City and county officials throughout the U.S. lead the response to COVID-19, enacting stricter measures as the total number of cases increases
As COVID-19 continues to spread across the country, local governments have taken drastic measures in an attempt to contain the virus.
Somerville Mayor Joe Curtatone says municipalities and states have two tools at their disposal to combat the spread of COVID-19: extensive testing and extreme social distancing measures. While the number of available testing kits in the country remains low, officials at all levels of government in the U.S. have enacted measures to “flatten the curve” and protect at-risk populations.
Such measures include limits on public gatherings, school closures, rescheduling elective surgeries and, recently, mandatory shelter-in-place orders. As COVID-19 continues to spread in communities across the U.S., politicians and public health officials have ramped up their efforts in an attempt to contain the virus. From the earliest recorded cases of the virus in the U.S., local officials have led the effort to mitigate its effects. Curtatone said city officials from across the Commonwealth were prompted to act, referencing a meeting of local officials that took place in Somerville more than two weeks ago.
“Cities and regions have been leading the way,” Curtatone said. “We hosted more than almost two weeks ago … a panel of medical experts, scientists and epidemiologists who presented a very sobering scenario … and it sparked people into action.”
In cities across the U.S., local leaders have often led the way in enacting new measures to slow the spread of COVID-19. On March 12, Seattle Mayor Jenny Durkan closed public buildings throughout the city. Schools closed in three Washington counties on March 12, and Governor Jay Inslee enacted a limit of 250 people for public gatherings. On March 16, San Francisco Mayor London Breed issued a shelter-in-place order for the city, being one of the first in the nation to do so. Three days later, California became the first state to universally enact such a policy.
In developing and implementing policies to combat the virus’ spread, Curtatone said that Somerville officials have studied responses from cities, states and nations affected by the virus earlier this year. In order to do so, officials have looked to epidemiologists, medical professionals and logistical experts for guidance.
“We looked really across the spectrum, seeing what's happening in the Bay Area, in New York City and in other city-regions,” Curtatone said. “We really rely heavily upon, in these few weeks leading up to where we are now, on the advice of experts.”
Rosemary Taylor, a sociology professor at Tufts University who studies community health and epidemics, spoke to the importance of comparing responses across regions. Taylor said that, as new policies are implemented to contain the virus, researchers are able to analyze which are effective and which fail.
“My research is both historical and comparative which can be helpful: looking at the responses of the United States to the coronavirus in light of those attempted by European nations allows us to analyze the factors that have led the US to choose some strategies rather than others, and why some may meet with success while others will fail,” Taylor told the Daily in an email.
Comparisons drawn not only from regions, but also from past pandemics and epidemics, allow policy and public health officials to learn from these events, Taylor said. Whether this knowledge is actively employed to shape modern responses and institutions, however, is another question.
“If one reviews the epidemics of the last two decades – avian flu, swine flu, Ebola, zika – each has led to a spate of conferences which in turn have produced reports documenting in detail the ‘lessons learned,’” Taylor wrote. “However it is unclear how many of these lessons have been absorbed in the sense that they have generated concrete changes in the practices of international organizations and individual nations
Looking across the U.S., Somerville and Medford officials have enacted similar measures to those in Washington state, California and other regions. Within a week of each city recording its first case of COVID-19, city and school officials closed schools, limited the size of public gatherings, closed public buildings and declared a state of emergency. On March 16, Somerville ordered all gyms, theaters, entertainment venues and places of worship in the city to cease operations through at least April 6. Two days later, Medford followed suit.
However, the enactment of such measures at the local level has just a small impact if not implemented on a broader scale, Curtatone said.
“It doesn't work one city at a time,” Curtatone said. “It is much more effective to have it across the Commonwealth when we’re all following a uniform set of parameters, rules and guidance.”
On the state level, governors have adopted measures previously implemented on the city or county level as the number of reported cases escalates. On March 23, Massachusetts Gov. Charlie Baker issued a statewide order for all nonessential businesses to close, after many cities in the Commonwealth had already done so.
As governments grasp for ways to combat the virus, a nationwide trend has emerged: over time, governments have enacted stricter measures. For example, on March 15, Baker issued a statewide limitation of just 25 people for public gatherings, going further than previous restrictions enacted at the local level. On March 16, President Donald Trump urged citizens not to attend events with more than 10 individuals.
Restrictions on businesses, too, have grown increasingly stringent. One of the first economic sectors in Massachusetts to see restrictions was the food service sector, which was ordered to suspend dine-in services. Since then, nonessential businesses have also suspended operations and construction sites are likely to be next.
One of the strictest measures to be employed in the U.S. is a shelter-in-place policy, which cities and states have enacted in recent days to limit unnecessary movement and social interaction. Just days after six San Francisco Bay Area counties issued a shelter-in-place policy, California Gov. Gavin Newsom extended the measure to the entire state. Since then, 21 states have issued shelter-in-place orders.
Amid growing pressure from city and state officials, Baker directed the Massachusetts Department of Health (DPH) to issue a statewide shelter-in-place advisory, going just short of enacting a formal order. The directive asked DPH to outline self-isolation and social distancing protocols, while advising citizens to avoid unnecessary travel and activities from March 24 through April 7 at the earliest.
City and statewide restrictions are likely to become more stringent in coming weeks, according to Curtatone. He says such measures are needed to provide adequate healthcare for those affected and to protect at-risk populations, particularly older populations and those with underlying health conditions.
Students share experiences with increasingly stringent COVID-19 responses
As a result of the rapid efforts to contain the spread of the virus, the majority of universities have sent students home to complete their courses remotely. This includes students at Tufts University, who were told via an email sent out March 10 that they would finish their semester online.
Many students who were sent home from their universities due to the COVID-19 outbreak returned to states that have been quarantined or under a shelter-in-place order. Lizzie Gleeson, a junior who briefly returned home to Palo Alto, Calif., recounts repeatedly checking updates to ensure she could return to Somerville.
“I was checking [the news] a lot because I was really worried about being stuck in California and not being able to come back,” Gleeson said.
Gleeson returned to her off-campus house in Somerville on March 22, after spending 10 days in California. While in California, she followed the shelter-in-place order closely, only going out to purchase groceries for her family and neighbors who belong to an at-risk population.
“I would only go to the grocery store to get food for [my father], and I also went to the store to buy groceries for some of my older neighbors, who were people at a higher risk,” Gleeson said.
Although staying home takes its toll, the benefits of the measure seems worth it for Gleeson.
“It's tough just being stuck inside all day,” Gleeson said. “But at the same time, if you look at the early numbers, it does look like the Bay Area is flattening the curve from all these shelter-in-place orders. I think it was definitely for the best.”
Sophomore Ananya Pavuluri left campus to return to New Rochelle, N.Y. — one of the areas in New York that is considered a “hot spot” in terms of coronavirus outbreaks. New Rochelle has been in the public eye since March 2 when the first coronavirus case was recorded. Lawrence Garbuz, a 50-year old man from New Rochelle was hospitalized and later tested positive for coronavirus. Since his diagnosis, it was found that more than 50 cases traced back to him in New Rochelle, prompting New York Governor Andrew Cuomo to enforce one of the strictest measures in the nation — a “containment zone” with a one-mile radius surrounding the city. Residents were asked to stay inside and limit non-essential ventures outside of their homes.
Pavuluri explained that living under quarantine in a “hot spot” town while watching businesses close because of the virus is nerve-racking. She said hearing about her friends from home being diagnosed with the virus was especially hard.
“It is very sad to see businesses, like restaurants I grew up going to and stores I went to often, get hit so hard by this,” Pavuluri told the Daily in an electronic message. “In the containment zone, all nonessential businesses, meaning anything that is not a pharmacy, grocery store, bank, or hospital, is closed or has shortened hours. It is also scary to hear about people I’ve known since childhood testing positive for coronavirus.”
Alongside establishing the containment zone, Cuomo ordered the National Guard to enforce the policy and provide assistance to affected citizens. Although Pavuluri has not had many interactions with members of the National Guard, she said they have been helping her community by providing resources to families in need and those particularly susceptible to severe health issues caused by the virus.
“I don’t see the National Guard much,” Pavuluri said. “From what I’ve heard, they help with setting up testing centers and providing supplies to those who are drastically affected. It doesn’t feel like there is a large military presence at all. For me, it hasn’t made much of a difference, but I know it’s been helpful to city officials to have this help.”
Pavuluri believes the guidelines enforced by the state are well suited to combat the virus. She feels the issue lies in whether or not people are truly following those guidelines.
“At this point, the virus has spread way past New Rochelle, with the city surpassing Westchester[, N.Y.] by a lot a while ago,” Pavuluri said. “I think Governor Cuomo and the legislative body of NY are doing all they can to flatten the curve and I don’t think it can get much stricter. I just wish people would actually listen and stay at home.”
Pavuluri ended the interview by providing us with insight into the tasks faced by health workers amidst the growing spread of the virus. Her mother, Dr. Kameswari Lakshmi, works as a physician in the main New Rochelle hospital. Pavuluri noted that from hearing her mother’s daily experience as a healthcare worker treating those with the virus, it is evident that the United States is underprepared in the face of this pandemic. She noted that as healthcare workers are facing increasing pressure, guidelines are becoming more lenient, which is a major source of concern. Pavuluri made the point that as the pandemic progresses, it calls upon us to analyze the functionality of our healthcare system, and make the necessary changes.
“My mom is a physician in the main New Rochelle hospital. A concerning amount of her patient base is testing positive and she is really on the front lines of this situation. From talking to her, I realize how underprepared we are for this pandemic — we just do not have the resources in the healthcare system. There are not enough beds. People are being turned away from the ER because they are 'not sick enough.' Doctors are testing positive. They are saying it’s ok for doctors to come in to work if they’re asymptomatic. " Pavuluri said.
Pavaluri finished saying that her mother’s experience as a healthcare worker during the pandemic has highlighted the shortcomings of the healthcare system in the United States.
“Having this perspective during this pandemic has really shown me the deep flaws of our healthcare system, and I worry for how things will progress,” she said.
More from The Tufts Daily
