By Josh Cohen, PhD, Deputy Director
The Boston Globe recently interviewed Brown School of Public Health dean, Ashish Jha about how Massachusetts has done with the COVID crisis. The Globe summed up Jha’s assessment, saying “he generally gives Gov. Charlie Baker high marks”, but adding that according to Jha, “the administration made several ‘costly’ mistakes”. Here are Ashish Jha’s main criticisms, my take, and what we can learn from the missteps.
First, Jha says the Baker administration was “a little slow to respond and shut things down … in March of last year.” Jha explains that because of the epidemic’s exponential growth, it “would have saved a bunch of lives if it happened a week or two earlier.” Maybe. But it’s hard to imagine Baker acting much earlier. He declared a State of Emergency on Tuesday, March 10, a day before the World Health Organization declared COVID a pandemic. There were only 600 confirmed US COVID cases and 91 cases in Massachusetts. The first state to declare a state of emergency – Washington – had acted only 8 days earlier (on Monday, March 2), and it was only on Saturday, February 29 that the US had confirmed its first COVID death. Moreover, almost nobody had envisioned the adaptations that would allow many activities to continue. In short, it was still hard to imagine how bad the pandemic would get or how life could go on if work, school, and other activities shut down.
Jha’s second criticism was Baker’s handling of restaurants and bars. He noted, “it was very clear what was causing spread in the fall … late October, November, December. It wasn’t a mystery.” He continued, “Bars have essentially no justification being open in the middle of a pandemic until you have large numbers of people immunized.” I agree. True, CDC did not declare COVID airborne until May 2021, but plenty of evidence pointed in that direction by July 2020, and it became more compelling in the fall. So it was clear that indoor bars and restaurants must be spreading COVID. Jha acknowledged the tough situation: closing restaurants would hurt economically vulnerable workers. But would it have been possible to beef up government support for them and to cover fixed costs for restaurants so that they could get through the winter months?
Third, the vaccine rollout. Spoiler alert: Massachusetts has done well (ranked second for percentage of population vaccinated as of July 9). But early on, the state’s vaccine website was a mess. Exclaimed Baker in mid-February 2021, “My hair’s on fire about the whole thing. I can’t even begin to tell you how pissed off I am…” The state’s slow start that winter was particularly maddening because (1) when it comes to websites, we have the technology; and (2) the impending arrival of the vaccines was well-known following Pfizer’s release of its stunning Phase III results back on November 9. As Jha explained, “everybody had a pretty good sense of where we were going to land. You would have thought that we would have built good websites.” I agree. When the MBTA’s Green Line misbehaves, it’s an inconvenience. But vaccine distribution is important. The Baker administration should have brought in a more prepared team to get it right from the start.
But keep the mistakes in perspective. As Jha noted, “I think there are two or three instances where I think [the Baker administration] made mistakes … But, my God, in a 16-17-month pandemic if you have only a few, it’s hardly a catastrophe.”
Still, there are some lessons. First, strive to balance costs and benefits. Arguably, given what was known in early March 2020 about COVID and the feasibility of shutting down our normal activities, I can understand why Baker moved no earlier than he did. But by fall 2020, we understood the costs of keeping indoor restaurants and bars open. Second, if needed action – like closing restaurants and bars – hurts vulnerable populations, move quickly to both take that action and compensate those who are hurt – that is, take Pareto optimal actions and redistribute resources so that nobody is (terribly) worse off. Finally, when it matters, hire the right people to get the job done.