our communities deserve. Now is the moment to finally accelerate facilities investment, which can include investing in energy efficiency and sustainability, such as replacing lighting, updating heating and cooling systems, upgrading windows, and even installing solar panels. These investments are not only good for our air quality and our carbon footprint, but the district will reap the financial returns for years to come, allowing us to make long term investments in services our children deserve.

Ensure Vaccine Equity. 

Andrea deeply and personally understands the complicated history of medical mistreatment within communities of color in our city and our country, and the long-standing health inequities exposed by COVID-19. Our City’s leaders must recognize this complex history and work to 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 as Boston recovers and reopens. 

  • Build trust across Boston.  Widespread adoption of any vaccination program depends 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. 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 to reach Bostonians in need. 

Get Boston Back To Work

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 thrive and hire.  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.  
  • Prioritize front line workers. Andrea will ensure that our businesses have continued access to PPE, and can provide the safe conditions Bostonians need to work. As we transition to a “new normal,” Andrea will work with City Hall employees and leading employers to implement the hybrid, flexible work models that we know working families need.  
  • 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 well-being 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 in the City of Boston. 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 also 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. 

Improve Transparency, Testing, and Surveillance 

City Hall must consistently communicate data and a clear strategy around COVID-19.  To contain the pandemic, 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 daily 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 and 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. 

Invest in Resilient Public Health Infrastructure

Andrea will prioritize disease surveillance efforts to mitigate ongoing and future pandemic risk, and invest in preventive services to build more resilient public health.  City Hall must consistently communicate data and a clear strategy around COVID-19.  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 refocus the mission and leadership of the BPHC, ensure Mayoral oversight, modernize the tools and resources at the Commission’s disposal, and build stronger partnerships with the healthcare community, nonprofits, and the private sector.   
  • Prioritize preventive care.  COVID-19 disrupted the delivery of routine primary care.  Andrea will 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, BPHC would operate a  robust public communication strategy around the importance of the vaccine, 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 continue to fight and ultimately 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.