December 21, 2021
Cc: Health and Human Services Secretary Marylou Sudders
Department of Public Health Commissioner Margret Cooke
Dear Governor Baker,
As the House Chair of the Joint Committee on Public Health, I would like to thank you for issuing new statewide guidance on masking in indoor spaces. I would, however, strongly urge you to reconsider and call for a statewide indoor mask mandate rather than an advisory, as well as temporary implementation of indoor gathering limits. There is a clear public health consensus on the necessity of wearing masks indoors; we need the same clarity from you. An advisory still leaves too much up to personal choice. It is important that our statewide public health messaging engages people in where we are in the evolving pandemic. We should be asking people to take two steps back for 4-6 weeks with the goal of taking three steps forward once we can safely navigate the surge.
I would like to commend your decision to implement a vaccine mandate for employees of the Executive Branch and public safety officials, who come into contact with the public in the course of their work. I hope that this logic will extend to school staff, who are also public-facing and oftentimes interact with children and adolescents who are too young to be vaccinated. The CDC has now recommended booster shots 6 months after the initial vaccine series. This was followed by the Pfizer and Moderna data that confirms two doses will give very little protection for most, and essentially none for some, compared to three doses. Will you now include boosters for those who are currently covered by your vaccine mandate? The booster shots are becoming increasingly necessary as the Omicron variant becomes more prevalent.
I would also like to commend your plan to establish Fenway Park as a high-volume booster site in recognition of the critical importance of increasing booster rates and the current lack of availability. However, I do want to express that it seems like we are repeating the initial pitfalls of the early vaccination rollout if we fail to provide more accessible community-based sites for those who will never get to Fenway Park. As the Black Boston COVID-19 Coalition noted, when the state started vaccinating at Fenway, 96% of those residents were white. I hope that we will see the state continue to expand access to boosters for residents across the Commonwealth. Without data from the Department of Public Health on booster rates by municipality, or by race/ethnicity, we have no way of knowing whether booster distribution is equitable.
Boosters alone are not enough; we need a concerted effort to reach the nearly 900,000 residents who are eligible but have not yet been vaccinated. Of particular concern is the huge disparity in vaccination rates among children, which is why the experts I have spoken to recommend a public education campaign for parents along with vaccine clinics for children.
We know how to develop robust public health campaigns in Massachusetts. It is my hope that you will invest more resources for DPH to continue building and expanding its good work on addressing the role of booster shots, the importance of good-fitting masks and where and when to wear them, as well as educating the public on the differences of PCR vs rapid tests and how to use them. I appreciate your Administration’s distribution of free rapid tests to 102 communities. This is a great first step, but it is not sufficient to protect the majority of Massachusetts residents. I’m sure that you are also hearing from legislators whose constituents would qualify to receive a free test if they lived in one of the 102 communities targeted. We urgently need to find ways to purchase more rapid tests and make them free for many and subsidized for others. Ideally, we would also do the same for KN95/N95 masks: make them widely accessible by giving them out and/or subsidizing them.
I have spent the past two weeks meeting with epidemiologists, infectious disease physicians, hospital leaders, and medical directors of companies that are conducting primary research related to COVID-19. Their message has been consistent: limits on indoor gatherings and mask mandates for indoor, public venues are the strongest tools we have to complement our efforts in improving vaccine uptake. This is consistent with recommendations from the Centers for Disease Control and Prevention and the Mass Medical Society. I know you and the hard-working team at the Department of Public Health are looking at the same data as I am and talking to many of the same researchers in epidemiology and infectious disease.
You recently commented that Massachusetts is in a different position than at this time last year, as we have “far more tools at our disposal to fight COVID this time.” We must translate that information and those tools into decisive policy decisions if we are to actually see better health outcomes across the State. To arrive at a better place, we must ensure the equitable implementation of and access to all public health tools. The current rate of vaccination, not to mention their questioned efficacy against new strains of COVID, is not high enough to solely rely on for protection this winter. This is already showing up in the data. The number of daily cases and test positivity rate are comparable to those reported in January of 2021.
Today you wisely activated the National Guard to help support our overburdened healthcare staff. Our hospitals are experiencing a surge similar to that of last year as well; on December 14, 2020, 371 COVID patients were admitted to the ICU, and 200 were intubated; on December 14, 2021, 326 patients were in the ICU and 176 were intubated. The number of daily deaths has climbed since September, and the seven-day average of coronavirus patients in Massachusetts hospitals has more than doubled over the past months. Additionally, over the past month the number of COVID cases in our schools has increased 164%. We know that the Delta variant is predominantly responsible for the current surge, so I am greatly concerned that these trends will be further exacerbated as cases of the Omicron variant inevitably rise across the State. A recent study found that Omicron SARS-CoV-2 infects and multiplies 70x faster than the Delta variant and original SARS-CoV-2 in the human bronchus.
Please take the additional steps necessary to slow the surge and ease the burden on our exhausted healthcare staff. Advisories have the most impact on people who pay attention to public health guidelines, and they are already wearing masks. A mandate is for those who are not hearing the latest public health information or who are choosing to ignore it. You have been a trusted leader by many and now is the time to capitalize on the goodwill that you have built. Your leadership would be strengthening the position of municipal officials who have been left to make difficult decisions within their own communities, leaving them vulnerable to criticism and harsh repercussions.
I respectfully request that you set limits on indoor gatherings and provide stronger guidance on masks. These non-pharmaceutical interventions are low-hanging fruit, particularly as we focus on making it through the winter months without unnecessary surges in COVID-19 cases, hospitalizations, serious illness, and deaths. You can assure residents that you will reassess the situation in January. The time is now to bring all of our tools to the table.
Marjorie C. Decker
State Representative, 25th Middlesex
House Chair, Joint Committee on Public Health