Coming to a grocery store near you: meat shortages

This article was written by Janelle Nanos and originally published by The Boston Globe on April 29, 2020. 

Gary Holland is a carnivore: He’s on a first-name basis with the meat manager at his local Market Basket, and gets special cuts put aside for him at the counter.

So when he got word from his guy this week that the store’s supply was growing thin, Holland sprung into action. “I have two big freezers, so I loaded up on things and grabbed as much of the chicken as I could,” the Stoneham-based electrician said, spending more than $200 on meat alone at the checkout. The thought of being without, he said, “was like dragging an alcoholic out of a bar.”

The novel coronavirus has brought the US meat industry to a seemingly unheard of moment in a first-world country: rationing in the grocery aisles as some two dozen meatpacking plants across the country have shuttered as infections have raced through the workforce. Consumer prices have jumped, stores are limiting purchases, and farmers and ranchers are euthanizing livestock because slaughterhouses are closed.

On Tuesday, in an effort to stave off shortages, President Trump took the extraordinary step of an executive order directing US meat plants to remain open. After weeks of inaction, the executive order closely followed the administration’s release this past weekend of social distancing guidelines for plants where workers stand elbow-to-elbow slicing the sirloins and flanks for our dinner plates.

But many who have been watching the virus creep into the food system say that because the new CDC guidelines are not mandated, they’ll do little to stem the spread.

“The executive order allows companies to knowingly put workers at risk. It removes the few legal protections that workers have, and protects the companies from lawsuits instead,” said William Masters, a professor of economics at the Tufts University Friedman School of Nutrition. It’s “astonishing to see the Defense Production Act used in this way, especially when the administration has done so little to use the law to fix shortages of medical supplies and PPE… It’s breathtaking, really.”

Food industry analysts say this crisis has revealed the vulnerabilities in the meat system. More than 3,000 workers have been diagnosed with the virus, and at least 17 workers have died. Pork and beef production is down 25 percent as result of the outbreaks, and two of the country’s largest producers, Tyson and Smithfield, have suspended operations at two massive plants. The US Department of Agriculture now anticipates beef, chicken, and pork prices to climb between 1 and 3 percent this year. This past weekend, Tyson took out full page ads in major newspapers stating that the “food supply chain is vulnerable.”

The crisis is now playing out throughout the region’s grocery chains. After weeks of having a steady meat supply “we’ve hit a wall,” admitted Arthur Ackles, vice president of merchandising for Roche Brothers. He said that he expects the chain to begin limiting meat purchases to two packages of each type per customer on Thursday.

“And prices are going through the roof,” he added. “We’ve been really careful, we don’t want to put any more stress on customers, but it’s getting to the point where we’re seeing a 100 to 200 percent increase in cost particularly in beef and the consumer is going to start feeling that.”

So how did we get here?

“When we suddenly declared everyone working in food production as essential, it was a green light for those businesses to keep doing business as usual,” said Emily Broad Leib, head of the Food Law and Policy Clinic at Harvard University. Plants continued operating without issuing proper protective gear to their workers, she said, and once people started falling ill, it set off a chain reaction that we’re seeing now.

“This is going to get worse before it gets better,” she said.

But industry hardships are not only being borne by factory workers.

“The coronavirus pandemic has amplified all the challenges of the food system and animal supply chain,” said Jessie Deelo, a sustainable agriculture consultant based in Boston. She said modern, large-scale agricultural systems are designed to optimize efficiency, with hundreds of farmers relying on some of the largest meat-processing plants in the country to process millions of animals each week.

But that efficiency means running on the tightest of margins. So when plants slow down their processing, or close entirely, shock waves ripple through the system. Farmers who have raised livestock for slaughter are now left without options, she said, and many are now euthanizing barnfuls of animals and burying them.

“When the system works, consumers benefit,” said Deelo. “But when the system is disrupted, the weaknesses are hurting the individuals the most. And consumers are going to see inflated meat prices and possible supply disruption.”

Adding to the disruption is the closure of restaurants and other institutions that buy meat in bulk, said John Kinnealey, president of T.F. Kinnealey & Co., which distributes meat to hotels, universities, and more than 1,500 restaurants in New England.

“If you look at the industry five weeks ago there was a great symbiotic balance between food service and retail in terms of the different parts of animals being divided up for consumption,” he said. Ground beef went to grocery stores, while the choice sirloin cuts ended up at steakhouses. But now those restaurants have shuttered and “buying habits have gone haywire” with empty nesters suddenly shopping for a houseful of kids again.

That’s the exact scenario Patty Astuti of Tewksbury is experiencing. She’s attempting to feed seven people during the pandemic, including one son home from college and another who moved in with his wife and daughter earlier this year so they could save up for a home. She typically spent $200 a week on groceries, but now goes multiple times a week to keep stocking up due to shortages.

During a trip to BJ’s in Stoneham on Tuesday she said the meat department was nearly wiped out. “They had no chicken in the cooler,” she said, and the entire meat section had only some rotisserie birds, some beef, and a few slabs of ribs.

Experts say they understand why consumers would choose to bulk up their meat buying, even if it’s not in their own best interest, as that may drive up prices. “Some of the gyrations at the meat counter have been due to panic buying or seeking comfort foods,” said Masters.

“We’re not going to see a scarcity, but the immediate effect is that we won’t see a wide variety of product on the shelves over the next months while the sheltering-in-place is happening,” said Christopher Mejia Argueta, a research scientist at the MIT Center for Transportation and Logistics.

He said it’s important to remember that unlike swine flu or mad cow disease, this virus is not impacting the animals. So while prices may rise slightly, the supply will remain largely intact. He anticipates that, like the virus itself, the impacts on the meat supply chain will be cyclical, with the US turning to imports from other countries that many not be experiencing viral outbreaks. “While certain regions of the world are recovering,” he said, “others will be helping to provide food to them.”

Many industry experts say that while the COVID-19 pandemic has exposed the vulnerabilities of the food system, they’re skeptical about whether it will impact the industry in the long run.

“I’m a bit of a cynic,” said Deelo. “If the Newtown [school shooting] couldn’t fix gun policy, I don’t know how coronavirus fixes this. Tyson can take out a full page ad, but your chicken farmers are up to their necks in debt.” Until the industry adjusts and workers and farmers have a social safety net, little will change, she said.

“The deck is stacked against them.”

Rethinking Food Insecurity During a Pandemic: An Equity-Based Approach

Originally published on April 25, 2020 by Jurist. Written b

In just a few weeks, COVID-19 has overwhelmed the world and drastically changed our lives. Arvind Suresh, a medical student and Albert Schweitzer Fellow, has begun to research the impact that “stay at home” orders and social distancing have on communities with longstanding challenges with food insecurity.

For the vast majority of us, only grocery store trips remain on what was once a long list of routine activities outside the home. Yet, even this simple activity is now subject to external stressors as the current outbreak exacerbates the inequities and food insecurity that many households already face. In rural New Hampshire and Vermont, where Arvind’s medical school, Dartmouth, is located, there are large food deserts with no grocery stores for over 30 miles. In these regions, there is a large proportion of low-income households, inadequate access to transportation, and a limited number of food retailers providing fresh produce and healthy groceries at affordable prices. As a consequence, many communities may rely on the local convenience store to meet the majority of their nutritional needs. As nutrition status is closely linked with the immune system’s ability to mount an effective response against infectious agents such as the coronavirus, this puts communities living in food deserts at a higher risk for complications and death without adequate nutrition.

Arvind is partnering with Little Rivers Health Care, a Federally Qualified Health Center with offices in rural northeastern Vermont tasked with improving food access and nutrition literacy. The Little Rivers service area includes the largest food desert in Vermont. Although Congress has passed legislation expanding federal benefits through the Supplemental Nutritional Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) and waived requirements for school districts to provide meals to children, these primarily reactive measures do not address the underlying problem. In response to growing patient needs and lackluster support from federal and state programs, health centers like Little Rivers have had to take matters into their own hands by repurposing staff to deliver food to patients.

Making Food Policy Work for Everyone

Even before the pandemic, one in seven Americans relied on food banks to ensure they had enough to eat. With the rising unemployment numbers each week, these needs are only rising and leading to long lines at food banks that are running empty without access to their normal food sources and donations. Congress, therefore, needs to do more to support community-oriented approaches to support food delivery rather than a one size fits all approach. FEMA should be deployed directly to hard-hit communities to support the work of nonprofits and engage in public-private partnerships. Such an approach would ensure food banks are adequately stocked and aid in deliveries to rural communities that are not well-connected to the food system.

There is also a need for comprehensive legislation that addresses the long-term impact of this public health crisis on our food system. Current data already suggest that our commercial distribution network is not capable of readily adapting to unexpected changes in product demand.

Few policies are in place to support farm workers who are producing an adequate supply but are being forced to plow over fields and dump gallons of milk they cannot sell. Flexibility could be afforded to federal and state governments to purchase food directly from farmers and redistribute them as needed to food banks. This would ensure that families are not going hungry while also supporting the livelihood of farmers so they are able to sustain their operations and support their workers.

According to a brief prepared by the Food Law and Policy Clinic at Harvard Law School, there is flexibility in existing statues that has not been used to the fullest extent possible. For example, the 2018 Farm Bill has already established a precedent for allowing online purchasing with SNAP. Yet only a few states, including New York and Washington, are currently offering online purchasing in a pilot program for SNAP recipients. No such effort has been made to implement such a program nationally. For vulnerable families who rely on WIC and SNAP, this inability to purchase food online or get free delivery widens their inequity in food insecurity, increases their exposure to COVID-19, and puts even greater stress on an already faltering food supply chain.

Balancing Public Health Needs and Individual Rights

Relating to Arvind’s work, about twenty minutes from Dartmouth, Vermont Law School Juris Doctor student and fellow Albert Schweitzer Fellow Matthew Fischer is considering various emergency public health intervention methods, such as social distancing, and their potential for inadvertently violating individual and human rights. What sacrifices can be deemed necessary to protect public health and the public’s best interest?

There is a false dichotomy being presented to Americans in today’s discourse around positive and negative rights surrounding issues of public health. Communities throughout the country have begun protesting that their civil liberties are being infringed upon by stay-at-home orders and closed businesses.

According to Ronald Bayer, a professor at the Center for the History and Ethics of Public Health at Columbia University, public health and human rights do not need to be in opposition. Bayer explained, “good public health respects civil liberties, and anything that advances human rights and civil liberties would advance public health.”

In Mississippi, Temple Baptist Church is suing the City of Greenville (Temple Baptist Church v. City of Greenville) for violating its first amendment right to freedom of religion. The city sent eight uniformed officers to end a drive-in service even when nobody was outside of their vehicle or in close contact with each other. The actions of cities like Greenville are incongruous with their intended goals when they do not carry a clear public health benefit. While religious gatherings are prohibited, state and local governments are largely ignoring the public health consequences of forcing communities to gather at the single grocery store in a food desert to buy food and allowing farmworkers to live in close quarters because they are deemed essential workers.

If governments are given so much leeway in the name of protecting public health, they should do more to address the needs of the most vulnerable. A government that preserves both positive and negative human rights would be able to ensure that individuals living in rural communities are able to meet their nutritional needs, as well as provide farmworkers and grocery store workers with the protections necessary to avoid unnecessary exposure.

Lawrence Gostin, a professor of global health law at Georgetown Law suggests a way forward to meet public health demands while maintaining basic individual rights during a pandemic. He proposes that officials ask the following questions when deciding the pros and cons of a public health intervention such as social distancing:

· Is there evidence that an individual/group pose(s) a significant risk?
· Is the measure the least restrictive option to meet the public health needs?
· Are the measures used supported by the public?
· Do the people have access to due process to challenge the intervention if desired?
· Is the intervention discriminatory or arbitrary?

Simply put, food insecurity is an injustice that during the current pandemic has revealed broader problems with our food distribution network and public health infrastructure. Government entities like Congress and FEMA should prioritize addressing the root cause of these problems through public-private partnerships that will help sustain our communities well into the future. Creative and sustainable policies implemented now can ensure both equitable food availability and support ongoing efforts to overcome the COVID-19 crisis. Rather than viewing public health and civil liberties as opposing forces, a truly robust public health framework can balance both while building solidarity around the human rights necessary for our communities to thrive.

Puerto Rico Lifts Barriers to Accessing Hepatitis C Treatment

Increasing access to treatment will help Puerto Rico eliminate hepatitis C and improve treatment options for more than one million Puerto Ricans.

April 27, 2020 – The National Viral Hepatitis Roundtable (NVHR), a national coalition working to eliminate viral hepatitis, and the Center for Health Law and Policy Innovation of Harvard Law School (CHLPI) today applauded Puerto Rico removing discriminatory restrictions on access to treatment for hepatitis C. Puerto Rico’s restrictions on access to treatment were limiting more than one million Puerto Ricans who are covered by the Medicaid program from accessing life-saving hepatitis C treatment.

Puerto Rico had previously received a “D” rating as part of NVHR and CHLPI’s Hepatitis C: The State of Medicaid Access report for imposing strict sobriety and narrow specialist prescribing requirements. These discriminatory barriers have been reduced and Puerto Rico has formally included hepatitis C treatment in its managed care program that covers all beneficiaries, increasing Puerto Rico to a “B” rating. These new policies coincide with updated guidance from the U.S. Centers for Disease Control and Prevention (CDC) that recommend hepatitis C screening for all adults and pregnant persons with every pregnancy.

“At least 2.3% of Puerto Ricans 21-64 years old are estimated to be living with hepatitis C, putting them at risk of developing liver cancer or passing the infection on to others,” said NVHR Director Lauren Canary. “Puerto Rico has taken the necessary steps to move towards eliminating hepatitis C, which is more important than ever as those who are living with a chronic liver disease, like hepatitis C, are at greater risk of COVID-19 complications.”

“Puerto Rico’s discriminatory restrictions were harming thousands who are living with hepatitis C, and leading to massive increases in liver cancer,” said Robert Greenwald, Clinical Professor of Law at Harvard Law School and the director of CHLPI. “We are grateful that Puerto Rico has joined the many Medicaid programs across the country that have improved access to life-saving hepatitis C treatments.”

Hepatitis C: State of Medicaid Access grades each state, as well as the District of Columbia and Puerto Rico, according to its overall “state of access.” Each grade is determined by curative treatment restrictions related to three areas: 1) liver disease progression (fibrosis) restrictions, 2) sobriety/substance use requirements, and 3) prescriber limitations – all of which contradict guidance from the Centers for Medicare & Medicaid Services (CMS), as well as recommendations from the American Association for the Study of Liver Diseases (AASLD) and the Infectious Disease Society of America. The report also offers suggestions for each state to reduce its treatment access requirements.

To read the full Puerto Rico report card, visit

INSIGHT: Just When It’s Most Critical, Republicans Seek End of Affordable Care Act

Originally published on April 23, 2020 in Bloomberg Law. Written by Robert Greenwald and Will Dobbs-Allsopp, HLS Law Student.

The Affordable Care Act remains one of our best resources in the struggle to contain the coronavirus. The White House and Republican state officials seeking to void the ACA should withdraw their case now before the U.S. Supreme Court, write Harvard Law Professor Robert Greenwald and Will Dobbs-Allsopp.

Even in the midst of the worst domestic crisis in over a century, the White House and Republican state officials still want the U.S. Supreme Court to invalidate the Affordable Care Act in a case set for review later this year.

It’s a baffling decision given the circumstances: amid escalating health-care needs, increased strain on our health systems, rising rates of uninsured, and an impending recession, the ACA offers policymakers critical tools that can help steer the nation through the Covid-19 pandemic.

In the U.S., Economic Downturns Carry Public Health Implications

Because many Americans receive health insurance through their employer—itself a vestige of an earlier crisis—a pink slip frequently also entails a loss of health insurance coverage. In recent weeks, the Department of Labor has reported record-shattering unemployment insurance claims, more than 22 million to date. One analysis predicts that the number of employees losing health coverage will grow to between 12 million and 35 million by the crisis’s end.”

Fortunately, lawmakers crafted the ACA in the immediate aftermath of the 2008 financial crisis, and thus with economic emergencies in mind. Today the law directly insures more than 22 million individuals, and guarantees coverage to many more by allowing young adults to remain on their parents’ plan and offering protections to those living with pre-existing conditions. That number will, as the legislation’s drafters intended, assuredly grow as job losses mount in the months to come.

The ACA’s state and federal health exchanges will offer many workers who lose their job, and thus their employer-sponsored health coverage, access to subsidized, affordable private insurance plans. And for those who fall into a precarious financial situation, Medicaid expansion programs can provide comprehensive coverage, at least in the 37 expansion states. (States that have failed to adopt the expansion should do so, or they risk exacerbating the pandemic).

As a result, millions of newly-vulnerable Americans will be able to seek medical counseling and care for Covid-19-related (and other) conditions, a fact that will save lives and help ensure those infected can be identified and treated. After all, individuals with health insurance coverage are much more likely to seek out necessary care than those without. And by expanding the insured population, the ACA helps safeguard the financial solvency of hospitals and other front-line providers, who foot the bill when uninsured patients show up at their door.

Voiding the ACA Would Have Dire Consequences

The ACA’s recession-mitigation features, mostly overlooked given the decade of steady, if slow, economic growth that followed its implementation, will soon become apparent—that is, unless the Trump administration and its red-state allies have their way at the Supreme Court later this year. In the case, California v. Texas, they primarily take aim at the constitutionality of the law’s individual mandate, but only in an effort to ask the high court to void the entire ACA.

Yet the world has changed dramatically in recent weeks. In these difficult circumstances, the Republican litigants in the case should ask themselves if they are truly prepared for what will happen if they prevail.

To start, the Centers for Disease Control and Prevention would have to trim its infectious disease and local public health programs, which are partially financed through the ACA. Insurers would no longer need to provide an eventual Covid-19 vaccine free-of-charge, as the law currently requires.

Meanwhile, millions of their constituents would immediately lose access to health care during a pandemic that the White House estimates could kill up to 240,000.

Increasing numbers of uninsured individuals would arrive in emergency rooms with no way to pay for care, financially overwhelming hospitals already on the brink. Rightfully fearful of sky-high medical costs, many others would avoid filling necessary prescriptions or seeking treatment for Covid-19 symptoms, in the process endangering their own lives, undermining public health strategies, and prolonging the pandemic’s stranglehold on the economy.

In short, if the Department of Justice and Republican state attorneys general win, Americans will needlessly die and the crisis will drag on. Luckily, an easy solution is at hand: They should drop the case.

This column does not necessarily reflect the opinion of The Bureau of National Affairs, Inc. or its owners.

Author Information

Robert Greenwald is a clinical professor of law at Harvard Law School and faculty director of its Center for Health Law and Policy Innovation. For over 30 years he has been actively involved in health reform design and implementation at the federal and state levels. From 2010-15 he served on President Obama’s Advisory Council on HIV/AIDS focusing on health policy and the Affordable Care Act.

Will Dobbs-Allsopp previously worked as a journalist covering Congress for Morning Consult. You can follow him on Twitter @wcd_a.

AIDSWatch 2020: United Together in a World with COVID-19

This blog post was written by Health Law and Policy Clinic advanced clinical student Nina Roesner ‘21.

AIDS Watch

Image source: AIDS United,

On March 30th, I was one of nearly 900 participants in AIDSWatch 2020. As the largest constituent-based national HIV advocacy event, AIDSWatch has brought together people living with HIV and their allies for nearly three decades. This year, however, marked a first in AIDSWatch history as the coronavirus disease 2019 (COVID-19) pandemic forced AIDSWatch to move online. Rather than convening in Washington, D.C., AIDSWatch participants all over the country logged into Zoom for a day filled with education, advocacy, and community.

A recurring theme throughout the day was the ever-present strength of the HIV community—a strength that has been built and fostered at AIDSWatch over several years. Part of what makes this connection robust is the active effort to connect across generations, races, gender identities, and more. In his opening remarks, Jesse Milan Jr., President and CEO of AIDS United, spoke about expertise within the HIV community in the context of the COVID-19 pandemic, emphasizing not only the experience of fighting a viral pandemic, but also the experience of building solidarity and lifting up the voices of the most vulnerable.

After the morning plenary and advocacy orientation, I attended a session on HIV and Aging. This session focused on long-term survivors and seniors living with HIV. I was struck by the generosity of the speakers, who talked about their experiences with remarkable candor. Personal stories of mental illness, comorbid conditions, stigma, economic instability, and personal loss illustrated the dynamic and intersectional nature of the challenges they faced as people aging with HIV. The stories underscored the need for equally dynamic and intersectional solutions. As the discussion shifted to strategies to advocate for such policies, someone raised the point that there has not been a single congressional hearing focused on long-term survivors or seniors living with HIV. This is just one example of how entire communities can be overlooked by policymakers.

Nonetheless, the manifest determination of individuals living with HIV and their allies throughout the day left me with a sense of optimism. The backdrop of political division and global pandemic underscores the urgency of these issues and the need for advocates to continue amplifying the voices, experiences, and needs of people impacted by HIV in pursuit of justice for all and in pursuit of an end to the HIV epidemic in the United States.

To learn more about the policy priorities of AIDSWatch 2020, visit

Coronavirus Could Usher In A New Era Of Local, Sustainable Eating

Originally published on April 10, 2020 by HuffPost. Written b

Small farms are finding new ways to stay in business as the pandemic shuts down farmers markets and restaurants.

Harvard Law School Clinics Focus on Coronavirus Legal Aid

Originally published on April 15, 2020 by The Harvard Crimson. Written by Kelsey J. Griffin

Several Harvard Law School clinics are shifting their focus to provide legal aid to vulnerable populations affected by the ongoing coronavirus pandemic.

Legal clinics offer students the opportunity to gain practical experience and provide pro bono aid to real clients. The Law School currently offers 46 clinics and student practice organizations covering more than 30 areas of law.

Sabrineh Ardalan — director of the Immigration and Refugee Clinic — said the group is currently advocating for the release of its clients from densely populated detention centers where detainees are unable to practice social distancing.

“We’ve been doing policy advocacy to try to get Immigration and Customs Enforcement to release immigrant detainees from detention centers locally and nationally,” she said. “We’ve also been doing advocacy to try to get Immigration and Customs Enforcement to halt immigration enforcement actions.”

Ardalan noted the clinic’s team at Greater Boston Legal Services successfully secured the release of one of its clients from a New Hampshire detention center Friday.

The clinic also continues to serve its clients who are not detained by connecting them to health services and financial assistance.

“Our social worker, Liala Buoniconti, has been busy with a lot of clients to try to connect them to unemployment insurance — to try to connect them to funds for undocumented workers,” Ardalan said.

Emily M. Broad Leib, who directs the Food Law and Policy Clinic, said the group is finding ways to aid food producers and farmers unable to sell their food to restaurants, universities, and other large buyers.

“Some of our work has been really looking at what are the ways that we can try to send funding to them to kind of purchase this food they produce and also make sure that it doesn’t get wasted,” she said.

Broad Leib also said the pandemic has drastically increased the number of people facing food insecurity due to unemployment and reduced income, and that students at the clinic hope to find ways to address this growing problem.

“We’ve been doing a lot of work thinking about how can we get more money into the emergency food system and also about how we can get more opportunities for that food to be delivered to people in their home,” Broad Leib said.

The Law School’s Federal Tax Clinic also continues to serve its clients, but partial IRS closings limit its ability to operate, according to the clinic’s director, T. Keith Fogg. Still, students at the clinic are working to help those who need to obtain their tax rebates but cannot fulfill the necessary filing requirements on their own.

“The clinic has engaged in advocacy, to the extent allowed, to encourage the IRS to create rules that do not require individuals to file tax returns in order to obtain the rebate if they are otherwise identifiable by the IRS through Social Security or VA records,” Fogg wrote in an emailed statement Monday.

Fogg wrote stipulations attached to the clinic’s federal grant restricted its ability to help people prepare their current year tax returns or file other information needed to receive tax rebates. The Federal Tax Clinic can only represent taxpayers who have a “controversy,” or ongoing dispute, with the IRS.

Volunteer Income Tax Assistance sites typically provide current year return assistance, but many of these sites are closed due to the pandemic or require in-person meetings with the taxpayer.

“The people who need help because of the pandemic don’t need controversy assistance,” Fogg wrote. “If the grant administrators change their interpretation of the statute and if we can find students to assist us, we will expand our efforts to assist people with current filing requirements in order to obtain the rebate and to otherwise assist in filling the gap left by the closure of the VITA sites.”

The Low Income Taxpayer Clinic Program announced Tuesday it would allow temporary exemptions to the grant’s requirements due to the pandemic. Fogg said the clinic will now be able to more freely provide needed tax assistance.

Broad Leib said she applauds the extra work students in clinical programs are taking on through their efforts to help during the pandemic.

“A lot of them have just gone way above their workload hours to do this extra research,” she said. “We really rely on the kind of brainpower and research skills and creativity of the students that are really digging into these issues and helping us come up with solutions.”

Don’t Repeat the Mistakes of 1918

Originally published on April 15, 2020 in The Boston Globe. Written by Robert Greenwald and Carol Rose. 

During the 1918 influenza pandemic, local governments in the United States placed special placards on the doors of homes where sick people were subject to quarantine. The measure was an attempt to contain the spread of a virus that ultimately killed nearly 700,000 people in the United States alone. Sadly, this well-intentioned move backfired: Many doctors chose not to report cases in order to prevent homes from being quarantined. Families of sick people sought to evade the stigma of a placard on their homes by not seeking medical attention.In light of today’s coronavirus crisis, it’s useful to recall this history and to avoid repeating the mistakes of the past. Yet in an executive order dated March 18, the administration of Governor Charlie Baker directed local boards of health to submit to first responders the home addresses of people who have tested positive for the virus. The idea is that police, fire services, and EMTs should know which homes have COVID-19 cases so that responders can adequately protect themselves.

Protecting the health of first responders is certainly an important priority that the state needs to address; however, some public health experts have noted that disclosing addresses does not ensure a first responder would be safe from exposure from asymptomatic people or from those who are infected but remain untested. It may seem counterintuitive, but this order could indeed do more harm than good.

This truth is that we do not know — and at this point cannot know— who has COVID-19 and who does not. Recent estimates are that as many as 1 in 4 cases may be asymptomatic. Thousands of people who have fallen sick and who may have the virus have been unable to obtain a test, and so won’t appear on any list of homes provided to responders. Providing the addresses to first responders of people who have tested positive thus makes no sense — from either a public health or patient privacy perspective. To protect public health, we cannot create lists that give our responders a false sense of security and instead they must treat everyone as a potential carrier of the virus.

First responders deserve the best equipment, and the best policies, to ensure their safety. But the harsh reality is that our first responders continue to lack sufficient personal protective equipment and, system-wide, we don’t have enough COVID-19 tests. Emergency medical technicians, paramedics, firefighters, and police officers — like our doctors, nurses, and other front-line essential workers — are being asked to continue to do their jobs amid acute conditions, without the equipment they need to keep themselves safe.

Thankfully, government officials in Massachusetts are taking important steps to address the lack of PPE and tests for front-line workers. The Baker administration and Mayor Marty Walsh of Boston announced plans to set up additional testing sites that give priority to first responders. These sites should be open to all workers who are putting themselves at risk, whether they are first responders or grocery store workers.

Ultimately, we must listen to public health consensus during public health emergencies. And the public health experts are clear: The twin threats of community-level transmission and a lack of wide-scale testing make the use of home addresses dangerously ineffective. Worse, since screening is critical to slowing the spread of the disease, disclosing addresses of confirmed cases will undermine public health efforts by deterring some people from seeking testing and treatment — just like during the 1918 influenza.

Sometimes public health needs overtake our normal expectations of privacy or other civil liberties. But disclosing the home addresses of people who have tested positive is not one of those cases. First responders, like all of us, should treat every person they interact with as a possible COVID-19 patient. Relying on the training of our first responders, not the home addresses of those stricken by the virus, is the best way to ensure public health and safety for everyone.
Carol Rose is the executive director of the ACLU of Massachusetts.

Robert Greenwald is a clinical professor of law at Harvard Law School and the faculty director of the Law School’s Center for Health Law and Policy Innovation.

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