Some Massachusetts communities labeled as high risk for coronavirus question state’s methodology
Carlo DeMaria worries Everett has been painted with a “scarlet letter.”
Week after week, DeMaria watches as the city he presides over lands in the state’s red zone for having a high risk of COVID-19 transmission.
Week after week, the mayor raises the same issue with the state’s population-based methodology — a complaint being echoed by officials in other hot spots.
Cities and towns are labeled red for high risk on the state’s color-coded risk assessment map if they have an average daily case rate of more than eight per 100,000 residents. Everett was one of 17 high-risk communities this week, with an incidence rate of 16.3.
But DeMaria argues the state is using 2010 Census data that’s skewing the numbers by putting Everett’s population at roughly 45,000 while the mayor estimates it to be “definitely north of 50,000.”
If the state used the higher population number, Everett, long one of the hardest-hit communities in the state, “would be out of the red,” DeMaria claims.
And as Everett, like many other communities across the commonwealth, looks to dig its way out of a public health crisis that simultaneously decimated its local economy, labels matter.
“It just makes it sound like Everett’s in the red, stay away from there,” DeMaria said. “It could hurt our businesses, it could hurt people coming to the casino. It’s almost like a scarlet letter.”
The state defended its use of the average incidence rate per 100,000 scale, with coronavirus command center spokesman Tory Mazzola calling it “a widely used metric by public health experts.” Gov. Charlie Baker upheld its use when asked by the Herald this week, saying a city’s Census count “for the most part does get updated on a fairly regular basis.”
But Nantucket’s health and human services director, Roberto Santamaria, expressed concern after the town landed in the red zone this week. Santamaria told Nantucket Board of Health members in a livestreamed meeting Thursday that he had reached out to the state’s lead epidemiologist to ask why they were using a 2010 Census population count of 11,399 for Nantucket when the population now hews closer to 17,200.
“If we can get them to use the real number, the 17,000, that actually drops our incidence by over a third,” Santamaria said. “This sort of epidemiological mistake in calculations can skew an entire response. If we were to use the real number, we’d be in yellow right now, versus red.”
But the reaction from board member Meredith Lepore was swift: “We won’t get asymptomatic testing,” she said. “That doesn’t work to our advantage.”
High-risk status is typically what triggers additional resources from the state: expanded testing — including for asymptomatic individuals — stepped-up enforcement of public health restrictions on gatherings and businesses, and awareness campaigns that range from billboards to multilingual field teams on the ground.
It’s a level of aid that officials across the high-risk communities say they’re grateful for, even as some question the methodology that paints them red.
Mazzola, the command center spokesman, said localized intervention plans “take into account much more than the daily case rate per 100,000 residents, including positive test rate, age group positive tests and contact tracing analysis.”
Framingham Mayor Yvonne Spicer — whose city has been in the red since the end of August — said it’s imperative to use multiple metrics when the state’s rate-by-population scale allows a community to slide in and out of the red based on as little as one cluster of cases — as has happened in Chatham and Methuen.
“That’s the pendulum swing that can happen when we’re using just one metric,” she warned.
In Revere — which had one of the higher average daily incidence rates of 18.8 per 100,000 residents this week — Mayor Brian Arrigo said public officials tend to watch the city’s percent positivity, which has fallen from more than 6% earlier in the summer to 4.5% now, more closely than its incidence rate as they look for signs of progress.
“Some other communities may be concerned about what exactly it means to be red,” Arrigo said. “But we’ve been dealing with this head-on from the beginning, and what we’re working to do is to make sure we use this situation as one to really advocate for those systemic changes in terms of how funds get allocated and how resources get shared with those Gateway Cities.”
from Boston Herald https://ift.tt/2ZSDK0Z
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